How are emerging spine surgeons viewing private practice vs. employment opportunities? Dr. Kris Radcliff discusses

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Kris Radcliff, MD, is a fellowship-trained spine surgeon with 10 years of experience in private practice with Philadelphia-based Rothman Institute.

Here, Dr. Radcliff recalls how his practice began at Rothman and discusses how emerging spine surgeons are viewing private practice versus employment opportunities.

Q: You began practicing in 2009. What was your mindset in terms of seeking employment opportunities versus private practice after you completed your fellowship? Where do you think the next generation of spine surgeons' heads are at now?

Dr. Kris Radcliff: I did a fellowship at the Rothman Institute at Thomas Jefferson in 2009. I was offered a job with my fellowship mentors and have had one job ever since I started my practice. Before I got offered the job, I considered going back to where I did my residency in Houston at Baylor College of Medicine and taking a hybrid academic/private practice job. 

I love working in this hybrid private practice/academic model. My partners are international experts in orthopedic surgery who have made a significant academic contribution to the literature and to our societies. Consequently, they are absolutely supportive of my own academic endeavors and they continually open doors for me. I have an academic appointment at a university. I'm very involved in research and teaching.

However, I also really enjoy working in a private practice, physician-run group. Our president and board are physicians who are very sensitive to our needs, perspectives, and training. Our group is very nimble. Because we only do musculoskeletal care, we're very good at being a center of excellence. Thus, it's easy for me to get the clinical resources that I need to advocate for myself and my patients. Certainly, being private practice carries some financial risk, which is more present than if I were employed by an organization with a bit more of a guaranteed salary. But it's interesting, it even changes your perception of the office, the building and so forth. You own part of it, so you take more care in it.

I was at a meeting recently where someone spoke about trends in employment among physicians. According to a recent American Medical Association survey, the majority of physicians are employed. Within orthopedics, there are way more people taking employed jobs now than when I was a fellow 10 years ago. That is probably a reflection of consolidation in the job market as well as the growth of hospitals and healthcare organizations. I think it's probably hard to negotiate as an independent eight to 10 person group from an insurance and contracting perspective. The generation of surgeons who are coming out now have seen significant changes in healthcare in the last two years with the Affordable Care Act and potential repeals. I think that it's probably appealing to work for a big organization that will buffer you a little bit from potential future changes to the way healthcare is practiced. The problem is when you're employed you do lose some leverage, and you probably lose some degree of autonomy over various aspects of your practice.

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