I was always told if it was not good not to say it. "Less I pour water onto your flame of passion for private pracitice" let me just say "count up the cost." I am two years out in private practice in rural TN. The adminstrative issuses such as negoitating with insurances, the hastle of dealing with employees, and the overt sheer amount of time put into private practice can be very overwhelming. If you practice evidence based medicine then it is even worse as more time is required in your clinical duties with little time left to carry out the administrative duties. Employees must be paid, insurance and other overhead in not negotitable and at the end of the day you mostly come out with what you would make as a hospitalist or ED doc anyway with far less time off for family and fun. I love medicine and patient care don't get me wrong but on the other hand it is very difficult when we have been outsourced to insurance companies and business men. I made the hospital about 3 million over the last two years of which they collected 75%. I got none of that money and very little respect, you do the math. It seems a travesty that the entire deal is dependent on the face to face encounter but the one with the most important part is getting the least. Most CEOs at the hospitals make more to do a lot less. I just ask you to honestly count up the cost. So many forms for home health, referrals, labs, dme, etc that we do not get paid to handle but takes up so much time. I cannot speak for all but I am out of the hayday when good medicine meant good money and into the bottom line era of "get what you can, while you can as easily as you can."
