a bird in the hand

[GA8314]

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Hello,

So, in essence, I'm nearly a partner in a 70-75% MGMA group. This is W2, not including a very generous benefits package. Work balance is quite good, and a great group of guys. Sure, there are some issues but nothing insurmountable that we can't deal with as professionals.

Here's the rub. I'm just over 6 mo from partner on a 2 year track. But, a >95% MGMA group is talking to me about a 3 year to partner gig. This would have been my dream gig 2 years ago, and indeed I talked to them as a resident but they had no requirements at the time. Now, they have some retirements they are planning for.

They swear they have decided AGAINST a sell out, and I have a good buddy whom is 1 year away from partner at the same firm. He gets a good vibe.

I can't go into details but I'm conflicted. Maybe some will think I'm crazy. The "new" group takes me closer to family, however, but there is risk in a 3 year to partner gig. Not to mention a good gig currently, and better as partner at existing group...

Thoughts?

 

[Hoya11]

Hello,

So, in essence, I'm nearly a partner in a 70-75% MGMA group. This is W2, not including a very generous benefits package. Work balance is quite good, and a great group of guys. Sure, there are some issues but nothing insurmountable that we can't deal with as professionals.

Here's the rub. I'm just over 6 mo from partner on a 2 year track. But, a >95% MGMA group is talking to me about a 3 year to partner gig. This would have been my dream gig 2 years ago, and indeed I talked to them as a resident but they had no requirements at the time. Now, they have some retirements they are planning for.

They swear they have decided AGAINST a sell out, and I have a good buddy whom is 1 year away from partner at the same firm. He gets a good vibe.

I can't go into details but I'm conflicted. Maybe some will think I'm crazy. The "new" group takes me closer to family, however, but there is risk in a 3 year to partner gig. Not to mention a good gig currently, and better as partner at existing group...

Thoughts?

Stay. See what awaits you as partner in your current group. You probably dont have any hard data on what the other groups income actually is/partnership structure, ect to make an informed decision to leave your current decent gig. Believe me a lot of people are unhappy and just surviving at their gig so I would feel lucky you are happy and not rock the happiness boat for a little more money. Who knows maybe once you make partner the 70% group will sell and youll get a piece.

 

[chocomorsel]

Your title speaks for itself. Stay. Times are a changing. And just cuz they aren't willing to sell this year, doesn't mean when approached next year by another AMC with more money they won't change their minds. Doctors are a greedy bunch in case you haven't realized.

 

[Ezekiel2517]

"And for what? For a little bit of money. There's more to life than a little money, you know. Don'tcha know that?"

 

[deleted162650]

I say just stay where you're at. On a completely unrelated note, can you please pm me the contact info for the other group.

 

[Scotty_G]

Yes me to lol

 

[YGK]

I say just stay where you're at. On a completely unrelated note, can you please pm me the contact info for the other group.

 

[YGK]

Pardon my ignorance; what is 75% or 95% MGMA ?

 

[PainDrain]

Pardon my ignorance; what is 75% or 95% MGMA ?

Physician salary data. He is saying his current gig is 70-75th percentile for earnings out of anesthesiologists polled, while the other group is 95th.

 

[k12balla]

Regret it, you will. Stay, you must.

 

[mostwanted]

Hello,

So, in essence, I'm nearly a partner in a 70-75% MGMA group. This is W2, not including a very generous benefits package. Work balance is quite good, and a great group of guys. Sure, there are some issues but nothing insurmountable that we can't deal with as professionals.

Here's the rub. I'm just over 6 mo from partner on a 2 year track. But, a >95% MGMA group is talking to me about a 3 year to partner gig. This would have been my dream gig 2 years ago, and indeed I talked to them as a resident but they had no requirements at the time. Now, they have some retirements they are planning for.

They swear they have decided AGAINST a sell out, and I have a good buddy whom is 1 year away from partner at the same firm. He gets a good vibe.

I can't go into details but I'm conflicted. Maybe some will think I'm crazy. The "new" group takes me closer to family, however, but there is risk in a 3 year to partner gig. Not to mention a good gig currently, and better as partner at existing group...

Thoughts?

There are a number of points to consider:

What is your current non partner salary vs other group's non partner salary?
The actual difference in take home between the two jobs, a difference of $50k, may only be a difference of $30k (depending on Fed/state tax etc)
How do the two groups distributes salary / profits? If any portion is K1, that can significantly increase your take home number
How long will it take to cover the salary deficit of 2.5 yrs, at maximum it shouldn't be more than 3-4 years.
Work hours between the two jobs? How much more time will you actually be able to spend with family?
Is the 95 group closer to a major city? then more likely to be taken over
Number of weeks off?
Percentage of people who make partners etc

I think most likely the salary difference between the two jobs might not be that much after all is said and done and more importantly it will take you at least 7-8 years after starting the partnership track to come ahead with the new gig. If you are financially set, and the new gig will significantly add to your personal satisfaction, you should consider it. Otherwise, stay put.

