Practice Settings and Transitions

Private Practice Settings

Starting a solo practice or joining a private practice brings opportunities for long-term relationships with colleagues and patients, business ownership, and financial investment. It’s important to understand what to expect when choosing private practice.

Pros

• Clinical autonomy
• Practice design
• Control over one's future
  
  

Cons:

• Business administration responsibilities
• Less insulated from economic impacts
• Fewer predictable referrals
  
  

Resources:

Planning for Independent Practice

Practice Help for Independent Physicians

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Employed Settings

Employment opportunities with a private practice, a health system, or an academic institution each come with their own merits and challenges that should be taken into account. 

Pros

• Predictable income
• No start-up costs
• Built in referral network
  
  

Cons:

• Limited income growth potential
• Future tied to organization’s success
• Limited input on strategic decision-making
  
  

Resources:

7 Things You Must Know Before Signing an Employment Contract

What Financial Questions Should You Be Asking

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Academic Settings

Teaching can be rewarding and carries with it a level of prestige and job satisfaction. But the decreased opportunities for face-to-face patient care can be a drawback. 

Pros

• Time for research
• Teaching opportunities
• Flexible clinical responsibilities
  
  

Cons:

• Limited compensation
• Often dependent on grant funding
  
  

Resources:

Leadership, Advocacy, and Health Policy Curriculum Toolbox

Med School Mission - How TMA gives academic physicians a voice

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Rural Settings

TMA has championed new medical schools and residency programs in rural and underserved areas and fought to increase funding for medical school loan repayment programs. TMA has long advocated for diverse investments in Texas’ rural physician workforce pipeline, which have paid off with the recent openings of two new medical schools – one in Conroe in 2019 and another in Tyler in 2023.

Pros

• Tend to offer larger income guarantees
• Greater scope of practice
  
  

Cons:

• Longer requirement to live in area
• Usually not state-of-the-art facilities
  
  

Resources:

TMA Advocacy Comment Letters

TMA Urges Rural Workforce Investment

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Starting a Practice

Whether you’re just out of training and eager to strike out on your own or mid-career and considering practice ownership, starting a new practice can feel daunting. From credentialing, contracting, and compliance to health information technology, revenue cycle management, staffing, and marketing, the number of moving parts can quickly become overwhelming. The Texas Medical Association helps simplify the process by offering a wide range of resources to guide you in every step.

TMA's dedicated Starting a Practice webpage provides access to:

• Resource centers for billing, HIPAA, health information technology, and human resources
• Toolkits for practical guidance and tools for designing and launching a practice
• Licensing and registration information 
• Insurance and payer resources to help navigate payer and insurance requirements
• New patient forms 
• Topical articles, quick tips and white papers
  
  

Resources:

Practice Start-up Toolkit

Hiring the Right Person for Your Practice

Closing or Selling a Practice

Every practice is unique. The decision to retire, close, or sell a medical practice always depends on the facts and circumstances of the practice situation. You love what you do, but you know you need a change. Perhaps you need a break from the daily rigors of practicing medicine, or maybe your interests have changed, or you want to spend more time with family. In some cases, the change will come as a result of advice from your accountant or, worse, due to your health. The Texas Medical Association cannot tell you why to change, what to do, or even when to do it. However, there are many things to consider when contemplating retirement or other professional practice changes.

Here are a few things to consider once you decide to make a change.

• Notifying patients and staff
• Valuation of a medical practice if the practice is to be sold
• Legal issues surrounding practice sales
• Retention of medical records
  
  

Resources:

Practice Change Sample Forms

Selling or Closing a Practice