Thanks.

Well I almost did go academic, but they wouldn't make me the associate program director for my fellowship. A position I invented, and sadly was underqualified for ;). Actually they did come back and sort of offer it to me a little later but I was liking my job too much. As for feeling like a slave, not so much. Geriatrics really isn't very high stress, I don't really have set hours and call is very reasonable. I have a lot of down time which I know I wouldn't have otherwise, but I do miss the intellectual stimualtion a teaching hospital has. Try and touch base with Umber76 since she just went through a very similar decision

Thanks for your input. But what about the concern that with PP, you become a slave to the office/time b/c of the constant thought of cost/profit? Do you miss the meetings/ traveling etc? Do you think of going back to academics and what would draw you back?

I initially was thinking of staying on as staff at the institution I trained at, but the lure of private practice is pretty great. Part of the problem with institutional work is that there are some very heavy demands on your time which exist in a grey zone - so it less likely you'll be compensated for your efforts. However if you love educating and/or research you'll be miserable in private practice. The downside to what I do now is that I don't get to spend time with other docs discussing interesting cases.