In 2011, after completing her pediatric otolaryngology fellowship at the University of North Carolina School of Medicine in Chapel Hill, Alisha West, MD, knew she wanted to work in an academic hospital. “If you look at medicine in general, the future and the progress lie in the academic institutions where they’re doing the research and they’re teaching the residents,” she said. She is now a pediatric head and neck surgeon with University of California Los Angeles (UCLA) Health.
Explore this issue:October 2017
Eric Mansfield, MD, was drawn to private practice after serving four years as an otolaryngologist in the United States Army. In the structured environment of the military, “there were always people above you who were making decisions for you,” he said. “I knew I didn’t want to work in another system where I couldn’t make my own decisions.” In 2001, he opened his private practice in Fayetteville, N.C.
If you look at medicine in general, the future and the progress lies in the academic institutions where they’re doing the research and they’re teaching the residents —Alisha West, MD
An Atmosphere of Collaboration
While solo practice has attractive benefits, including autonomy and the potential for higher income, the number of otolaryngologists in solo practice declined by 5% between 2001 and 2009, according to a 2011 report from the American College of Surgeons (ACS Health Policy Research Institute, January 2011). For urban otolaryngologists, the decline was 15%. One theory to explain these trends is that younger physicians tend to want the more dependable income that comes with hospital employment (or a group practice) and are less interested in the business and administrative tasks that come with running a small business.
Dr. West, who is also an associate professor of otolaryngology at UCLA, was drawn to hospital employment, specifically at a tertiary care center, because she wanted to work with very sick patients. “For me, it brings a lot of excitement and joy and fulfillment to take care of those patients,” she said. She also enjoys collaborating and operating with a diverse group of colleagues from various subspecialties, performing research, and taking in the invigorating energy of a college campus.
But, she said, an academic hospital might not be the right fit for otolaryngologists who want a balanced lifestyle. Dr. West, who covers three UCLA hospitals, often works from 7 a.m. to 7 p.m. and takes call 22 days a month. “At an academic institution, we do long hours,” she said. “And we do extra things like research and teaching residents, all on our own free time beyond our clinical practice. The lifestyle is probably not why you go into academic medicine.”