Evidence of Learning Assessment #3

Type of Assessment: ​Research Assessment

Date: February 2, 2018

MLA Citation:
Source #1:
“Medical Practice - Types Of Practices.” ​Income, Physicians, and Solo - StateUniversity.Com​,

careers.stateuniversity.com/pages/100000668/Medical-Practice-TYPES-PRACTICES.html

Source #2:

“Types of Medical Practices.” ​Types of Medical Practices | ACP​,

www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-couns

eling/guidance/types-of-medical-practices​.

Analysis:

As defined on Merriam-Webster dictionary, a private medical practice is: ​practice​ of a

profession (as ​medicine​) independently and not as an employee. In the medical field, there are

multiple practices, however some of the main ones are, solo/private, solo-HMO, group practice,

and Locum tenens. There are many advantages of each practice and disadvantages.

A solo/private practice is a practice without partners or employment affiliations with other

practice organizations. Solo/private practices are usually characterized by a small staff and

typically have a limited patient base. Solo practitioners are considered the largest group of

practicing physicians, but their numbers are decreasing as the healthcare system changes.

These physicians have direct contact with each one of their patients as the provider of

professional services. In exchange for remuneration they are personally responsible for their
patients' health. They operate out of their own office or time-share one with others. This smaller

size and the autonomy of being the only physician gives the advantage of being able to design,

grow, and develop the practice as you'd like relative to other practice settings. Plus, a smaller

patient base provides the opportunity for you to develop close, personal relationships with your

patients and staff and provide your own unique style of medical care. On the other hand, the

entire burden of running the practice rests entirely on you. This includes the medical care (such

as the need to manage or arrange for hospital care and weekend coverage for your patients) as

well as the entire business enterprise. The work involved in developing agreements with

insurers and the burden of documentation for compliance and other regulations is usually

significant. Although there are many advantages to solo practices, there are also

disadvantages. One disadvantage according to ​acpoline.org​ is, solo practices are frequently at

substantial financial risk due to the costs of business (such as hiring staff and maintaining

malpractice coverage), possible lack of referrals, the small patient base, shifting patient

allegiances because of insurance issues, and lost income caused by illness or vacation.

A subdivision of Solo/private practice is, Solo- HMO practice. Solo- HMO practice is

when a physician owns the practice with the help of the Health Maintenance Organization.

However, some of the differences are, when physicians are working in an HMO setting, they are

paid as employees and may receive bonuses based on production, utilization of resources and

patient satisfaction scores. These type of physicians only provide care to the patients who are

enrolled in the HMO.

The second most popular form of practice is, group practice. As stated on

stateuniveristy.com,​ “a group practice is defined as three or more physicians, who provide

medical care, jointly using the same facility and personnel and dividing the income as agreed to
by the group. A group practice may be a corporation, a partnership, or an association of solo

practitioners, but the majority of group practices are corporations.” When new physicians are

transitioning to post-residency employment, they traditionally opt to join group practices. The

majority of new physicians transitioning to post-residency employment traditionally opt to join

group practices, which range widely from as few as three physicians to as many as several

hundred. Being a physician in a group practice comes with multiple advantages such as,

increased financial security and better control of lifestyle. Due to the larger number of physicians

and a greater size of the patient base, group practices are able to accept and manage financial

risks better than solo practices. Being in a group practice, can lead to more employee benefits

that are more feasible than solo, although often less than what may be available in employed

physician organizations. Philip Masters, MD, FACP, stated that in addition to the other

advantages of being in a group practice, due to the increased number of physicians in a group

spreads the burden of covering clinical care in the hospital, at nights, and on weekends across a

greater number of people, allowing more flexibility in scheduling relative to a solo practice.

Lastly, locum tenens (literally "placeholder") is an alternative to more permanent

employment. Locum tenens positions are temporary (from a few weeks up to a year) that are

offered by practices, hospitals, or healthcare organizations that have an unfilled clinical need.

Physicians that choose this route, are like people buying cars, they want to test drive the

practice to see if they like it and want to commit to it. One of the advantages of Locum tenens is

that the rate of compensations is higher than what a permanent position would offer.

After reading and doing research on this topic I have a better understanding why my

family doctor decided to be a solo-HMO and why my mentor, Dr. Dharamsi has a solo/private

practice. Knowing all this information is helpful because, when I finish my residency, I want to
start with a group practice and when I the ropes of dermatology, I hope to open my own

practice, just like Dr. Dharamsi!