Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Combining academic medicine and private practice: a success story

Francisco M. Torres, MD
Physician
February 26, 2023
Share
Tweet
Share

In the United States, physicians are typically categorized as either academics or private practitioners. However, a case can be made that it is possible to construct a career path that incorporates both professional avenues. I was put in an excellent position to realize this during my fellowship at LSU, which structured some parts of its community medicine program in a way that resembled private practice.

I enjoyed my experience as a hospital and clinical fellow. After my fellowship ended, my love affair with academic medicine quickly soured. My director was a rheumatologist, and physical medicine operated under the umbrella of internal medicine at LSU. We were expected to make grand rounds of presentations to some of the world’s leading experts. Impressing these experts was the bar for success.

One day, I was assigned to conduct grand rounds by my director. I was still very self-conscious about my accent when speaking English at the time. Moreover, I was actively struggling with panic and anxiety disorders stemming from a major past trauma that I had not yet learned to treat successfully.

The result was that I stood before the prestigious audience at grand rounds with my heart pounding and my voice, legs, and hands shaking. To make things worse, some doctors who had written the textbooks I studied in medical school were in the audience. I felt wildly unprepared to teach them anything new, and afterward, I had the sense that I rushed through my presentation just to be done with it. Of course, I was magnifying in my mind what had actually taken place.

But, encounters like this can have a powerful effect on a new doctor or professor’s self-esteem. I felt I failed my director in one of my most important duties as an assistant professor. Later, the medical school dean found me and congratulated me on doing an “excellent job” on grand rounds. I am unsure if I did better than I thought or if he said this to shore up my confidence.

This anecdote exemplifies the pressure academic medicine can place on doctors. However, there were other conflicts. Additionally, I was not overly fond of the competitive environment of academia, which at times felt like backstabbing. I was aware by this point that competition to publish papers and bring in grant money was so fierce that senior professors often claimed credit for their assistants’ work. New research ideas were commonly kept tightly under wraps for fear of being “scooped” by someone who might procure grant money to fund the research before you did. I saw the pernicious effects of “publish or perish” in full display.

Some people thrive on this type of competition, but none of this suited my personality. So, after a few years as an assistant professor, I moved into private practice.

Private practice, of course, came with its own set of challenges. It was now entirely up to me to bring in my salary, and any lawsuits filed would also be my responsibility rather than falling on the School of Medicine’s shoulders. I found myself working more hours with less support. But the pressure to publish and compete with other doctors for publications and grant funding was gone. So I was happy.

Still, I missed a part of academic medicine, and that was teaching students and residents. I had taken pride and pleasure in teaching Fellows the way I had once been taught myself. I decided to do something many few other doctors were doing. I created a private practice fellowship program. In this way, I could give opportunities to young doctors, just as a life-changing fellowship opportunity had once been given to me. For a time, my students and I even worked to conduct on-site research and publish articles.

My students saw what it was to work in private practice medicine and learned that it was possible to incorporate some elements of academic medicine while doing so. This was both exciting and fulfilling to me. I had found a best-of-both-worlds scenario.

Some people thrive in the environment of academic medicine. Others are born for private practice. But for those who aren’t satisfied, remember that you can blaze your career path as a doctor. It is often possible to build a career path incorporating both aspects.

After all, as a doctor, you are the only genuinely essential requirement for the practice of medicine to happen.

I hope that cultural progress in academic medicine will alleviate some of the burdens of “publish or perish” and create a more supportive, collaborative atmosphere where research can happen with the principal focus on advancing knowledge. This may be a panacea. But, while the logic of incentivizing research publications and grant funding makes sense, we all know of the problems in academic publishing and grant funding that can sometimes create a divide between the most medically-essential questions and the most well-funded and well-published topics. The assumption that seminal scientific publications can only be done independently in an academic environment is incorrect. The private practice offers experience, resources, and infrastructure that can enable basic research to be carried out with the proper guardrails and compliance expectations supporting it.

ADVERTISEMENT

That is a complex and weighty issue for the medical community and colleagues in academic publishing and grant funding to tackle. But for today’s physicians and medical students, remember that alternative and innovative paths are always available to you in your career. These hybrid approaches could accelerate the advances in medical research and understanding. Ultimately, it is up to you to define your career and life direction. What is critical is to understand clearly what is important, relevant, significant, and rewarding to you.

Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness. 

Prev

Why your intuition is key to better physical and emotional health

February 26, 2023 Kevin 1
…
Next

The pebble versus the rock: a case for mental health reform

February 26, 2023 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
Why your intuition is key to better physical and emotional health
Next Post >
The pebble versus the rock: a case for mental health reform

ADVERTISEMENT

More by Francisco M. Torres, MD

  • What prostate cancer taught this physician about being a patient

    Francisco M. Torres, MD
  • A philosophical shift: the doctor’s journey into the role of patient

    Francisco M. Torres, MD
  • The key to longevity: fitness, mindset, and nutrition

    Francisco M. Torres, MD

Related Posts

  • How social media can advance humanism in medicine

    Pooja Lakshmin, MD
  • Translating social justice into meaningful change for underrepresented minorities in academic medicine

    Keila Lopez, MD, MPH and Jean Raphael, MD, MPH
  • The effects of the nationwide stimulant shortage on a private psychiatry practice

    Christine Tran-Boynes, DO
  • Why academic medicine needs to value physician contributions to online platforms

    Ariela L. Marshall, MD
  • The difference between learning medicine and doing medicine

    Steven Zhang, MD
  • 42 ways to advance racial equity in academic medicine

    Sylk Sotto, EdD, MPS, MBA, Jada Bussey-Jones, MD, Inginia Genao, MD, Maria Maldonado, MD, Kimberly D. Manning, MD, and Francisco A. Moreno, MD

More in Physician

  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...