Since 1990, I have been practicing otolaryngology with an emphasis in otology in the Twin Cities of Minneapolis and St Paul. My time is divided between a private practice and an academic practice. My private practice is with Aspen Medical Group (AMG), which is a division of Allina, a large group with 11 hospitals and 90 clinics. I am the Department of Otolaryngology Chairman, which has 7 providers. My academic practice is with the Department of Otolaryngology at Hennepin County Medical Center (HCMC) where my practice is limited to otology. I am Adjunct Assistant Professor of Otolaryngology and Pediatrics at the University of Minnesota. At HCMC, we have medical students and 3 to 4 ENT residents.
It is very enjoyable to have both practice settings. At HCMC, I am able to teach medical students and residents otologic related issues, and, of course, teach residents how to do major ear surgery. We run multiple rooms so more than one resident can be doing ear surgery at the same time as I staff both rooms. This allows us to perform many ear surgeries, providing a great experience for our residents. The types of cases we do are usually quite complicated and technically demanding, e.g. extensive cholesteatomas, highly sclerotic mastoids, and trauma.
In my private practice, most of what I do is otology, however I also do general ENT and sinus disease. I would estimate about 50% to 75% of my surgeries are major otologic cases. Most of the cases I do in the private setting are more common problems, but I do get plenty of complicated cases.
In private practice, the pace is fast, and things get done quickly. The decisions are made swiftly and without much interaction with peers. Intraoperative decisions are done usually without OR staff having any idea about what is going on. In the academic setting, each patient is typically seen by medical students and residents, and the OR cases are performed by residents. This means that every case is discussed and reviewed, and every significant surgical move in the OR is analyzed and assessed by me. This means more time is required to do the same thing I do in the private setting. This requires patience, empathy, and understanding that the learner needs help. This would seem difficult to do, since in the private setting I don’t need to take this time. However, this has not been my experience. I enjoy seeing residents progress and improve over time, and by the time they’re finished, they’re ready to perform the surgeries on their own as well as run their own clinics successfully.
Overall, I have been fortunate to have the opportunity to do both private and academic practice. Although you make much more money in private practice, academic practice provides much satisfaction in handling very difficult problems and teaching future leaders of our field.
Rex Haberman, MD
Minneapolis & St. Paul, MN