Earlier this week, I spoke with our new GBMC colleagues at employee orientation. I gave the opening welcome and talked about the parts of our organization and how they fit together as a community-based system of care. I explained our mission and our values, and how we are owned by the community. I explained to our new people that the Board of Directors are the members of the community who oversee me and the rest of our team in the fulfillment of our mission of health, healing, and hope. I told our new colleagues how the Board held a visioning retreat in late 2010 that created our plan and that we have been implementing this strategic plan ever since. We are now a system that is designed to provide the care that we want for our own loved ones as defined by: the best health outcome and the best care experience, with the least waste of resources and the most joy for those providing the care. I did this because it is important for our new people to be enrolled in this vision as they are beginning their careers with us.
Among the people that I welcomed at orientation was someone who is not a new colleague. He has been with our system for quite some time, but he is moving from the private practice of medicine to employment with GBMC Health Partners. He is Jon E. Simon, MD, a double board-certified physician in Pediatrics and Internal Medicine. He attended medical school at the University of Maryland and completed his residency training at the University of North Carolina Hospitals in Chapel Hill, NC. He has been practicing primary care in Baltimore since 1998 and will now be joining our advanced primary care practice at Hunt Manor.
Given Dr. Simon’s transition from private practice to an employed Health Partners physician, I thought it would be a good idea to get his thoughts on the transition, the joys, and challenges of private or employed practice and to learn why he chose employment with GBMC.
Q: Prior to joining GBMC Health Partners, you owned your practice. What factors led you to switch to employed practice? Are other physicians faced with the same issues and how would you counsel them to proceed?
A: "For years, I have enjoyed my solo private practice, which included seeing patients of all ages, as well as going to the hospital to see newborns and hospitalized adults. I read about so many of my primary care colleagues around the country experiencing burnout, and while I have never felt that in my career, I expect that many changes in healthcare in the next 5-10 years would add excessively to my administrative burden; I was looking for a way to help manage the administrative aspects of practice."
Q: There are positives and negatives associated with being an employed physician and with being in private practice. Can you briefly describe the advantages, disadvantages, and similarities that you see in these roles?
A: "The advantage of a private solo practice was in allowing me to have total control over my schedule, my employee wages, my office setting, etc. If I know that a certain patient needs an hour of my time, I can make that happen. If an unexpected number of patients need same day appointments, I can make that happen. I place a high value on making sure the patients have a good experience (are seen on time, don't feel rushed, get their phone calls returned, get same-day appointments, etc.). As an employed physician, I will need to rely on other people to make all those things happen. At the end of the day, being a primary care pediatrician/internist is about the experience of taking care of patients, regardless of the practice setting. The professional satisfaction comes from that experience in the exam room with the patient."
Q: You’ve just described some of the advantages and disadvantages to employment versus private practice. I’m guessing that ultimately, it's up to the individual physician to decide what they want most. What did you want most and why did you decide to move to employed practice? Moreover, why did you choose GBMC Health Partners?
A: "As a solo pediatrician/internist, I was the only doctor in the office. However, I was also responsible for administering all the immunizations, doing EKG's and spirometry, as well as managing the payroll, accounts payable, laundry, maintenance and repair, and IT support. Those secondary roles have been very gratifying, but that gratification can't last forever! In choosing to return to an employed group practice, I was looking for a way to keep the joyful parts of patient care and to lessen the burden of those secondary roles. I also am looking forward to having my patients benefit from the team-based approach of GBMC Health Partners. I have been on staff at GBMC for 18 years, and I trust the organization and respect the leadership. GBMC was not always skilled at running outpatient practices, but they have improved a great deal, and have committed to and invested resources in primary care practices especially."
Q: The switch from private practice to a salaried position can be a complex decision. There were various factors that you had to consider. Are your colleagues in private practice dealing with the same issues? How might you advise them if they are considering making a similar transition to employed practice?
A: "I can't really address what colleagues are going through, though I suspect that there are very few out there still in private (especially solo practice). For many years, I have noticed that there are few if any physicians younger than myself going into private practice. I am 51 and was still the youngest one I know of."
Q: Whether a physician chooses to be employed or in private practice, what are a few tips you’d share on how to thrive in either work environment?
A: "It is very easy to let the administrative hassles of your job get to you. There is a high degree of physician burnout in primary care, but it doesn't have to be that way. We should all recall that every day we come to work, we will make a difference in somebody's life. For me, whether it is seeing a newborn in the hospital, or helping patients in the office with complex or even simple problems, the patients are grateful to have a physician on whom they can rely. Keeping this basic fact in mind will help us all thrive as physicians, regardless of the practice setting.
Q: What are you looking forward to the most in working for GBMC Health Partners and what will you miss the most in not working in private practice?
A: "I will miss the intimate setting of my small office, the very personal, welcoming venue that allows me to be very close to my patients and close to the business as well. Though it sounds a bit crazy to hear myself say it, at times I enjoy answering the phones, making appointments, and running patient payments through the credit card machine. Having been in solo practice for the last 16 years, I wouldn't exactly say that it was lonely, but I can say that I am really looking forward to working with other physicians at Hunt Manor! There are a few physicians whom I already know and have great respect for, and there are others whom I do not know but am looking forward to getting to know."
I am so grateful to Dr. Simon for his willingness to give us his insights. Please join me in welcoming him in his new role! We are delighted that he is a teammate in our system of care.
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