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Primer on Business of Medicine

Bill Moran, MD, discusses the top priorities for residents when they are considering where to practice.

Bill Moran, MD, discusses the top priorities for residents when they are considering where to practice.

As residents approach completion of their otolaryngology training, they face a big decision. Should they remain in academia or go into private practice? Often, they do not have the tools to evaluate the practice situation that best suits their professional and lifestyle needs.

During a Monday Miniseminar, “The Business of Medicine for Residents and Fellows: Planning for the Future,” several physicians shed light on the many factors that should come into consideration. Lee D. Eisenberg, MD, MPH, who is in private practice at ENT & Allergy Associates, Englewood, NJ, was the moderator. He shared his insights on contract negotiation and advancing one’s practice. Bill Moran, MD, who is retired from his Oklahoma City, OK, otolaryngology practice, noted that a 2015 survey revealed that geographic location and lifestyle are top priorities for medical residents coming out of their final year of training.

After about six years in private practice, Mark K. Wax, MD, switched to academia. A professor of otolaryngology-head and neck surgery and oral maxillofacial surgery at Oregon Health and Science University, Portland, OR, Dr. Wax compared the aspects of working in academia and private practice, including contract negotiation, geographic location, quality of life, call hours, personal time, compensation package, fringe benefits, the roles of management and colleagues, and malpractice insurance.

For example, although a small academic otolaryngology department may not seem conducive to advancement, departments in a hospital and the medical school provide potential to pursue other interests in ancillary locations, such as in information technology and quality assurance, he said.

Dr. Wax also noted that the median salary for an assistant professor starting out is about $285,000 and about $400,000 for a professor, although there is some variability depending on geographic location. Statistics from a 2014 Medical Group Management Association report showed otolaryngologists’ median salaries (not starting) for physician- and hospital-owned practices were $425,000 and $396,000, respectively.

Sonya Malekzadeh, MD, a professor of otolaryngology and director of the residency program at Georgetown University Medical Center, Washington, DC, described some of the practice improvement requirements residents need to fulfill for lifelong learning, including continuing medical education accreditation and Maintenance of Certification. She added that otolaryngologists can access education from AcademyU® offerings, including Annual Meeting lectures, online courses, subscriptions, eBooks, and self-assessment.

Christine B. Franzese, MD, recently moved from Virginia to her position as professor of otolaryngology-head and neck surgery at the University of Missouri-Columbia, and she revealed statistics on how women and men negotiate, noting that gender alone is not a reliable predictor of negotiation performance.

“What is reliable are situational gender cues,” said Dr. Franzese said, adding that a study of MBAs found a 7.6 percent difference in men’s and women’s salaries. The study’s researcher asked respondents if they attempted to negotiate; 7 percent of women did, compared to 57 percent of men. Dr. Franzese said that studies also show that compared to men, women negotiate far less frequently, are not prepared to express what they want, and negotiate better on behalf of others rather than themselves.

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