Introduction

The practice of medicine has continued to evolve. Currently the business climate is more favorable to a large group practice rather than solo or small group practice. This has led to more physician decisions to seek employed positions rather than work as independent practitioners [1].

The push toward the universal adoption of electronic medical record, the multiplication of regulatory bodies as well as increased access to avenue for health information by patients have in some ways improved the practice of Ob/Gyn but overall have fostered new practice challenges. The escalating costs of medical practice and liability insurance premium only add to the financial pressures.

These events necessitate the need for physicians to not only focus on the acquisition of excellent clinical knowledge and skills but also to learn the skills to run the business of medical practice.

Scope of the Problem

Physicians are highly educated in patient care, but in most cases individual physicians are poorly equipped to provide leadership for multimillion dollar medical businesses. Discussions on business and finances with medical students, residents, and practicing physicians have in most cases been relegated to the background in order not to interfere with their duties as healthcare providers. Healthcare expenditure now account for about 17.5 percent of the gross domestic product or about $9523 per person in 2014. It is therefore imperative for physicians to be more business savvy in order to have a seat at the decision table [2,3].

Medical Practice Options

Group Practice

This can either be in a single or multispecialty group, small or large with various pros and cons, and job offers can either be in the form of a guaranteed salary or a combination of salary and productivity.

Large multispecialty groups tend to offer better benefit packages at the expense of lower salaries than smaller single specialty practices [1, 4].

There may also be more bureaucratic bottlenecks to decision making and conflicts of personalities but they generally have more staff to cover nonclinical responsibilities. Advantages and disadvantages of this type of practice are as listed in Box 39.1.