Name: 醫師職涯大比拼：學術界 vs. 社區 vs. 私人診所 | 哪個最適合你？ (Academic vs Community vs Private Practice | Best Doctor Career)
Uploaded: 2025-11-13T18:01:05.000Z
Duration: 9 min 51 s

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Although your chosen specialty will have a major impact on your paycheck and work life balance, it's not the be all and end all.

雖然你選擇的專科會大大影響你的薪水和工作與生活平衡，但這並非全部。

The setting you choose to work in, whether it's academic, community or private practice, also plays a key role.

你選擇的工作環境，無論是學術、社區還是私人執業，也扮演著關鍵角色。

But what are the differences between these options and how do you know which one is best for you?

但這些選項有什麼不同，你又該如何知道哪個最適合你呢？

Dr. Jubbal medschoolinsiders.com first, let's define each kind of practice.

Dr. Jubbal medschoolinsiders.com 首先，我們來定義各種執業方式。

Academic hospitals are affiliated with medical schools or universities, including and these hospitals require more from you than just clinical practice.

學術醫院附屬於醫學院或大學，這些醫院對你的要求不僅是臨床實踐。

In academic hospitals, you'll also be spending time teaching students and residents and doing research.

在學術醫院，你還會花時間教導學生和住院醫師，並進行研究。

People sometimes use the term community medicine interchangeably with private practice, but

有些人會將社區醫學和私人執業互換使用，但

in reality they're comparing academic to non academic medicine.

事實上，他們是在比較學術與非學術醫學。

In a community hospital, you're employed by the hospital and take on a more clinical role.

在社區醫院，你受僱於醫院，扮演著更偏向臨床的角色。

你可能會有或沒有住院醫師訓練，

the majority of your work will be based in the hospital and its affiliated clinics.

大部分的臨床工作會是在醫院及其附屬診所。

Private practice differs from academic and community hospitals in the sense that you're not employed by the hospital.

私人執業與學術醫院及社區醫院不同之處在於，你不是由醫院僱用。

Instead, you're either starting your own practice or joining a pre existing group, but

相反地，你可能會自己開業，或是加入現有的執業團隊，但是

your practice can still be affiliated with community hospitals.

你的診所仍然可以附屬於社區醫院。

What are the pros and cons of each practice?

這些執業方式各有哪些優缺點呢？

Let's break down the most important factors to consider.

我們來分析一下最重要的考量因素。

Depending on your practice, there are a few differences in the kinds of patients you'll see, and

根據你的執業方式，你遇到的病患類型會有幾種差異，

In community medicine or private practice, straightforward cases will be the bread and butter of your specialty.

在社區醫學或私人執業中，單純的病例將是你的專科的日常。

That's not to say you won't occasionally see difficult cases, but

這不是說你偶爾不會遇到棘手的病例，但

anything too complex will require more specialized care than what your hospital's resources have to offer.

任何太複雜的病例都需要比你醫院資源所能提供的更專業的照護。

Complex patients are usually referred to larger academic centers or where hospitals have more advanced diagnostic tools and specialized physicians specifically trained for these cases.

複雜的病患通常會被轉介到較大的學術中心，或是擁有更先進診斷工具和專門訓練的醫師來處理這些病例的醫院。

Academic medicine allows you to focus on a subset of patients.

學術醫學讓你能夠專注於特定類型的病患。

For example, as an academic rheumatologist, you can do most of your research on lupus and tailor your practice toward treating lupus patients.

例如，身為一位學術風濕科醫師，你可以在大部分的研究中專注於紅斑性狼瘡，並將你的執業方向調整為治療紅斑性狼瘡病患。

You'll become the expert at your hospital and colleagues will start referring their patients to you when more specialized care is needed.

你將成為你醫院裡的專家，當需要更專業的照護時，同事們就會開始將他們的病患轉介給你。

However, this doesn't mean it will all be lupus.

然而，這並不代表你會只處理紅斑性狼瘡。

When you're on service at the hospital, you'll still see a wider variety of patients.

當你在醫院值班時，你還是會看到更多樣化的病患。

On the other hand, in community medicine and private practice, you can expect a little bit of everything.

另一方面，在社區醫學和私人執業中，你會接觸到各種各樣的病患。

The general expectation is that you can confidently treat any disease in your specialty.

一般來說，你應該能自信地治療你專科裡的任何疾病。

The Next big difference is the typical schedule of each practice.

另一個很大的差異是每種執業模式典型的排班。

As an academic physician, your responsibilities extend beyond seeing patients.

身為一位學術醫師，你的職責不只在於看診。

Another major part of the job is teaching students and residents.

