Advanced Provider Employment Models: How Do I Find the Right Fit?

Cyndy Flores , PA-C

Director of Strategy and Innovation, Advanced Providers

Published April 30, 2019

The demand for advanced providers in hospitals and health systems continues to grow. As a job seeker or early career advanced provider, it’s never too soon to start thinking about your professional growth.

You have a wealth of opportunities to consider as you plan your career path. Beyond location and salary, one very important consideration is cultural fit.

I’ve seen the importance of a good work environment firsthand. As the Director of Advanced Provider Strategy and Innovation at Vituity, I’ve been responsible for the success and growth of a variety of care team models. Within just a few years, our advanced provider practice has grown from 80 providers to almost 1,300.

In my own clinical practice, the culture of support and respect has enabled me to express my opinions and contribute ideas to improve our hospital site.

As you consider your first job (or next move), there are a number of employment models to evaluate. While one approach isn’t necessarily better than another, each offers a culture that may suit some advanced providers better than others.

Here are four common employment models that advanced providers should understand:

1. Hospital Employment

Hospital employment typically includes a competitive, guaranteed salary; clearly defined benefits; and predictable schedules and workloads. Annual bonuses based on patient satisfaction and quality measures are also sometimes available.

By choosing hospital employment, advanced providers have the ability to focus on practicing medicine rather than handling the administrative burden associated with small independent practices or contract work.

Although it’s a common model, hospital employment does have potential drawbacks. For one, hospital-employed providers don’t have much autonomy in their jobs. A lot of directives that affect your practice as an advanced provider come from the top down.

This lack of autonomy can stifle leadership and engagement and lead some providers to do just enough to get the job done.

2. Corporate Employment

A number of companies across the country manage physicians and advanced providers for hospitals. Some specialize in a single service line, such as emergency medicine, while others offer multiple service lines.

These companies often tout proprietary technologies and best practices for improving quality and patient experience metrics. They also relieve hospitals of the significant burden of recruiting, staffing, and scheduling clinicians.

For advanced providers, employment by a management company has many of the same perks as hospital employment, including predictable schedules and benefits.

While many advanced providers find satisfying careers with management companies, others find the culture at odds with their desire to focus on delivering great patient care. In a corporate environment, the first responsibility is to the shareholders’ profits, not to providers’ personal missions to help and heal others.

Like their hospital-employed colleagues, advanced providers employed by corporate management companies typically have little voice in practice matters. Often, the top clinical leaders at a corporate management company oversee a large number of advanced providers and practice locations and lack the time and resources to offer meaningful support.

3. Independent Contracting

Another option for advanced providers (albeit a less common one) is self-employment. Some advanced providers choose to work with hospitals and management companies as independent contractors.

There are pros and cons to this arrangement. An independent contracting advanced provider has the freedom to decide how often to work and when to take vacation. They can even work a second job to increase earnings.

Independent contracting isn't for everyone, though. Contracting relationships tend to be shorter and more tenuous, so these advanced providers generally don’t have a say in how the practice is run and may be left out of important decisions that affect their work. Contractors also do not receive insurance and other benefits from the practice.

4. Working With an Independent Physician Group

Many independent physician groups employ advanced providers as part of the care team.

These groups come in all sizes, governance structures, and specialties. But generally speaking, providers in independent groups enjoy more practice autonomy than their employed colleagues. In many groups, advanced providers are part of the decision-making.

Working within a partnership model

Partnerships are a type of independent group in which all physicians have the opportunity to become owners. Because of the shared ownership, partnerships encourage a sense of shared responsibility for success and tend to incentivize a high level of engagement and innovation.

So, how do advanced providers fit into a partnership model?

At Vituity, the physicians are owners, while the advanced providers are nonexempt employees. However, the values of the organization are such that everyone has a voice in the practice.

Advanced providers collaborate closely with physician colleagues while also enjoying autonomy to manage patients. They're encouraged to join committees, pursue other leadership opportunities, and provide input in practice decisions.

It’s important to keep good providers in the organization through professional development opportunities. At Vituity, advanced providers have access to free clinical and leadership education. They also have the ability to explore career opportunities across different practices lines and in more than 250 locations across the country.

While working for an independent group or partnership has many advantages, it's not for everyone. Some advanced providers just want to focus on clinical care and leave running the practice and hospital to others. And that's okay.

But for advanced providers who want to be engaged in their group and hospital, as well as decisions affecting patient care, the partnership model is a great fit.

Finding the Right Fit

As you consider these different employment models, keep in mind that there's plenty of variation within each. Regardless of which model you choose, make sure you’re going to be treated fairly and as an important member of the team.

Assess whether you will have the support you need to grow and flourish in your role. Ask yourself whether you want the responsibility to use your voice in your practice and be in control of your destiny.

The bottom line: finding an organization that’s a good cultural fit leads to greater job satisfaction and success.

To learn more about Vituity’s physician-owned Partnership model, visit our website.

Originally published December 25, 2017. Last updated April 30, 2019.

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