An Age-Old Profession
Given the unique and complex childbearing role of women, doctors that specialize in treating them have existed for centuries. These ancient specialists are the forefathers of today's gynecological doctors and researchers.
Fortune favors the Dedicated
They are often at the forefront of debates over women's health and healthcare. Their role requires extensive training, but Gynecologists are in high demand and tend to be well-compensated. A Gynecologist can opt for a model of medical practice from among the following alternatives.
Solo Practice
A small staff and a limited patient base usually characterize solo practice without partners or employment affiliations with other practice organizations. It allows the physician to design, grow, and develop a unique style of medical care.
On the flip side, medical care (such as the need to manage hospital care and weekend coverage for patients) and the entire business enterprise rests on the sole physician. Developing agreements with insurers and documentation for regulations involves considerable work.
Solo practices are often at substantial financial risk due to the costs of doing business, possible lack of referrals, the small patient base, shifting patient allegiances because of insurance issues, income loss caused by illness or vacation, and the extent of the physician’s educational debt.
Suburban or rural areas are often better suited to solo practice because of significant medical needs and less competition from medical resources. Some local hospitals affiliate with and support solo practices (financially or with access to electronic medical records) in maintaining their patient base.
Group Practice
The group practice may comprise single-specialty or multi-specialty entities. The single-specialty practice comprises two or more physicians providing patients with a specific type of care (primary care or a particular sub-specialty practice). Multi-specialty group practices offer various types of medical specialty care under one roof.
Group practices enjoy increased financial security and better control of lifestyle. They may provide more employee benefits than are feasible in a solo practice, though often less than what may be available in organizations that employ physicians.
Group practices usually have the resources to manage the administrative tasks associated with running a practice, allowing the physician to focus more time and energy on patient care. They allow for the distribution of clinical care in the hospital at night and on weekends across a more significant number of people leading to more flexible scheduling than in a solo practice.
However, autonomy and decision-making ability decrease, increasing the risk of conflict around significant practice issues. Larger practices may also tend to become more bureaucratic and policy-driven.
Employed Physician Practice
Physicians may be employed within one of several practice models. Some hospitals may purchase and manage existing solo or group practices or may directly hire physicians to work in their inpatient facility or ambulatory clinics. Health-care corporations may own and run clinics with employed physicians.
Some physician-run groups are structured on an employment model. Group practice is structured more like a corporation that employs clinicians instead of pursuing a more traditional partnership model.
Much of the administrative responsibility of running a practice is shifted to the employing entity, allowing the physicians to focus more on practicing medicine. A baseline level of compensation is usually assured, although productivity demands and incentives may be significant. The organization usually has more resources than solo or independent group practices. There is better coverage for clinical responsibilities, more efficient control of lifestyle, more robust support services, and further education and training opportunities.
The downside is that physician autonomy may be substantially diminished relative to other practice models. Scheduling and productivity may be beyond the physician’s control; others may develop policies and procedures. There may be less clinical flexibility due to limitations of referrals and facilities based on the employing organization. Serving on committees or participating in other organizational activities may be likely.
Other Types of Medical Practice
Some physicians work as independent contractors in a solo or group practice where other physicians or physician groups share the facility and possibly clinical coverage. It may spread the costs of running a practice and may provide some flexibility in clinical scheduling. On the other hand, there is the loss of a degree of decision-making compared to a solo or small group practice.
Locum tenens (literally “place holder”) is an alternative to more permanent employment. Locum tenens positions are temporary (from a few weeks up to a year) offered by practices, hospitals, or healthcare organizations with an unfilled clinical need. The compensation rate is generally higher than what the permanent position would offer. Locum tenens allow physicians to gauge a specific type of practice or location without committing to long-term employment.