It's a different world, being in private practice versus in academia.
It's probably one of my biggest challenges here, to learn to operate in a different system.
You don't have time for research (maybe a good thing?). Anything you want to do has to come out of your own time. My work from the lab (2007) just got accepted for publication- I'm thinking that's probably going to me my very last publication, unless I can find time to write papers here.
You get a lot less patient time. Something that I don't quite fancy, but I suppose I've been pampered as a fellow. After all, 60 mins for a consult is probably too much. Here I get 45 mins for a new patient and 30 mins for returns. Some of my colleagues do it in 15 minutes. And if I decide to biopsy a thyroid, I somehow have to squeeze the procedure into my alloted time.
You learn to be real succinct and to the point. And yet to be thorough in your clinical notes. Because you realize that how much you get reimbursed has more to do with how well you document your notes, and not what you actually do. If you spent 60 with a patient but don't chart the details well, you don't get paid fully for what you bill.
And here, pharmaceutical reps are actually welcomed. Coming from WFMC, this was a total opposite. Reps were hardly seen on campus, and sponsored activities and drug samples were big no-no's (no offence to any reps out there). Only because the Mother Ship said so. Here, as much as I think the drug companies are making too much money from my middle-class patients, I've given away more free drug samples in the last month to patients with financial problems than I have ever as a physician. You realize that everything has their place; and it's all a balance.
A mentor once told me how 6 years of residency and fellowship never prepares you for the realities of being in practice. How, while the medicine is the same, it's altogether a different world.