As the demands on the financial and emotional reserves of practitioners increase, a practice arrangement, such as full-time academic medicine, offers attractive features. Those usually cited include security, immunization from the business aspects of practice, and the opportunity to be as good as one can be.
As an otolaryngologist who left private practice to return to full-time academic medicine, I began to examine what needs academicians have vs those of their counterparts in the private practice community. Several things became quickly evident:
1. The differences between private practice and full-time academic otolaryngology are rapidly becoming blurred. Medicolegal issues, business pressures, and competition are squeezing medical school faculty members as tightly as private practitioners. It appears the problems are the same, though the solutions may differ.
2. What is expected of academic clinicians is changing. Tension is building to "pay as you go." Those clinicians who cannot at least partially subsidize