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MEDICAL YEAR
IN REVIEW

YOUNGER

PHYSICIANS –

Why They Choose an

Employed Health Care Setting

By Nora Vasquez, MD and Veronica Vasquez, MD

One of the most notable trends nation- primary focus on patient care rather than ernment institution, such as the Veteran Af-
wide is the increasing number of employed managing a medical practice. Dr. DeLa- fairs system. Furthermore, medical students
physicians. The term “employed” is gener- Torre’s decision to be employed was com- and residents have limited exposure to pri-
ally defined as those who work in a setting mon among her peers. vate practice groups or other models of
where they do not have ownership or have According to the Texas Medical Board, health care settings such as rural medicine,
decision-making authority in their practice. 75% of newly licensed physicians are grad- locums, telemedicine, direct primary care or
According to a 2019 survey by the American uates of medical schools outside of Texas. concierge medicine. In addition, they are
Medical Association, approximately 47% of The passage of Tort Reform in 2003 likely not exposed to the intricacies involved in
physicians nationwide are now employed. contributed to this trend. As more physi- managing a medical practice. Therefore, it is
This major shift of physicians choosing an cians move to Texas, they may lack estab- not surprising that many younger physicians
employed health care setting is also being lished connections to the local community. want to focus on patient care rather than
seen in Texas. According to a Texas Medical This may influence their decision to obtain worry about the financial and legal chal-
Association (TMA) Survey, from 2014 to employment with larger academic or gov- lenges of running a medical business.
2018 there has been a 12% decrease in ernment entities, or even as an employee of Some of the immediate benefits that at-
Texas physicians who own their practice. larger medical practices rather than go into tract doctors to employed positions include:
Currently, 38% of Texas physicians are now private practice as an owner or partner.
• Work-life balance
employees. Interestingly, the increase in em- Dr. Erin Moody, a Vascular and Interven-
• Guaranteed salary
ployed physicians appears to be most no- tional Radiologist who practices in Corpus • Loan forgiveness
table in physicians who are less than 45 years Christi, Texas has experience in an em- • Health insurance
of age or within 8 years of residency or fel- ployed practice. After Dr. Moody com- • Retirement benefits
lowship training. pleted her fellowship in California, she • More clinical support staff
Dr. Renee DeLaTorre is a recent Family joined an employed setting, as it offered her • Malpractice Insurance
Medicine graduate from Corpus Christi, work-life balance and a stable salary. She • Call coverage
Texas. She was drawn to an employed po- was not alone. A survey from Merritt • Continuing Medical Education funds
sition because it felt like a natural extension Hawkins revealed that 43% of the 2019 • Paid vacation
• Disability Insurance
of residency. In addition, she wanted to graduating residents preferred to be em-
have a patient panel that was already estab- ployed by a hospital. This is reasonable Despite these incentives, many employed
lished with ample support staff to start in given that most medical training occurs in physicians realize these benefits come at a
her new clinic. She decided to devote her an employed setting at an academic or gov- great cost. The leading causes of dissatis-

18 San Antonio Medicine • December 2019