Exploring Physician Practice Models: What Future Doctors Need to Know
March 18, 2025
Students at PCOM South Georgia recently participated in two “Lunch and Learn” sessions focused on medical practice
models and the business aspects of clinical medicine. The sessions—led by Dr. Lissa Murphy, chair of clinical sciences and associate professor of emergency medicine at PCOM
South Georgia—focused on helping student doctors navigate the complexities of choosing
the right medical practice model and understanding the financial and contractual implications
associated with different employment options.
Lissa Murphy, MD
Murphy emphasized the importance of preparing students to make informed decisions
early in their careers. “Our goal was to provide the students with information that
allows them to critically evaluate offers of employment, partnership, and other options
in order to not only find the best practice model to suit their needs, but also to
discern possible trouble spots,” she noted.
The presentation outlines key advantages and disadvantages of various practice models
including:
Employed hospital-based physician roles: While this arrangement offers financial stability, predictable scheduling and other
benefits associated with being a salaried employee of a hospital or health system,
it may come with less autonomy and productivity-based compensation.
Independent contractor or 1099 arrangements: As an independent contractor, physicians are responsible for their own taxes, insurance,
retirement planning, and other business-related expenses but may enjoy higher compensation
and greater flexibility.
Independent practice (solo or group): In this model, physicians have full control over operations but also have full responsibility
for managing the business. Group practices allow for resource sharing and reduced
individual burden.
Concierge medicine: In this type of practice, patients pay a membership fee in exchange for personalized
care and greater access to their physician. This model may provide better work-life
balance and patient satisfaction, but is not practical or feasible in all communities.
Direct Primary Care (DPC): Focused on providing affordable care without insurance billing, DPC simplifies some
aspects of the medical business but may be challenging in terms of revenue.
Locum tenens positions: Physicians work in temporary roles, sometimes filling short-term staffing gaps.
While this is a way to obtain diverse experiences, it lacks long-term stability and
benefits.
Non-clinical roles in research, industry, and academic medicine: These roles do not involve direct patient care. Compensation and career progression
may vary greatly from clinical practice.
Murphy pointed out that some students may not be familiar with all practice types.
Without exposure to business models, students may unintentionally enter practice arrangements
that do not match their goals or expectations.
For example, emergency medicine, radiology, and primary care hospitalists frequently
work as independent contractors through large contract management groups. In contrast,
Golden noted many primary care physicians are employed by hospital systems under compensation
models that combine a base salary with productivity-based bonuses, often tied to Relative
Value Units (RVUs).
“Pitfalls in this setting include physicians who don’t generate the revenue that was
agreed-upon as their initial salary offer,” Golden cautioned. “Many of these physicians
are caught in the situation of having to pay back the difference between what they
generated and what they were paid.”
Murphy and Golden encourage students to carefully review contract terms and seek legal
guidance before signing, paying particular attention to common contract components
such as:
Non-compete clauses
Productivity expectations
RVU-based compensation metrics
The involvement of practice management groups
The use of ancillary services in private practice as both a convenience for patients
and a revenue stream for physicians
Murphy and Golden stress the importance of being informed about these issues before
entering into practice, as some matters may be difficult or impossible to change after
a contract is signed.
Key Points
Physician practice models vary widely, each with distinct financial and operational
considerations.
Specialty choice often influences practice setting.
Reviewing employment contracts carefully is critical.
Early exposure to business and contractual aspects of medicine can help students make
informed decisions and avoid challenges after entering practice.
According to Murphy, the presentation was well-received with the interactive format
allowing students to ask questions and engage in open discussion.
Amaan Ismail (DO ’27), who serves as president of the General Surgery Club, vice president
of the Nutrition and Medicine Club, and treasurer of the Physical Medicine and Rehabilitation
Club, spoke positively about the experience.
“Our ‘Lunch and Learn’ on physician practice models was a fantastic session,” he said.
“It gave us a clear, real-world look at the different ways physicians can structure
their careers. The discussion was engaging, insightful, and left everyone with a better
understanding of the pros and cons of various practice models.”
What made this session distinctive, Murphy added, was its focus on providing practical
information based on real-world experience.
“It was unique in that it was presented from the perspective of the needs of student
doctors and incorporated the experiences and observations of practicing physicians,”
she said. “Overall, it was a review of the economic risks and benefits that could
occur in certain practice settings so that the students can protect themselves from
the consequences of an uninformed decision.”