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Choosing the right practice environment is arguably the most pivotal decision a physician makes—one that often extends far beyond the scope of formal training. A new series from the American Medical Association, titled “Finding My Place in Medicine,” offers invaluable perspectives from physicians across diverse settings, aiming to guide those transitioning into practice or considering a career shift.
The AMA initiative profiles physicians in private practice, academic medical centers, community hospitals, and large health systems, highlighting the influence of personal values, mentorship, and patient needs on career fulfillment. The series provides a framework for residents and practicing physicians to refine their priorities, identify potential pitfalls, and ultimately align their skills and purpose with the ideal practice setting.
The Allure of Established Systems
For some, the stability and resources of larger organizations prove decisive. Dr. Abdelghani, practicing thoracic surgery for 13 years with Ochsner Health in Covington, Louisiana, cited the organization’s “outstanding reputation for delivering high-quality care, its investment in the latest technology and the stability of its hospital system” as key factors in her decision. She also emphasized the importance of “leadership opportunities, an attractive compensation model and a physician-led structure.” Ochsner Health is a member of the AMA Health System Member Program, which provides resources to support medical leadership and care teams.
Similarly, Dr. Alex, a thoracic surgeon at Rush University System for Health in Chicago, prioritized location—both professionally and personally. “I wanted a location that would not only be important for my career but my husband’s as well,” she explained. “Being in a major city afforded both of us that opportunity.” Beyond career considerations, Dr. Alex underscored the significance of proximity to family and friends, noting that a strong support network is “invaluable” for physicians working demanding schedules. Rush University System for Health is also part of the AMA Health System Member Program.
The Pursuit of Autonomy in Private Practice
While established systems offer security, others prioritize the independence afforded by private practice. Dr. Bhatnagar, of Frederick Primary Care Associates in Maryland, transitioned to private practice after experiencing increasing interference from hospital systems. “Hospital systems were increasingly intruding on my practice of medicine by controlling my workflow and schedules—without providing clear information on quality metrics,” she stated. “The productivity bonuses were vague and subject to change at their discretion.” Maintaining physician autonomy was paramount, leading her to seek a practice where she could retain greater control over her work. Her practice is a member of Privia Health, also part of the AMA Health System Member Program.
Culture and Long-Term Vision
For physicians with established careers, organizational culture can be a defining factor. A physician executive with 34 years of experience, currently serving as the chief physician executive for Advocate Health, found a thriving environment early in her career. “During my residency, I was able to work not only with our faculty but also with the practices and physicians within the community,” she recalled. “It became evident very early on that the culture they were developing was one where I knew I could thrive. People worked exceptionally well together and were always willing to lend a hand to help.” Advocate Health was formed through the merger of Atrium Health and Advocate Aurora Health and is also part of the AMA Health System Member Program.
The Freedom to Design
The desire for complete control and creative freedom can lead physicians to establish solo practices. Dr. Tyroch, owner of Intellimedicine in El Paso, Texas, and a practitioner for over 30 years, described the process of designing her practice as “so exciting.” She likened it to building a home, where “every single design detail is by your choice. Your imagination, vision and dreams become reality at this point.”
As physicians navigate these complex decisions, the AMA offers resources to support their journey. Residents and fellows can access a “cheat sheet” to aid in their job search, and the AMA’s Transitioning to Practice series provides guidance on contract negotiation, work-life balance, and the nuances of starting a practice—including private practice. Ultimately, the “Finding My Place in Medicine” series underscores that a fulfilling medical career is not solely defined by clinical expertise, but by a thoughtful alignment of personal and professional values within the right practice environment.
