Reasons to Work at a Hospital


Is employment with a hospital the right fit for your endocrinology career?

As an endocrinologist, you may find yourself having to choose between employment with a hospital or a private practice. For Ageliki Valsamis, DO, endocrinologist, Northwell Health, Great Neck, NY, joining the health system was an easy choice because it has an academic program. “It was a great opportunity to gain teaching experience and participate in scholarly activities,” she says.

In addition, Dr. Valsamis appreciates having a large network of other specialists and colleagues at hand. “I can refer a patient in a timely manner or discuss a case about a mutual patient,” she says. “I think the overall care is better for the patient; it’s more comprehensive.”

And, because all physicians at the health system use the same electronic medical record system, communication is much easier. “When I worked in private practice, trying to reach another physician by phone was difficult at times,” Dr. Valsamis says. Furthermore, by having a laboratory station at the facility, it’s more convenient and less time consuming for patients.

Northwell Health gives patients an opportunity to complete Press Ganey patient satisfaction surveys. Dr. Valsamis gets access to these reports every month. “It’s rewarding to hear patients’ feedback,” she says. “In private practice, we didn’t have the capability to send out surveys and get patient feedback.”

Marilyn Tan, MD, clinical assistant professor of medicine/endocrinology, Stanford Health Care, Stanford, CA, also chose hospital employment because she desired an academic environment. “I enjoy the mix of inpatient and outpatient clinical work,” she says. “There are more research opportunities (i.e., collaboration with other physicians and researchers, clinical trials). In addition, I like teaching and working with residents, fellows, and students.”

She also feels that a hospital setting offers more support in a variety of areas, including billing, financial assistance, social work, and nursing. And, like Dr. Valsamis, she values being able to see other providers’ notes on the same electronic medical record. “I can easily communicate with other physicians through messages, routing clinic notes, joint conferences, tumor boards, and so forth. This results in better patient care,” she says.

A Few Downsides

While working for a hospital has a lot of perks, there are few challenges. When Dr. Valsamis worked in private practice, it was easier to express concerns and she seemed to have more influence in getting changes made. “You go through a smaller chain of command to get your voice heard,” she says. “At a hospital, you are one of many physicians and your input may not be valued as much. Having a good relationship with your division head is integral to getting your voice heard.”

Dr. Tan concurs. “In any large system, it’s more difficult to get things changed because there are many layers of people involved. I would encourage physicians to actively participate in meetings and committees if they’re interested in getting changes implemented.”

A Piece of Advice

For endocrinologists debating which type of employment to pursue, Dr. Valsamis would encourage those with an interest in teaching to choose a hospital-based practice. “In private practice, it’s more challenging to keep up to date with the latest literature and publications. Here, I have the opportunity to participate in scholarly activities, which helps me to stay current,” she says.

If you decide on hospital employment, Dr. Tan suggests exploring various options, as hospital operations vary significantly.

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