Some rheumatologists find that an option other than working in a private practice makes the most sense for them. The reasons rheumatologists choose hospital or academic employment vary.
When Lisa Criscione-Schreiber, MD, MEd, associate professor of medicine and rheumatology training program director, Duke University, Durham, N.C., was finishing her fellowship in 2003, she chose to stay in an academic setting. She wanted to teach and remain in an environment where she would be surrounded by physicians who, as teachers and researchers themselves, would stay at the forefront of advances in rheumatology. “This would push me to keep my medical knowledge current and comprehensive,” she says.
At the time, Dr. Criscione-Schreiber was primarily planning to have a clinical career and considered working in private practice. “But the [practice] I liked the best was in a rural area, and there weren’t any employment opportunities for my husband, so we chose to stay where we both had opportunities,” she says. “Additionally, the local private practice I was considering was not able to offer guaranteed salary or leave opportunities. Because I didn’t have children yet, I made a partially economic decision to stay at Duke, where I would have benefits, such as a set salary, coverage for malpractice insurance and paid maternity leave.”
David Fernandez, MD, PhD, rheumatologist, Hospital for Special Surgery (HSS), New York, chose hospital employment because he wanted the opportunity to participate in basic and translational research. He appreciates having a wealth of established investigators and clinical colleagues at hand, and a large and diverse patient population.
Like others, Laura B. Hughes, MD, MSPH, associate professor of medicine, University of Alabama at Birmingham, chose an academic, hospital-based practice for the research prospects, in addition to mentoring and teaching opportunities—both didactic and in the clinical setting. The opportunities offered by the university for collaboration, both in clinical care and research, were advantageous, as were having a variety of daily tasks and minimal administrative duties. She says the many positive aspects counter-balanced the lower salary offered in an academic setting than she would have earned in private practice.
Because his profession is in pediatric rheumatology, Matthew Stoll, MD, PhD, MSCS, associate professor in pediatric rheumatology, University of Alabama at Birmingham School of Medicine and Children’s of Alabama, chose to work in a hospital-based setting, in part, because he observed that it was most common for pediatric rheumatologists to work there.