Anesthesia partnership track and group buy out

[vman]

I have the possibility of joining an Anesthesiology group with a partnership track. Given that many groups are selling themselves or being bought out by corporations I am concerned that if a sale were to happen before I become partner I would be left with nothing.
Can I have a clause in the contract that stipulates I be paid a certain percentage of what a full partner would be paid in the event of a buy out?
Do contracts ever specify the details of becoming a partner?

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[Mman]

you can have whatever sort of clause in a contract you want. You just need to get them to agree to it.

How long is the partnership track? 2 years? 3 years? If it's 3 years, perhaps you suggest that during your first 12 months of employment if they sell out you get 33% and months 13-24 you get 66% and months 25 and on you get full 100%.

 

[caligas]

If they refuse such a clause you have to question their intent. Seems like if they have no plans to sell out they would do it. They may be reluctant because its not been done in the past?This is new territory in our world to be sure. You will need the help of a lawyer experienced in doctor contracts.

 

[countingdays]

you can have whatever sort of clause in a contract you want. You just need to get them to agree to it.

How long is the partnership track? 2 years? 3 years? If it's 3 years, perhaps you suggest that during your first 12 months of employment if they sell out you get 33% and months 13-24 you get 66% and months 25 and on you get full 100%.

I'd try to get something like this. The downside is that it gives them a big incentive to fire you before the sale is final so that they can keep your share.

 

[nimbus]

I doubt you will get any group to agree to this. The entire point of a partnership track is to deny you the rights, benefits, and risks of partnership until you actually become a partner. And a payout upon the sale of a practice is one of the most valuable perks of partnership.

My group has a boilerplate contract. No modifications, no exceptions.

 

[caligas]

Nimbus is right, they wont agree, despite the fact that its the ethical thing to do to give a new person some legal assurance that they wont get skrewed. But they probably wont do it because they know they might skrew you.

 

[cognitus]

I doubt you will get any group to agree to this. The entire point of a partnership track is to deny you the rights, benefits, and risks of partnership until you actually become a partner. And a payout upon the sale of a practice is one of the most valuable perks of partnership.

My group has a boilerplate contract. No modifications, no exceptions.

With that being said, would you join the PP in this climate where consolidation is frequent? Sounds risky. Are there any questions you can ask that will give you some reasonable assurance that the practice will not be bought before you get partnership? I know there are no guarantees, but I'm sure there are certain questions that will allow you to assess "body language" and other hints that the PP is an acquisition target.

 

[Mman]

I doubt you will get any group to agree to this. The entire point of a partnership track is to deny you the rights, benefits, and risks of partnership until you actually become a partner. And a payout upon the sale of a practice is one of the most valuable perks of partnership.

My group has a boilerplate contract. No modifications, no exceptions.

We'd do it. In fact on our next hire, we might put the language in the contract. Last time we were approached to acquire, the numbers we provided to the AMC told them they'd be paying full freight to all non-partners. It's the fair thing to do.


But crappy groups will never go for it.

 

[nimbus]

With that being said, would you join the PP in this climate where consolidation is frequent? Sounds risky. Are there any questions you can ask that will give you some reasonable assurance that the practice will not be bought before you get partnership? I know there are no guarantees, but I'm sure there are certain questions that will allow you to assess "body language" and other hints that the PP is an acquisition target.

I would join a group like mine. Productivity based compensation, equal unit value and equal access to schedule from day 1. Partnership with nominal buy-in (less than 1 mo income) after 2yrs. Partnership gives you a vote. New hires are frequently among our highest earners.

 

[cognitus]

I would join a group like mine. Productivity based compensation, equal unit value and equal access to schedule from day 1. Partnership with nominal buy-in (less than 1 mo income) after 1 year. Partnership gives you a vote. New hires are frequently among our highest earners.

So in your practice, you can earn more if you simply decide to work more hours (longer shifts, more calls). AMCs basically offer you the same salary (~$300K) and there is NO room to make more? Do I have that right? If so, I like your practice too. I'm not even a resident yet, so this may be moot when I'm done with training but it's good to think about.

