What is Hybrid Practice?
An early career cardiologist has three options to practice medicine: private practice, academic setting or hybrid model. A hybrid model of medical practice is a blend of academic and private practice, in which a practitioner typically works in a community setting while they are affiliated with an academic center locally.
Why Hybrid Practice?
Often, a graduating fellow is torn between choosing a private practice world or pursuing a career in academic medicine. Fellows often have a strong desire to stay in academics, however, a private practice with more flexibility and financial gains may sound more appealing to some. As one starts to pursue their dream job, they understand more about the pros and cons of their career choice and realize what fits them best.
My view: The hybrid practice has allowed me to develop my cardiology career in an academic setting by staying active in teaching and research through a University of Kentucky appointment, while working as a private practitioner at Western Kentucky Heart and Lung Institute. I have been able to pursue my academic goals of teaching fellows, publishing and designing research studies, and participating in multicenter trials. However, balancing between private practice obligations while maintaining research and teaching commitments can be daunting at times. Here are some of the tips that I would like to share as these tips have helped me significantly over the last five years.
1. Planning is Key:
Plan three to four weeks ahead. I use my iPhone calendar to make sure all the meetings and deadlines for that month are in place. I make sure that I am not committing to obligations that I can't follow through with. There is limited availability of staff to assist with planning events and meetings in a hybrid model unlike an academic medical practice, so meticulous planning becomes even more important.
2. Set Your Goals:
The sky is the limit but being realistic is equally important. Setting small, achievable benchmarks is crucial. I set my goals realistically to avoid burnout and fatigue. For example, I joined the American Board of Internal Medicine (ABIM) last year to participate in exam development. I gave myself six months to get comfortable with training and writing questions so that I'm able to meet deadlines in time for my assignments. Since I completed the ABIM task, I have joined the National Lipid Association (NLA) Equality and Diversity Committee with a goal of learning and contributing to the committee efficiently this year.
Multitasking is essential for the success of hybrid medicine practice. Unfortunately, if you're not a multitasker, a hybrid setting could be relentless. Getting "protected" time for teaching, research or any voluntary activities can be nearly impossible. You'll find yourself wearing multiple hats on most days. Prioritizing correctly so that you can meet your goals is very important. I have prioritized my clinical work, but I continue to try my best to keep up with my teaching and research commitments on most days. I also use the clinical time to talk about interesting cases so that trainees are encouraged to write case reports/images/videos for publication. I use my time in between patient encounters to review journal articles.
4. Delegate Work:
Doing everything by yourself would not only be overwhelming but also underproductive at times. Work delegation will help you stay on track. Choose your teams carefully so that you are matching them (mostly trainees) with work that best suits their interest. This will increase productivity and their satisfaction.
5. Stay Informed:
We often start living in our own bubble, especially being in a busy small to medium sized community medical practice. Make sure you stay in touch with at least some of the major national and international activities that suit your interest. I have subscribed to informative emails from the ACC, the American Heart Association, the NLA and the ABIM. This allows me to be aware of multiple opportunities as they become available round the year.
Bottomline: Hybrid practice offers the best of both worlds, private practice and academia. It requires wearing multiple hats, multitasking, and oftentimes working from home on weekends. However, the ability to design your own academic curriculum gives you immense flexibility. The right planning can lead to exceptional productivity and job satisfaction.
This article was authored by Aniruddha Singh, MD, FACC, Western Kentucky Heart and Lung and University of Kentucky College of Medicine.
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