Events such as the ARA’s ECG sessions help trainees work through the intricacies of going into ‘private work’.
Events such as the ARA’s ECG sessions help trainees work through the intricacies of going into ‘private work’.
When I talk to friends who have been with me on the physician training journey, we keep returning to the question: “So, what are you planning on doing when you get your letters?” (And at risk of any ambiguity, I’m referring to the FRACP postnominal, rather than the letters you get from the postie; in any case, as a millennial, I don’t really understand the postal system.)
Most of my peers seem relaxed about what comes next, idyllically predicting that a public hospital job vacancy supplemented by some “private work” will fill the void left by back-to-back ward rounds, consult rounds, outpatients and a seemingly endless stream of calls that characterise the physician training experience for most of us.
But do many of them understand what “private work” will entail?
Some trainees will get exposure to private practice, as well as some rural and regional rheumatology, as part of a “specialist training program” rotation. In addition to broadening trainees’ exposure outside of the traditional teaching hospital setting, a benefit of these rotations is learning a little about how the “business” of rheumatology works.
Unfortunately, with only a handful of these rotations available across Australia, only a few trainees each year will have this opportunity.
The ARA’s Early Career Group (whose somewhat incongruous initialism ECG I’ll use herein) recently hosted its annual private practice event this weekend. Early-career, mid-career and “seasoned” rheumatologists formed a panel and gave us their unique insights into taking the leap into private practice after fellowship. Topics covered included everything from the merits of joining a group practice versus going solo, deciding how you want to work and manage your time, setting up regional and remote clinics, and even the pros and cons of the different practice software systems.
A theme that emerged from the questions during the event was around the various styles of private practice. We heard from rheumatologists who have designed a light-footprint, low-overhead, transportable clinic, to those who have grown a larger business with multiple locations, specialists and allied health staff (and vibrant staff culture, to boot!). Other trainees’ interest may have been piqued by advice about joining group practices if job flexibility and leave cover is a priority.
It seems that there won’t be a shortage of work for rheumatologists in the years to come. And addressing this looming chronic disease crisis is a big problem that deserves greater social and political attention.
But aside from many other useful practical takeaways from the ECG’s private practice event (including about billing and hiring good staff and practice software – the list goes on), there was a reminder that this crisis won’t be solved by an individual rheumatologist. The panel emphasised that focusing on joining or starting a good business, and developing a satisfying personal practice style, is key to an enjoyable long-term career working “in private”.
While the intricacies of private rheumatology practice remain a “black box” to my fellow trainees and I, sessions such as the ECG’s Private Practice Event are an important part of our professional education. As covid restrictions ease, it is hoped that the event will be run “in person” in 2022, enabling a more in-depth and practical discussion about all things business.
My takeaway from all of this? Running a sustainable and effective rheumatology practice (aka small business!) can only mean good things for its rheumatologists and for promoting greater access to rheumatology services for patients.
Dr Oscar Russell is a rheumatology advanced trainee from South Australia and the South Australian representative on the ARA’s Early Career Group steering committee.
