Dreams of Opening a Solo Practice Dwindling Says Survey of Future Docs

Only 10% of current medical students aspire to open up shop as a solo practitioner—a 50% drop since 2008. Last year, 17% of students surveyed said that solo practice was a consideration after graduation. On the other hand, those students who anticipate seeking employment with a large group practice or hospital has risen to 73%, as compared with 70% last year.

Results of a survey conducted by athenahealth and Epocrates indicate that balancing work-life issues is a factor in students’ decisions, as well as a work environment free of administrative burden. Another highlight from the survey is that 60% of current students indicate a dissatisfaction with the instruction they receive related to practice management and ownership, as well as a lack of training for billing and coding.

Additionally, the survey found that 65% of medical students felt they don’t know enough about accountable care organizations (ACOs), down from 72% in the previous year, with 39% unsure about the purpose or structure of ACOs.

For many current medical students, medical training revolves around hospital activities so the findings are not entirely surprising. The current system provides few incentives to pursue private practice.

"Training is structured around group and hospital settings, so the average student learns nothing about running a practice,” said Arvind Ravinutala, a third-year student at the University of Southern California School of Medicine.

The survey also focused on care coordination issues, noting that 96% of students believe that to deliver high-quality care, collaboration with extended care teams is very important. This includes registered nurses, physician assistants, specialists, and medical staff.

Conversely, 60% of medical students identified the lack of communication between care teams as a signficant obstacle to effective coordination. Inadequate cross-team communication was identified as a concen by 75% of students. There was some hope, however, that interoperability between electronic health record (EHR) systems could reduce the fragmentation of care within the next 10 years.

Michael Douglas, a third-year student at Loma Linda University of Medicine in California, is concerned by the absence of adequate technology to bridge the communication gap. "Communication tools are broken or antiquated, and this impedes our ability to provide continuity of care for patients. Despite a clear need for quick, efficient, and secure ways to communicate with and across teams, we're still stuck in the 90's using archaic paging systems and fax machines."

The ninth annual survey involved 1462 medical students who were surveyed between August and September.