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Career Advice Needed

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Hello all, sorry if this post is slightly off-topic in that IMP is

just one career option I am considering. I've been in internal

medicine practice now for 4.5 yrs total (first 2 in a larger 6 doc

group, last 2.5 in a smaller 3 doc group). I just left the last group

after the older doc wanted a ridiculous amount of money to buy him

out. I've looked around for other practice opportunities but in the

last few months I've only found 2 others which primarily consist of

inpatient/nursing home work without much outpatient/office. I like

the outpatient work for the continuity of relationships, but don't

like nursing home work as much for the amount of phone calls it generates.

So I feel like I am at a crossroads now. Should I try to wait it out

until an opportunity that has more outpatient work comes along? This

would entail then some period of unemployment which I can handle

financially but might look bad to future employers(?) Or should I

take one of the present positions with the thinking that it would just

be temporary for the next 1-2 years until the economy improves and/or

we get some health care reform after which I might start my own

practice. The idea of starting my own practice is attractive for the

independence aspect, avoiding the feeling that you are on a hamster

wheel trying to keep as productive as everyone else in the group

(particularly in groups where revenue is divided evenly). Also, I

don't mind the business aspect even though I'm sure there would be a

lot to learn. On the other hand, starting my own practice would be

risky in that I live in Northern NJ which might be considered a dead

zone that is saturated with PMD's already. (I currently don't have

the option to move due to my wife's job.) In addition, I've come to

realize that I don't exactly have the magnetic personality that draws

patients in droves (in addition to the disadvantage of being male).

The low overhead model of practice would be attractive in that I might

not necessarily need to see 20 or more patients a day to make a living.

So...I'm not sure what to do at this point. If anyone has any

thoughts, suggestions or words of advice it would be greatly appreciated.

-

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