ACR’s Community Practice Council Supports Independent Practitioners

Forging one’s own path after completing medical training can be daunting. As I entered the final six months of my rheumatology fellowship, I was also pregnant with my first child. Having grown comfortable within academic settings, I felt the nerves of trying to find my place outside medical education.

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For the best interests of my growing family, I limited my job search to a specific geographic region. Academic centers dominated the ACR’s State-of-the-Art Clinical Symposium job fair, but academic medicine did not offer an option that fit with my practice vision. Opportunities with large hospital systems come off as financially enticing, but also came with many red flags.

I distinctly remember a lucrative offer, but was taken aback by the fine print. As the solo rheumatologist for a large metropolitan health center, the contract required me to have a clinic at point A, unless “deemed elsewhere,” in which case I would have to travel to point B or C within a 50-mile radius. In addition to the 8 a.m.–5 p.m. office hours, Monday through Friday, I would be on call during nights and weekends for all three locations. The CEO of the hospital system advised me that he was unsure there was a need for rheumatology and could not guarantee my income after the first year. Six years later, no one has taken this offer.

Time continued to wind down on my fellowship, and the stress of finding a job, paying off medical school loans and becoming a parent was taking a toll. There were multiple rheumatology offices with solo practitioners in the region, but many were not looking to add a partner. Lack of knowledge and resources made the thought of starting my own practice an impossible and lonely task. I still wanted to collaborate and practice with colleagues.

It was through pharmaceutical representatives and non-rheumatologist physician contacts that I was finally introduced to private practice groups looking to add a physician provider. Offers were narrowed based on my predetermined non-negotiables—location, location, schedule flexibility!—and it was with my current practice that I found a supportive team and a place where I could grow as a rheumatologist while also succeeding in my non-medical roles.

Since I joined, our group has expanded to include four physicians and three physician assistants. Our practice prioritizes caring for our community and serves patients from across the state. We are humbled by our patients who drive over six hours to continue their care and happy to see those who live six minutes away or around the corner. Our practice serves individuals who face barriers accessing academic centers.