What and where is the 'ideal' medical practice? Is it a solo, group, or hospital based setting? Is it a government position, or a federally qualified medical clinic?
The answer is "It is in the eyes of the beholder". Like a valuable family heirloom it is a treasured asset, not defined by assets, or market value.
For some practiioners it may be independence, creativity, flexibility, self initiative, and freedom for independent decision making. Contolling your own schedule is an important factor for many solo doctors. Others may hold freedom from administrative duties, collegial interactions, the economic power of a group credit worthiness, or belonging to a larger institution with a standing reputation and/or receiving referrals from within the group itself.
Many disruptions have been caused by government interference, HMOs and insurance companies.
Innovative organizations such as accountable care organizations, PQRS, and health reform such as the Affordable Care Act create confusion, and contribute to increasing cost which is counter to the perceived goals of improving quality and the cost of healthcare.
Jean Antonucci M.D. describes her IMP in the video
John Brady M.D. talks about how the IMP model not only benefits his patients but drives his joy in practice and hope for the future of primary care. Dr. Brady questions if he can continue his practice model, a common concertn for IMPs.
Choosing your medical practice model begins in medical school or training. It may be effected by a mentor, or a practice setting in which a trainee works. There may be an economic incentive with rewards such as loan forgiveness, lifestyle, or geographic location.
Preparation for each of these goals begins in training. Independent medical practice requires additional preparation in business and administration as well as organizational abililties.
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