Clinic or hospital?

Medical Professionals, Would You Rather Work at a Small Clinic or a Large Hospital?

For new physicians entering the job market or employed doctors seeking to make a change, what is the optimal work environment—a small or a large practice?

Note the many excellent suggestions in this informative post from KPG Provider Services, comparing and contrasting large and smaller settings.

Structures of the workplace today

Some physicians are employed in private practice, and hope to become a partner in time. This was how most physicians used to find employment. But the growing form is for hospitals to buy local practices. In this system, physicians then are employees with no possibility of partnership. 

In both systems, physicians have either a fixed or a base salary and bonuses or fees for performing procedures (for example, an Obgyn would be paid per birth and an orthopedic surgeon per surgery).

Hospitals like the Mayo Clinic, the Cleveland Clinic, and others, employ physicians based on fixed salaries and create a structure of cooperation and team approach to caring for patients.

Do this before starting the job search

Ask yourself, What do you want most in your career? What motivates you?

You may already be interviewing. Remember: you are not only being interviewed, but you are interviewing potential employers as well.

The vibe at small clinics and large hospitals can be like night and day, each with their unique pros and cons.

PhysEmp works with hospitals of all sizes, placing physicians, nurses and allied health practitioners in all specialties. We know the landscape, and offer the information below.

Working at a small clinic: the pros and cons

As you embark upon your search, consider the more “manageable” sized work dimensions of a smaller hospital or clinic, which can include:

  • Smaller staff and more intimate connections. At a clinic, you’ll have time to get to know your coworkers, whether they are physicians, nurses, PAs, or others. Any difficulties that may arise generally must be dealt with rather than swept under the rug. The close bonding at a clinic may be gratifying for you.
  • Lower physician-to-patient ratio. You’ll have the opportunity to spend plenty of time with patients at a smaller facility. Generally, clinics are less busy than large institutional settings.
  • Salaries can be variable. We often see lower salaries at clinics in rural, outlying, suburban, or exurban areas. However, some clinics, knowing they cannot offer as many benefits as a large hospital, may offer higher salaries to make up for it.
  • Your success will be noticed. Your work and presence will be felt and known. However, this can be a double-edged sword, as your areas of challenge will be noticed, too.
  • Fewer layers and better communication. Smaller organizations generally have less red tape, so you’ll likely see faster action on items that need to be done.
  • Being a key member of the community. A doctor in a small community typically commands great respect. You may run into patients and community members at events, concerts, rec centers, and other locales, which may be enjoyable and fulfilling.

Working at a large hospital: a mix of opportunity and complexity

Here are a few items to consider as you apply for jobs at large hospitals:

  • Higher pay and generous benefits. You  may be offered a large salary that comes with working in a sizable, well-funded system. However, you may also have to contend with…
  • Politics. At larger employers, there are usually many voices vying to be heard, a rigid hierarchical structure, and no small amount of bureaucracy to contend with. Decisions can go slow and your voice may not always be heard.
  • More departments and specializations. You’ll likely have ample opportunities to expand your knowledgebase, log more experience, and meet more physicians in more specialties. This may appeal to you if you are ambitious and hungry for experience.
  • Flexibility within your position. At a large hospital, you may get the chance to work at multiple locations, work on more shifts, have greater latitude in certain ways, etc.
  • Extra perks. A larger hospital may offer daycare facilities, cafeteria, recreational activities, and other conveniences.
  • Your work may be tracked. Many large hospitals track metrics closely. Medicine, of course, is a business, and like all businesses, there is a bottom line that must be met. A smaller hospital, though it still may track your work, may not be as data-bound in its decision-making.

Which work environment is the best fit for you? 

It may be a good idea to peruse current job openings and read through job descriptions to help you get an idea. View current jobs now

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