 

[GA8314]

Stay. See what awaits you as partner in your current group. You probably dont have any hard data on what the other groups income actually is/partnership structure, ect to make an informed decision to leave your current decent gig. Believe me a lot of people are unhappy and just surviving at their gig so I would feel lucky you are happy and not rock the happiness boat for a little more money. Who knows maybe once you make partner the 70% group will sell and youll get a piece.

Does anyone know if a 65-75% gig (I said 70-75% but it's probably 65-75% depending on overlaps of retired guys with adding some day time folks etc) WITH a subsidy is still a target for a buy out? We have a substantial stipend to employ our CRNA's. I always assumed this was a limiting factor in buyouts (but not from being targeted by an underbidding AMC)......

 

[nimbus]

Does anyone know if a 65-75% gig (I said 70-75% but it's probably 65-75% depending on overlaps of retired guys with adding some day time folks etc) WITH a subsidy is still a target for a buy out? We have a substantial stipend to employ our CRNA's. I always assumed this was a limiting factor in buyouts (but not from being targeted by an underbidding AMC)......

Yes. Even below average groups are targets these days.

 

[GA8314]

Yes. Even below average groups are targets these days.

I know they are targets but there seems to be 2 major groups of big AMC players, no? There are the AA/Mednax types, and then there are the Northstar types. Mednax seems to buy groups out, where as Northstar seems to competitively bid against existing PP groups for the contract. I'm sure there's some overlap, but of course this is an important difference.

 

[Man o War]

Hmmm. This is tough, I looked for jobs not too long ago and made a promise to myself I was not going to do a long buy in given my experience (which you have too). 3 years was not acceptable to me, and I turned down a 90th percentile job that was 30 minutes from some family because I just couldn't stomach it. Had there not been good alternatives (which you have too), maybe I would've considered it, but there were. Plus, two different AMCs took over groups in the last few years in that metro area, and I just got a bad feeling about their future there. One group got a buy out, one was a hostile takeover. Not sure of those other circumstances in the market for this new job you're looking at, but I'd be really hesitant in this climate.

 

[GA8314]

Hmmm. This is tough, I looked for jobs not too long ago and made a promise to myself I was not going to do a long buy in given my experience (which you have too). 3 years was not acceptable to me, and I turned down a 90th percentile job that was 30 minutes from some family because I just couldn't stomach it. Had there not been good alternatives (which you have too), maybe I would've considered it, but there were. Plus, two different AMCs took over groups in the last few years in that metro area, and I just got a bad feeling about their future there. One group got a buy out, one was a hostile takeover. Not sure of those other circumstances in the market for this new job you're looking at, but I'd be really hesitant in this climate.

I hear you man. This climate of consolidation is just risky for a partnership track. This group says they talked to Mednax already and have decided that's not the direction they want to go.

My current group is in a different location. Not quite the barbarians at the gates in our market, like the other group. So, given a little over 6 mo to partner and zero (I would know in my group) chatter about a sale gives me a huge sense of relief. My BIGGEST fear was to be on a track and then have the group sell out......

I'm probably answering my own question. But I have it on very good authority that the prospective group makes life changing amounts of money per partner. Greed is powerful, but this may be where wisdom needs to step in.....

 

[Man o War]

How oppressive is the buy in? Also, would they be willing to make you whole on your buy in and/or give you a percentage of the partner buy out if they sell? In my case, the contract also had some oppressive clauses in it that spooked me a bit.

I hear you man. This climate of consolidation is just risky for a partnership track. This group says they talked to Mednax already and have decided that's not the direction they want to go.

My current group is in a different location. Not quite the barbarians at the gates in our market, like the other group. So, given a little over 6 mo to partner and zero (I would know in my group) chatter about a sale gives me a huge sense of relief. My BIGGEST fear was to be on a track and then have the group sell out......

I'm probably answering my own question. But I have it on very good authority that the prospective group makes life changing amounts of money per partner. Greed is powerful, but this may be where wisdom needs to step in.....

 

[turnupthegas]

Could someone post the most recent MGMA data?

 

[GA8314]

How oppressive is the buy in? Also, would they be willing to make you whole on your buy in and/or give you a percentage of the partner buy out if they sell? In my case, the contract also had some oppressive clauses in it that spooked me a bit.

