I’m very risk averse and have heard goods things regarding The Integrated Delivery Systems (IDS) benefits, e.g. income guarantee, academic appointment etc. Are there any downsides I should know about?

In an integrated delivery system (IDS), the hospital and its affiliated clinics serve as the hub for care delivery.

IDSs are typically formed around either a teaching hospital or a community hospital system, and the physicians are usually IDS employees. By virtue of its community standing, the IDS offers many benefits, including income guarantee, academic appointment and a good benefits package. The direct access the IDS affords to management services and support personnel can be a plus for physicians just out of residency. For physicians seeking autonomy, IDS employment has its drawbacks, namely the hospital policies and politics that can spark controversies. In addition, some newer IDSs are still learning how to manage physicians, and their learning curve can cause occasional issues.