Pros and cons of popular practice model options, according to Betsy J. Wernli, M.D., president of Forefront Dermatology.
Solo practice: Dermatologist owner run the show. The dermatologist has total clinical and administrative autonomy and decision making authority within the practice. However, they likely do not have the resources and capital to help them manage the expanding administrative aspects of running the dermatology practice. Work-life balance can be a struggle in the early years, and even later as operating pressures and requirements grow.
Hospital employment: Dermatologists have a built-in referral network and someone else is handling and worrying about the administrative component of the practice. But that’s at the expense of dermatologists relinquishing control. Hospitals are run by executives and business people — generally not dermatologists. Administrative leadership can result in financially-based decisions that aren’t in the best interests of patients or dermatologists. Another disadvantage of hospital employment is that dermatologists on staff cannot own equity or be partners in their practice environments.
Academic dermatology: Academic medicine offers many of the same benefits as working for a hospital, with the added benefit of being able to teach residents and others. For dermatologists with a passion for teaching or mentoring, academic medicine might be the best choice. Many of the cons are similar to hospital employment, as well, including that the decision makers tend to wear suits instead of white coats. There’s also no opportunity to own the practice or become a partner.
Multispecialty groups: Depending on the group’s size, multispecialty groups can use their strength in numbers to negotiate with payers, as well as centralize administrative duties to remove those burdens from dermatologists’ shoulders. But multispecialty groups might not be run by dermatologists and tend not to be dermatology-focused. In fact, many dermatology clinics in this model funnel money and resources to support the other specialties. And ownership is not usually an option.
Dermatology groups: Dermatology groups offer dermatologists autonomy; support with administrative services, which allows for work-life balance; and the opportunity to own or partner in the practice, giving the dermatologist a vested interest in the practice’s success. When dermatologists run the group practice, they’re able to make ethical decisions for patients and doctors. And, as a group, the practice has better bargaining power in the medical marketplace.