An AAO-HNS 2022 workforce survey of 1,790 members showed that 54% of respondents worked in private practice (https://www.entnet.org/wp-content/uploads/2023/07/2022-Otolaryngology-Workforce.pdf).
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April 2024A significant amount of medical training, at both the medical school and residency levels, occurs at larger academic hospital systems, however. This can make getting a firsthand view of private practice a challenge for physicians in training.
So, what are residency programs doing to facilitate exposure to and exploration of private practice? Quite a bit, it turns out.
Residents at Boston University Medical Center (UB) in Boston have exposure to attending physicians in private practice through two private practice facial plastic surgeon offices, a rotation at a multi-specialty clinical practice site, and clinical work with a private practitioner who sees patients at the academic medical center once a week, said Michael Platt, MD, MSc, the residency director in the UB department of otolaryngology–head and neck surgery. Additionally, private practice physicians speak about different practice models at a business of medicine lecture series.
“Our program openly supports residents seeking careers in private practice, which allows them to learn and explore different models,” Dr. Platt said. “Residents have direct exposure to mentors in private practice, as well as lectures to help prepare for a career in private practice.”
The Medical University of South Carolina (MUSC) in Charleston offers an elective rotation to PGY-3s and above who plan to enter private practice. The rotation occurs at Charleston ENT & Allergy, a large private practice group. Plans are underway to expand the program, which will enable all residents to be exposed to private practice so they can understand the challenges and opportunities in this setting, said Robert Labadie, MD, PhD, a professor and chair of the MUSC department of otolaryngology–head and neck surgery. Clinical rotations expose trainees to many aspects of the business of medicine, such as relative value units, staffing models, ambulatory versus hospital-based charges, and ancillary services, including in-office imaging and hearing aid dispensing, he said.
A Closer Look
The otolaryngology residency program at the University of Virginia School (UVA) of Medicine in Charlottesville, Va., includes a three-month private practice rotation for PGY-4 residents in Fredericksburg, Va., about 1.5 hours northeast of Charlottesville. The rotation gives residents a true taste of private practice otolaryngology, said Bradley Kesser, MD, a professor and vice chair in the department of otolaryngology–head and neck surgery.
Doing small cases in an ambulatory setting versus the operating room saves money and is good for patient care without sacrificing quality. Residents learn about healthcare utilization and how to use resources in the most efficient ways. — Bradley Kesser, MD