By Daniel Laury, M.D.
You would expect that, given a physician shortage, my goal of getting back into obstetrics would be supported and even welcomed. The Association of American Medical Colleges expects that the US will have over 91,000 too few physicians by 2020. I graduated medical school in 1988, completed an OBG residency in 1992 and went right into private practice. By 2002, I stopped delivering babies, focusing on gynecology, women’s primary care, esthetics, teaching, writing and research.
It became increasingly clear that the private practice model has been disappearing over time. Our reimbursement is going down, our costs are up, we are underrepresented in negotiations, etc. The AMA found that since 1983, physicians in private practice have decreased from 40.5% of the total to about 18.5% in 2012. I was tired of the constant competition; in the US, the average number of OBs is one for every 13,021 persons. However, in my locale it was closer to 1 in 4,375. I was not looking forward to buying and getting trained on $50,000 of EMR. The administrative burden of OSHA, CLIA, ACA, HIPAA and other acronyms was unsupportable. Taking time off in private practice is also costly; income stops when I am not working but expenses continue including rent, staffing costs, malpractice premiums… Patients can be unhappy when you take time off, expecting that their private doctor is always available to them.
Mark Twain’s comment, “Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do” rang true for me. I looked at my options, many that may be familiar to you, including administrative work, insurance opportunities, working for the military, writing full time, academics, giving talks and going into another field altogether. Ultimately, I decided that locums tenens work with be the best fit. I talked to various providers and overall, they seemed happier, more mobile and worked when they wanted to. Read More