 

[nimbus]

So in your practice, you can earn more if you simply decide to work more hours (longer shifts, more calls). AMCs basically offer you the same salary (~$300K) and there is NO room to make more? Do I have that right? If so, I like your practice too. I'm not even a resident yet, so this may be moot when I'm done with training but it's good to think about.

Yes. The only way to earn more is by working more. There is no bump in income when you become partner.

 

[deleted171991]

I would join a group like mine. Productivity based compensation, equal unit value and equal access to schedule from day 1. Partnership with nominal buy-in (less than 1 mo income) after 1 year. Partnership gives you a vote. New hires are frequently among our highest earners.

Sounds pretty fair. But if there is no incentive in becoming partner (except for cashing in if the group is sold), why would anybody share the risk of liability in case of a partner's malpractice?

 

[cognitus]

Sounds pretty fair. But if there is no incentive in becoming partner (except for cashing in if the group is sold), why would anybody assume the risk of equal fiducial responsibility in case of a partner's malpractice?

How hard is it to find a group like that?

 

[nimbus]

Sounds pretty fair. But if there is no incentive in becoming partner (except for cashing in if the group is sold), why would anybody share the risk of liability in case of a partner's malpractice?

So you can continue to practice at our locations. And you're right, we are self insured so we make sure everybody practices within the standard of care. We have denied partnership to people who are clinically weak or have ethical issues. If you have average skills and a nonpathologic personality then there is no problem.

We are stronger as an integrated interdependent group than as a bunch of independent cowboys.

 

[bigdan]

Nimbus...are you guys hiring? Seriously. Are you?

 

[norwood]

So you can continue to practice at our locations.

So with your group, it's partnership or bust? Interesting approach. How do you handle people who want to cut back on hours, i.e., who want to work part-time as new moms or when starting to get near retirement, if they're otherwise suitable for your group?

 

[nimbus]

So with your group, it's partnership or bust? Interesting approach. How do you handle people who want to cut back on hours, i.e., who want to work part-time as new moms or when starting to get near retirement, if they're otherwise suitable for your group?

Yes it is partner or bust. Aren't most groups this way?

We're a big group. We can accommodate almost any lifestyle. We have many part-timers. They are all partners. Like I said we are paid purely on production. Take your pick, money or time off. If you are 55+ you can opt for no call. Call is incentivized so most continue to take call.

 

[cognitus]

Yes it is partner or bust. Aren't most groups this way?

We're a big group. We can accommodate almost any lifestyle. We have many part-timers. They are all partners. Like I said we are paid purely on production. Take your pick, money or time off. If you are 55+ you can opt for no call. Call is incentivized so most continue to take call.

I'm all for this as long as there is enough pie to go around. I'd be happy if working 50-60 hrs/wk yields $300K/year and I can scale up or down depending on how much money I want to make.

 

[BLADEMDA]

I hope this never happens but I believe the near future includes massive cuts to anesthesia reimbursement or a global fee structure. This means every group will take a massive pay cut.

The future anesthesia model is 5-6 CRNAs being supervised by one Anesthesiologist. The CRNA is being paid 85 percent of his/her current wage while the anesthesiologist gets about half. I'm not advocating such an anesthesia model but I see it as one that is very likely to occur.

 

[Consigliere]

I hope this never happens but I believe the near future includes massive cuts to anesthesia reimbursement or a global fee structure. This means every group will take a massive pay cut.

The future anesthesia model is 5-6 CRNAs being supervised by one Anesthesiologist. The CRNA is being paid 85 percent of his/her current wage while the anesthesiologist gets about half. I'm not advocating such an anesthesia model but I see it as one that is very likely to occur.

Agree

 

[wjs010]

I hope this never happens but I believe the near future includes massive cuts to anesthesia reimbursement or a global fee structure. This means every group will take a massive pay cut.

The future anesthesia model is 5-6 CRNAs being supervised by one Anesthesiologist. The CRNA is being paid 85 percent of his/her current wage while the anesthesiologist gets about half. I'm not advocating such an anesthesia model but I see it as one that is very likely to occur.

This is a stab at all the hard work gas docs go through. It's not fair. I'm once again sorry for you guys and wish you had a more powerful lobby... Oh and I wish people respected physicians like they used to