It's not too oppressive from a salary standpoint. It's pretty good. I will also qualify for their SEP IRA plan which is rather generous. I WILL ask them about a % structure if they were to sell during my buy in, but I honestly don't think they will commit to that. But, I will ask for sure.

Worse problems to have. I just don't want to mess up/give up a good gig for the uncertainty of a 3 year track in a market seeing a lot of consolidation at the moment......

 

[Psai]

I would be really pissed if I spent 5 years trying to be partner and didn't make it

 

[pjl]

Make the decision based on lifestyle rather than cash. Which would you pick if salary was equivalent? Does your group make less because you are wasting time at home with your family at night?

 

[Consigliere]

Stay put = smart move
Join other group = you are an asshat

 

[GA8314]

Stay put = smart move
Join other group = you are an asshat

Seriously you may be right but can you please elaborate on your reasoning? Any contrarians?

 

[Mman]

I almost kinda lean towards the other job. You admit it's a better location for you as closer to family and you already have a good friend giving you the inside scoop. The only real argument in favor of the current job is money. More of a sure thing since you are so close to partner. But if the people are just as good at the other job and the location is better for you, well that's a good thing. Only downside is the potential sell out before you'd be partner. But if you would really like the location that might not be the end of the world and you'd always potentially have the ability to go back to your current gig.

Tough decision.

 

[Planktonmd]

At the new job you will be the new guy with everything to prove and zero credit, that alone is a huge disadvantage, also 3 years is a very long time during which you will not have a seat at the table, and if they swear to you that they will not sell out today that promise will have zero value tomorrow.

 

[Direct Laryngoscopy]

You live once. Happiness trumps money. You will not starve. Some of the most successful people take chances instead of doing the status quo.

Weigh what's most important to you and proceed. You'll be ok.

 

[GA8314]

I almost kinda lean towards the other job. You admit it's a better location for you as closer to family and you already have a good friend giving you the inside scoop. The only real argument in favor of the current job is money. More of a sure thing since you are so close to partner. But if the people are just as good at the other job and the location is better for you, well that's a good thing. Only downside is the potential sell out before you'd be partner. But if you would really like the location that might not be the end of the world and you'd always potentially have the ability to go back to your current gig.

Tough decision.

It is a tough decision. The location is better for sure, for lots of reasons. Family being most important to me.

The 3 years is based upon a salary which is not starvation wages, and you are correct, while it would suck to have the rug pulled out from under me during the 3 year risk period, being an employee for such a system would not be the end of the world, especially given some of the geographic advantages........

I've obsessed about partnership in the past, but one can't control what one can't control..... I'm meeting with some other partners within the month. This will be a long courtship and will evolve over time. Perhaps it will be more clear with some additional details....

I appreciate the input everyone.

 

[deleted171991]

If they swear they will not sell to an AMC, have an insurance clause in your contract: if they sell, you get the amount a partner gets multiplied by the proportion of partnership track you have completed. Also put very specific clauses about the reasons they can fire you for. If they won't commit to that, you know they need an employee, not a partner.

I personally would not give up a partnership in hand. 3 years is a very long time.

 

[GA8314]

If they swear they will not sell to an AMC, have an insurance clause in your contract: if they sell, you get the amount a partner gets multiplied by the proportion of partnership track you have completed. Also put very specific clauses about the reasons they can fire you for. If they won't commit to that, you know they need an employee, not a partner.

I personally would not give up a partnership in hand. 3 years is a very long time.

Yeah, like man-o-war stated, I don't think I could stomach another 3 years..... Lots of consolidation going on in that market also, and frankly, the work environment would be probably 1.5 times more stressful (I think) for a lot of reasons....

I think I'm gonna stay put.

I want to sincerely thank those that have put forth their input. I appreciate it.

 

[aneftp]

I would be really pissed if I spent 5 years trying to be partner and didn't make it

Exactly what happened to my sister in all MD practice in mid Atlantic top 5-7 population area in 2003. And it wasn't just one group. A couple of groups in area had 5 year partnerships tracks who screwed the young ones. Each making 120,140,160,180,200k than partly. Partners making 450-500k plus. So the "buy in" was close to 1.5 million. And at the end of 5 years nada.

I wouldn't take do more than a 2 year partnership track in this environment (and better have them out in stipulation that they pay ur malpractice tail if u don't become partner or group sells out). It's a little way to keep them hones (malpractice tail for 2 years of practice is worth around 20-25k). But it will send clear signals to you whether group is serious about you becoming partner or itself selling out.