工作的另一項主要內容是教學，教導學生和住院醫師。

Some of your time is also reserved for administrative tasks, especially if you're involved in a committee or take on a role as a director or chair.

你也會有一些時間用於行政事務，特別是如果你參與了委員會，或是擔任主任或主席。

If you're interested in research, you may have protected time for studies, but

如果你對研究有興趣，你可能會有一段受保護的時間來進行研究，但

this depends on your career goals and agreement with the university.

這取決於你的職涯目標以及與大學的協議。

Some academic physicians realize they prefer research over seeing patients and ask for more protected time for their projects.

有些學術醫師發現他們比起看診更喜歡研究，並要求更多受保護的時間來進行他們的計畫。

If you're employed in a community hospital, most of your time will be spent on clinical work since there's less teaching and research involved.

如果你在社區醫院工作，你的大部分時間都會花在臨床工作上，因為教學和研究的機會較少。

Even if you decide to work on a committee or take on another administrative role, the majority of your work still revolves around seeing patients.

即使你決定加入委員會或擔任其他行政職務，你的大部分工作仍然圍繞著看診。

This may sound ideal if you aren't particularly enthusiastic about research, but

如果你對研究不是特別熱衷，這聽起來可能很理想，但

clinical work is more intense than the slower paced life of academia.

臨床工作比學術界較慢的生活節奏更為緊湊。

Also, in community hospitals, you may not have residents or fellows to help shoulder the clinical burden of admitting patients and writing notes.

此外，在社區醫院，你可能沒有住院醫師或研究員來分擔收治病人和撰寫病歷的臨床負擔。

Private practice is similar to community hospitals since most of your time is spent seeing patients.

私人執業與社區醫院類似，因為你的大部分時間都花在看診上。

However, the time dedicated to administrative tasks may vary depending on your type of practice.

不過，投入行政事務的時間可能會因你的執業類型而異。

If you're part of a group, there's less administrative burden on you, but

如果你是團體執業的一員，你的行政負擔會比較輕，但

if you're running a solo practice, you're running the show.

如果你經營的是獨立執業，你就是老闆。

This means more of your time will be dedicated to running your day to day operations and administration, such as salaries and budgeting.

這意味著你將有更多時間用於日常營運和行政管理，例如薪水和預算。

Another important difference between practices is your independence and autonomy, which are determined by the nature of your work.

執業方式間的另一個重要差異是你的獨立性和自主性，這取決於你的工作性質。

If you're in academic medicine or a community hospital, you're most likely employed by the hospital.

如果你在學術醫學或社區醫院工作，你很可能受僱於醫院。

When you're in private practice, you're the boss.

如果你是私人執業，你就是老闆。

In private practice, you choose how you run your practice.

在私人執業中，你可以決定如何經營你的診所。

Administrative tasks are also more straightforward.

For example, if you need new equipment, there are no hospital guidelines to delay or deny your request.

例如，如果你需要新設備，沒有醫院的準則會延遲或拒絕你的請求。

You can order whatever you need, plus you don't have to deal with the politics associated with admin or hospital committees.

你可以訂購任何你需要的東西，而且你也不必處理與行政或醫院委員會相關的政治鬥爭。

Private practice doctors also make more money than their employed colleagues, which we'll touch on in a second.

私人執業的醫生收入也比受僱的同事來得高，這我們稍後會再談。

While all of this sounds like a pretty sweet deal, working in private practice is not without its cons, which include increased responsibility and financial risk.

雖然這聽起來是個很棒的選擇，但私人執業並非沒有缺點，包括責任增加和財務風險。

When you're running your own practice, you're responsible for building it up from nothing and making it successful.

當你經營自己的診所時，你必須從零開始建立並讓它成功。

This involves learning how to handle your own billing and marketing, how to properly budget for overhead and staff salaries, and

這包括學習如何處理自己的帳單和行銷，如何妥善規劃營運成本和員工薪資，以及

There's also a much larger financial risk involved.

其中涉及的財務風險也大得多。

Plus, in private practice, your income is dependent on how much you work.

此外，在私人執業中，你的收入取決於你工作多少。

When you have a schedule that doesn't account for vacations or breaks, you're likely to see these breaks as missed opportunities to earn more money.

當你的排班沒有考慮到假期或休息時，你很可能會將這些休息視為錯失賺更多錢的機會。

This increases your risk of burnout and ultimately could lead to a poorer quality of life.

這會增加你倦怠的風險，最終可能導致生活品質下降。

Employed positions, whether in academia or a community hospital, have their pros and cons as well.

受僱的職位，無論是在學術界還是社區醫院，也都有其優缺點。

The pros of being an employee include a more stable income and less responsibility.

