Earning Versus Learning

Pediatric Blog

Although there is a difference in the emphasis in private practice versus academic practice, one can grow as a physician in either setting. The reward however is also very different in each setting.

After Hurricane Katrina I joined a private pediatric group in Slidell, Louisiana. I was excited since it was my first job after residency. I was working as a hospitalist for a group which provided services to almost all the local pediatricians in the area. New job, lots of hopes and expectations.

My group was very supportive of a young graduate and helped me grow as a physician and build my confidence. Even though I was busy, I was expected to learn on my free time and keep myself up to date. I did have allotted CME time as well. But the emphasis in private practice is more on earning to meet the overhead and other expenses the group is making on your behalf.

As for productivity, the sky was the limit. As I grew busier the bonuses got bigger and soon my salary was based purely on productivity. The hard work I put in was rewarded in my paychecks, so the more I worked the bigger the paycheck. Learning was self-motivated, and it took a back seat on most occasions due to my being tired from all the long hours at work and trying to have a family life as well. Most of the time I did my CME  one month before renewing my license

Fast forward to 2011.  I accepted a position in the pediatric department at an academic institution where I was part of the team involved in resident’s training and learning. I soon realized that to teach someone, one has to keep up with the latest information.

Just a few years out of my residency, the academic world and the residency itself has changed so much. No more 24 hr calls. Dedicated time for teaching and learning set aside in such a way so that no one misses a conference due to busy service. Learning is first and foremost.  I found myself reading more, keeping myself updated with latest recommendations so I was prepared for the resident’s question. One can never be totally prepared for all the questions and because of that I have been able to learn with the residents as I teach them.

Being in an academic setting, I am able to see chronically ill, diagnostically complex patients and learn from each child. I didn’t get to see these kinds of cases in the private practice setting since they were usually seen at the children’s hospital where they had all the specialists.  I like that I am growing more as a physician with each case.

Although I learned a great deal in both settings, I found more opportunities for learning in the academic environment—this was more important to me than the earning potential in private practice. What practice is right for you?