Hospital Vs.Private clinic

[chevyy]

New graduate looking for a job and wondering what are the pros and cons of hired by hospital vs. hired by private clinic. Any thoughts? Thanks.

[EMEDPA]

Really specific to individual settings more than clinic vs hospital.

[Contrarian]

I've worked in private practice clinics with between 6-13 docs, in large multi-specialty clinics with over 100 docs, in free standing inpatient facilites with 2 docs and 10 NPs and PAs, and large non-academic hospitals/medical centers.

 

Clinic- More able to affect immeadiate change and practice the way you want... and able to develop a team and practice style... not so in a hospital/large depersonalized organization where you are "just an employee"... a number... a "cog in the wheel."

 

Clinic- Supervisors will be the physicians in the practice who can easily conceptualize any problems or issues you may present and can serve as clinical resources. If you want a change in a process or practice, it can be implemented within hrs. The Physicians owners simply need to make a decree, and it is done.

 

Hospital- Supervisors will be WETF they hire. Often these folks have less training and/or NO clinical training, are bureacrats and micro-managers only concerned with budgets and metrics and meetings. Think either nurses who hadn't physically touched a patient in 15yrs and/or Dip-Schitts with MHA degrees who wouldn't know the difference beteeen azotemia and zoster. If you need a accomodation/change in a process or practice, it has to go to commitee, then they have to have 3-5 meetings on it, and the folks meeting don't even se patients. The physicians aren't any help because they are EMPLOYEES like everyone else.

 

Beware of nurses and/or folks with not one iota of clinical training... telling you who, what, when, how to manage patients that THEY aren't trained to manage.

 

Just my initial thoughts...

 

Contrarian

[physasst]

New graduate looking for a job and wondering what are the pros and cons of hired by hospital vs. hired by private clinic. Any thoughts? Thanks.

 

Personally, I think all new graduates should spend some time in an academic medical center. They are MUCH more accustomed to teaching, and you will learn a lot more. Most specialties will have residencies and/or fellowships and have structured learning programs. Attending rounds and teaching rounds is a great way to learn. Also, some specialties will allow PAs to participate to varying degrees in those learning programs.

 

Physicians are often friendlier in hospital environments as well. Many will allow you to work specific shifts (depending on specialty) and benefits including retirement can oftentimes be better (not always though). Stability is also a factor. Docs may come and go in a hospital but so what? In a private practice, a doc could leave and you could lose your job.

 

PP can be more lucrative, but the hours can be much more painful, and many I know have call and other responsibilities that many in hospitals don't have. Plus, working in close environment in PP would be stifling, and having an MD as your "supervisor" isn't always the best thing. You can have big time friction in private groups (junior partners versus senior, etc.etc.)....and it can be hard for a new grad to catch on quick enough.

 

I've always thought it takes about 2-4 years for a PA to be TRULY functional in a specialty. That's what we count on in EM. You might be functional enough in 6 months to cover fast track on your own, etc. But to be really trusted by the attendings to manage complex patients...it's about 2 years at least.

 

Those are my thoughts. I will state the disclaimer that I have only ever worked in academia, and I never, have EVER had the desire to work in any other setting. But everyone is different. Which is kind of what E was speaking to.