成為員工的好處包括收入更穩定，責任更少。

While your income as an employee won't be as high high as private practice, its stability is guaranteed.

雖然身為員工的收入不如私人執業那麼高，但收入穩定是有保障的。

Plus, as an employee, you don't need to be involved in many of the administrative tasks required to run a practice.

此外，身為員工，你不需要處理經營診所所需的許多行政事務。

You also don't have to worry about marketing or budgeting for salaries, enabling you to focus on your specialty.

你也不必擔心行銷或編列薪水預算，這樣你就能專注於你的專科。

While more secure than running your own practice, being an employee is not without its drawbacks.

雖然比自己經營診所來得穩定，但當員工也有其缺點。

The cons of being an employee include politics, less income, and contract based employment.

當員工的缺點包括政治鬥爭、收入較少，以及合約制聘僱。

As an employee, you answer to hospital administration, which may mean not getting your way.

身為員工，你必須聽從醫院行政部門的訓示，這可能意味著你無法隨心所欲。

It's undeniably frustrating to request new equipment and be denied.

要求添購新設備卻被拒絕，這無疑令人沮喪。

You're also only protected for as long as you're under contract.

When your contract ends, you don't have any long term guarantees for what comes next.

當你的合約結束時，你對接下來的發展沒有任何長期保障。

Lastly, let's talk about the differences in pay.

最後，我們來談談薪資的差異。

There are two ways to approach this academic versus Non academic and employed versus Private practice For academics versus non academics.

有兩種方式可以探討，學術與非學術，以及受僱與私人執業。

Physicians in non academic settings can earn as much as $120,000 more a year than their academic colleagues.

在非學術環境下的醫師，年收入可能比學術界的同行多出 12 萬美元。

This is where relative value units or RVUs come into play.

這就是相對價值單位（RVUs）派上用場的地方。

RVUs define the value of a service provided by a doctor relative to all other services and procedures.

RVUs 定義了醫師提供的服務相較於所有其他服務與手術的價值。

It's a complex system that factors in all the different clinical work doctors do, such as appointments, procedures, consults, and

這是一個複雜的系統，考量了醫師所做的各種臨床工作，像是看診、手術、諮詢等等，

The number of clinical tasks required of a physician impacts how they're reimbursed.

醫師所需的臨床任務數量，會影響他們的報酬。

Since academic physicians have non clinical duties such as teaching and research, they less time is available to provide care for patients, which generates fewer RVUs.

由於學術界的醫師有非臨床職責，像是教學和研究，他們能投入於病患照護的時間較少，是以產生的 RVUs 也較少。

The amount of revenue a doctor generates for their hospital is reflected in their pay.

醫師為醫院帶來的收入多寡，會反映在他們的薪水上。

Non academic physicians have more time in the day for clinical tasks, which generates more RVUs for their hospital or private practice.

非學術界的醫師一天有更多時間可以執行臨床任務，這為他們的醫院或私人執業產生更多 RVUs。

Now let's look at employed physicians versus doctors in private practice.

接著我們來看看受僱醫師和私人執業醫師的差異。

Physicians in private practice generally make more money than their employed colleagues.

私人執業的醫師通常比受僱的同事賺更多錢。

In 2022, self employed physicians reported average earnings of $385,000, whereas employed physicians reported $320,000.

2022年，自僱醫師的平均收入為385,000美元，而受僱醫師的平均收入為320,000美元。

There's more than one reason for this salary gap the first and most obvious reason is Employees in any business aren't paid their true value.

薪資差距的原因不只一個，第一個也是最明顯的原因是，任何企業的員工都沒有獲得他們真正的價值。

If businesses, in this case hospitals, are expected to remain sustainable, then they must pay their employees less than their true value to account for administrative costs, overhead, operations and profit.

如果企業，在這裡是指醫院，要能永續經營，就必須支付員工低於其真實價值的薪資，以應付行政費用、營運成本、營運和利潤。

Another reason for this gap is a business owner's ability to adjust their exp if you own your practice, you can increase your revenue by optimizing your medical coding, reducing operating costs, and

另一個造成這種差距的原因是，企業老闆有能力調整他們的開銷，如果你擁有自己的診所，可以透過優化醫療編碼、降低營運成本來增加收入，

Many employed positions, especially in academic hospitals, make you eligible for Public Service Loan Forgiveness, a program that can help you tackle your student loans.

許多受僱職位，尤其是在學術醫院，讓你符合公務人員貸款豁免的資格，這項計畫能幫助你處理學貸。

So while private practice physicians have more opportunities to make significant bank, being employed could mean more money in your wallet early on.

所以，雖然私人執業的醫師有更多機會賺大錢，但受僱可能意味著早期就能賺到更多錢。