The full version of this article originally appeared on Dr. Bill.
Below, we’ll look at some of these different types of medical practices:
(1) Solo/Private Practice
Solo or private practices involve one physician working alone, without any partners. Typically, a solo practitioner serves a limited group of patients and is supported by just a small staff. This type of medical practice works well for physicians who wish to own and manage their own practice.
Physicians practicing alone usually opt for owning their own medical facility or leasing a medical office. Your location can determine the success of a solo or private practice. Because of significant need and less competition from other physicians, suburban or rural areas are often better suited for these types of practices. As well, some local hospitals affiliate with and support solo or private practices to help maintain a healthy patient base.
Read related story: Starting Your Own Practice: 5 Questions to ask yourself.
(2) Group Practice
A group practice consists of two or more physicians providing medical care in the same facility. These physicians typically have different specialties, which provides the opportunity to collaborate and consult with others and refer patients when needed. In a group type of medical practice, all of the work and staff resources are shared, including running and administering the practice. If you’re thinking of opening up your own medical practice it’s important to remember that the group must agree on whether and how to divide its income before setting up.
Within group practices, different types of medical practices exist, like associations and partnerships. Until recent years, most group practices in Canada were associations, but with the popularity of alternate funding models, partnership practices are now quite common.
Difference between associations and partnerships
An association is a legal agreement that specifies the degree to which expenses will be shared. These expenses can range from sharing only rent and waiting room costs to sharing all the costs associated with running a practice (such as staff, equipment, medical supplies, and office resources). The responsibility of expenses per physician is usually proportional to the amount of time they work in the office, though capital expenses such as rent and communications are often shared equally. Associates do not share income and are not professionally or legally liable to each other.
As an associate, you get the freedom and benefits of an individual practice while also enjoying the economies of scale, in-house coverage, and team collaboration. For the most part, physicians in an association create their own schedules, share the costs and tasks associated with overhead and administration, and enjoy being part of a team.
In a partnership practice, just as in an association, you share expenses, but the difference is – the income and personal and medical liability are also shared. Each partner’s share of income and expenses gets detailed in a legally binding partnership agreement.
To save time, stress, and money, advance planning is required for any type of medical practice. To help with planning, both association and partnership contracts outline the responsibilities of and benefits for each associate or partner, along with the obligations of the collective group. As well, these contracts address existing issues and potential problems by stating actions for common situations such as notice of termination and administrative management. Advice on contracts from an accountant and a lawyer is invaluable, and sometimes even required.
Over the last decade or so, group practice has been gaining popularity because of the changing medical and payment environments, and the efficiency and cost-effectiveness from sharing expenses for things like office space, medical equipment, supplies, and support staff. Keep in mind though, once a group exceeds seven or eight physicians, the economies of scale often plateau.
(3) Hospital-Based Employment
Other types of medical practices are common in hospitals. Some hospitals purchase and manage existing solo or group practices, or directly hire physicians to work in their inpatient facility or ambulatory clinics. In hospitals, you can count on a predictable income and work schedule while enjoying a regular patient base and solid referral network. Also, you are less liable, and at lower risk, for legal complications.
On the other hand, hospitals don’t provide the same degree of freedom and autonomy that other types of medical practices do, as physicians are required to meet specific hospital standards. Physicians may experience a lack of connection to patients since they see many at a time. As well, the potential expectation that physicians become involved in hospital committee work is common.
(4) Locum Tenens
Locum tenens (from the Latin phrase for “to hold the place of”) refers to physicians relocating for temporary employment to areas in great need of healthcare professionals. Solo or private practices, hospitals, and healthcare organizations often need locums, and this type of employment may offer higher pay than permanent positions.
Since about 15 percent of the Canadian population does not have access to a regular medical doctor, there tend to be a lot of locum opportunities in Canada’s urban areas. However, many positions exist in rural areas, too — where the physician shortage is extremely high.
Conventionally, locums are quite common for physicians who are in their first 5 years of practice, or for physicians who are near retirement. But this mindset is changing and many physicians are choosing locum work for the better work-life balance it offers.
If you’re thinking of locuming, check out this article – “Is a Locum Tenens Position Right for You?“
Each type of medical practice has its own unique features, advantages, and disadvantages. Whatever career stage you may be at, choosing the right type of medical practice for your personality and what best suits your lifestyle and needs can greatly impact your career satisfaction.
It is also important to review your financial situation to ensure that you choose a practice option that meets your needs. Talk to one of our dedicated RBC Healthcare Specialists, and see how we can help you with your planning.
This article is intended as general information only and is not to be relied upon as constituting legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. Information presented is believed to be factual and up-to-date but we do not guarantee its accuracy and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the authors as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by Royal Bank of Canada or any of its affiliates.