Family physicians are experts in comprehensive care, including acute, chronic, and preventive care. Over time, they build strong relationships with their patients and a deep understanding of the communities they serve. There are many opportunities for doctors interested in delivering this type of patient-centered care. Common themes across practice models are having team-based approach, integrating mental health care, and prioritizing easy access to care for patients. 

Physician Practice Models

Employed Status

A growing percentage of physicians elect to be employees of a hospital, community health center, or multispecialty group practice. Not having to pay overhead costs or deal with staffing and administrative issues is appealing to many. It is important to talk with physicians in each setting to better understand the pros and cons of these practice arrangements.

Multispecialty Group Practice

Practices may include specialists from family medicine and other primary care specialties, orthopedics, and cardiology in one building to enhance patient access. One of the advantages of working in a multispecialty group practice is that multiple patient services are provided at one location, enabling better communication and convenience for patients.

Part-Time Practice

Family physicians may choose to practice medicine part-time in order to take care of their families, pursue other interests or prepare for retirement. Part-time practice is economically viable for many family physicians but can be financially challenging for others. Another alternative to full-time practice is job sharing, one full-time equivalent (FTE) position shared by two physicians who each work part-time. This option is advantageous because it frequently cuts down on paperwork and administrative duties. 

Private Practice

Family physicians enjoy the career flexibility between running their own practices and working with colleagues in a group setting.

Rural Practice

The geographic spread of family physicians across the country more closely matches the geographic spread of the general population than any other medical specialty. In treating underserved populations, physicians in rural areas encounter illiteracy, poverty, and limited community resources.

The National Rural Recruitment and Retention Network matches health care professionals with jobs in rural and underserved areas helps to locate practice sites in rural and underserved areas.

Understanding Practice Settings

There are a variety of private practice models to consider when choosing to enter into private practice. Each has advantages and disadvantages.  Flexibility and autonomy are some of the key advantages of private practice.

Focus areas to consider are:

• Clinical medicine (seeing patients)
• Education (teaching medical students and trainees)
• Research
• Health system administration or leadership
• Patient community engagement (promoting health equity, community and public health, and patient education)
• Professional community engagement (participation and leadership in medical societies, organizations, medical staff, and collegial relationships)
• Entrepreneurship

 Answering the following questions may also help:

• How much control do I want over my day?
• Am I interested in taking on financial and management responsibilities?
• How much financial risk am I (and the people who depend on me) comfortable with?
• How much time off do I want? Flexible or part-time schedule; call schedule; coverage?
• What is my practice’s mission or affiliation?
• How will I earn income? (Compensation, including salary and loan repayment programs)
• How innovative and tech-savvy is the practice?

The great variety of private practice options—and their pros and cons—can be broken down in several ways (Table 1). There is no wrong answer; you should base your private practice journey on your individual priorities.

Prospective Practice or Partnership

It is important to consider other factors before joining a practice or forming a partnership with other physicians.  The new prospective practice/partner and you should have similar ideas, goals, and understanding of how this practice will run.  These are a few topics/questions to ask your potential employer, business partner, and yourself.

Physician Payment and Delivery Models

Even if you don’t want to be involved in day-to-day business decisions, understanding how a practice generates revenue can give you insight into how the business model will affect the way you practice.

Table 3 describes a simplified model for various payment types to help ground your understanding