Deciding how to structure your career is one of the most important decisions a physician will make, and it often begins with understanding the different types of medical practice available. Whether you are a resident approaching graduation or an established physician considering a change, choosing among the various types of medical practice shapes your income stability, autonomy, work-life balance, and long-term career trajectory.
This guide outlines the main types of medical practice in Canada, including group practice, associations, partnerships, solo practice, hospital-based employment, and locum work, so you can make an informed decision about which model fits your goals.
Why Understanding Types of Medical Practice Matters
Before signing a contract or opening a clinic, it is worth taking time to evaluate the different types of medical practice, since each model carries distinct implications for income, liability, autonomy, and administrative responsibility. Many physicians choose a practice structure based on what is common in their specialty or region, without fully considering whether it aligns with their personal and professional priorities.
Some physicians prioritize stability and a predictable schedule, while others value the independence of running their own clinic, even if that means taking on more administrative responsibility. Understanding the practical differences between each option allows physicians to make a more deliberate choice rather than defaulting to whatever arrangement happens to be most readily available after training.
Group Practice
Group practice is one of the most common types of medical practice, particularly among physicians who value collaboration and shared resources. In this model, two or more physicians, whether practicing the same specialty or different ones, provide care within the same facility.
Group practice offers several advantages, including opportunities for collaboration, cross coverage during vacations or illness, and the ability to refer patients to colleagues within the same practice when needed. Work and staffing resources are typically shared among the group, including the administrative responsibilities involved in running the practice. This shared structure can reduce the individual burden of managing a clinic while still allowing physicians to maintain a degree of independence in their clinical work.
Associations and Partnerships
Associations and partnerships represent two related but distinct types of medical practice, both involving multiple physicians sharing a workspace, though they differ significantly in how liability and income are handled.
In an association, physicians enter a legal agreement specifying how expenses will be shared among the group. These shared expenses can range from simply splitting the cost of rent and a waiting room to sharing the full range of costs associated with running a practice, including staff salaries, equipment, medical supplies, and office resources. Importantly, associates do not share income and are not professionally or legally liable to one another. Each physician manages their own clinical schedule independently, even while sharing physical space and certain operational costs.
Partnerships function similarly to associations in terms of shared expenses, but with one key difference: in a partnership, income, personal liability, and medical liability are also shared among the partners. This means that partners have a deeper level of financial and legal interdependence compared to an association, making trust and clear contractual agreements especially important when entering this type of arrangement.
Solo or Private Practice
Solo or private practice involves a single physician working independently, without partners or associates sharing the clinical or financial responsibilities of the practice. This model typically comes with a smaller patient roster and a relatively small support staff compared to larger group settings.
Solo practice is often more common in suburban or rural areas, where the demand for healthcare services may not support a larger group structure, or where physicians prefer the autonomy of managing their own clinic without the complexities of shared decision-making. While this model offers significant independence, it also places the full administrative and financial burden of running a practice on a single physician.
Hospital-Based Employment
Hospital-based employment is another widely chosen option among the various types of medical practice, particularly for physicians who prioritize income stability and a structured work environment. Physicians employed by hospitals can generally count on a stable income and predictable work schedule, a benefit that proved especially valuable during the pandemic, when many smaller independent practices were forced to close due to financial strain.
Hospital-based physicians typically benefit from a regular patient base, a strong referral network, and access to greater institutional resources compared to smaller independent practices. Additionally, the administrative side of running a practice is largely carried by the hospital itself, allowing physicians to focus their time and energy on clinical care rather than business operations. This structure also generally reduces a physician’s personal exposure to legal liability compared to independent practice models.
That said, hospital-based employment may come with less freedom and autonomy compared to other types of medical practice, since physicians must operate within specific hospital standards, policies, and administrative requirements.
Locum Work
Locum positions offer a more flexible alternative among the types of medical practice available to Canadian physicians. In this arrangement, physicians relocate temporarily to areas or facilities experiencing significant healthcare staffing needs, filling in for permanent physicians or covering gaps in care.
Locum work often offers higher pay compared to permanent positions, along with flexible scheduling that allows physicians to choose where and when they want to work. This flexibility makes locum work particularly appealing to early-career physicians within their first five years of practice, as well as physicians nearing retirement who want to scale back their workload while still practicing medicine. However, locum positions are inherently temporary and may not provide the same income stability or long-term professional relationships found in other types of medical practice.
Choosing the Right Practice Model for Your Career
There is no single best option among the various types of medical practice. The right choice depends on a physician’s personal priorities, financial goals, specialty, and stage of career. A new graduate with significant student debt may prioritize the income stability of hospital-based employment, while a more established physician may prefer the autonomy of solo practice or the collaborative environment of a group practice.
Physicians should also consider how much administrative responsibility they are willing to take on, since solo practice and partnerships generally require significantly more involvement in business operations compared to hospital employment or locum work. Taking time to honestly assess personal preferences around autonomy, liability, income predictability, and work-life balance can help guide this important decision.
Getting Professional Guidance When Setting Up Your Practice
Given the financial and legal complexity involved in choosing among the different types of medical practice, many physicians benefit from working with a medical consultant who understands the practical realities of medical practice structures in Canada. A medical consultant can help physicians evaluate contracts, understand liability implications, and compare the long-term financial outcomes of different practice models.
Beyond individual guidance, healthcare consulting has become an increasingly valuable resource for physicians navigating practice setup decisions, particularly as healthcare delivery models continue to evolve. A healthcare consultant with experience across multiple practice types can offer insight into emerging trends, regional differences in healthcare demand, and the operational considerations involved in setting up a new practice from scratch.
Physicians may also benefit from connecting with a medical consultant network, which often includes professionals experienced in advising physicians on practice structure, financial planning, and career strategy. These networks can provide trusted referrals and resources tailored specifically to the needs of physicians navigating major career decisions.
Final Thoughts
Understanding the full range of types of medical practice, from group practice and associations to partnerships, solo practice, hospital-based employment, and locum work, is an essential first step for any physician planning the next stage of their career. Each model carries distinct advantages and tradeoffs related to income, autonomy, liability, and administrative responsibility.
In the next part of this series, we will explore the practical steps involved in setting up a medical practice once you have chosen the model that best fits your goals. In the meantime, physicians considering this decision are encouraged to carefully weigh their personal and professional priorities before committing to a particular practice structure.
If you are looking to connect with experienced medical consultants or explore physician-focused consulting support, MDconsultants offers a trusted network of medical professionals ready to help.
