Med Students Eschew Private Practice and Seek Collaboration

Only 10% of 1, 400 surveyed medical students say they want to go into private practice and the percentage of students who will seek a job with a hospital or large group practices has risen to 73%.

According to athenahealth, Inc.’s ninth annual Epocrates Future Physicians of America survey released on December 15, 2014, the 10% private practice figure is a 50% drop since 2008.

What did the students cite for reasons for flocking to the security of employment over the freedom and risk of private practice?

Care, Not Business

Balancing their work and personal lives and being in a work environment free of administrative hassle was most commonly cited. Also noted by nearly 60% of the students was dissatisfaction with the instruction they receive related to practice management and ownership, as well as a lack of training for billing and coding.

A third-year student, Arvind Ravinutala, at the University of Southern California School of Medicine, said he believes the current system provides few incentives to pursue private practice. “Training is structured around group and hospital settings, so the average student learns nothing about running a practice. Plus, hospital employers promise candidates a stress-free environment where they can focus on being a doctor without incurring further debt. For most, the choice is obvious.”

Extended Care Team Collaboration

The students also had strong opinions about collaborative care as 96% said that to deliver high quality care, “it is important to collaborate effectively with extended care teams, which can include registered nurses, physician assistants, specialists, and medical staff.” Almost 60% consider lack of communication between care teams the biggest obstacle to effective care coordination. Concerns about inadequate cross-team communication were mentioned by 75% of the students. They predicted the “fluid sharing of data between electronic health record (EHR) systems, also known as interoperability, will advance health care—and possibly reduce the fragmentation of care within the next 10 years.”

Michael Douglas, a third-year at Loma Linda University of Medicine in California, said he was concerned by the absence of adequate technology to bridge the communication gap. “Communication tools are broken or antiquated, and this impedes our ability to provide continuity of care for patients. Despite a clear need for quick, efficient, and secure ways to communicate with and across teams, we’re still stuck in the 90s using archaic paging systems and fax machines.”

The key take-away for device companies is that their surgeon customer’s device choices will be increasingly dictated or influenced by their employers and devices need to demonstrate value for the entire care team.