any perspective for this situation?

[ghastly75]

Hey all-
Attending physician several years out, fellowship trained in Pediatrics. Work at Children's Hospital in Academic setting. Great location, but...

Have possible opportunity for job in "home" area for wife and I. This group has lock on entire "home" area too. Would have to take care of adults as well. ACT model. Partnership track.
Wife really pushing for it. Currently make good $ at job that is mostly satisfying and not too hard, good benefits and good vacation time. We have ACT model but also do own cases fairly regularly. Downside, (IMO) is academic setting and all the promotion pressure.
"Home" job would be essentially starting fresh, (70:30 adults to pedi )adults, som pedi (sick pedi as well) but partnership track with low starting $ (>100K less), equal vacation time, much busier practice (private) possibly less lazy peeps, but happy wife. Family all around to see kids.
My concerns are the obvious $ difference (we both have huge student loan debt), the fear of the PP selling to an AMC whilst trying to make partner at a lower wage, the challenge of working with adults again after quite a few years, more responsibilty with less time to do it, CRNA;s to keep happy.
It's obvioulsy a personal choice and some variables are deal breakers to some folks and not others but has anyone been in the situation of leaving a damn good job for thier partner's happiness?

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[Chloroform4Life]

Lol how hard is your wife pushing?

It sounds like you're pretty happy at your current job. Moving to a busier practice while making 100k less and still have a lot of student loans would be hard to swallow for me. Also, how prevalent are AMCs in that area? That uncertainty could be hard on you during that couple years of non-partnership (hopefully not >2 years). Once you become partner, are you going to making significantly more than what you are making right now (including benefits and everything)? I wouldn't worry too much about working with adults, keeping CRNAs happy, etc. You'll pick it back up easily.

I've been lucky enough to have a wife who've support me dragging her all over the place. There's been jobs though that I would have taken, but she did not want to live in those area, and I understand you have to take that into consideration as well.

 

[Hoya11]

I have a "home" partnership track gig. Its very nice to have family/friends/help in the area. And happy wife happy life. And I agree youll bounce right back into caring for adults. BUT the salary does sound a little low if you are talking around 220. If you have kids/debt it may not be the best time to take this potential risky investment on from a financial standpoint. Wait until your "home" with everyone around but y0u are stressed/fighting about money. Not a good situation either.

I guess it all depends on the future prospects with this group, your current financial situation, and how your life will be along the uncertain path. Maybe interview with an AMC in the home area, that way you would have high salary and be home and have no risk of losing income. Obviously, if you are a young guy and this is a good, true attainable partnership, its the right thing in the long term. I am on the track and my children are very young so we dont do much/have extravagant expenses so it all works. By the time they grow up/need money and other expenses come into play I will be partner for a while. Others with older kids took the local AMC job at higher salary no risk of lost income. Also my salary is significantly higher than what your describing and not far from market rate anyways, which makes me feel like not too much lost income. In the end I would try to negotiate salary up, and find out more information on the group like average partner income/vacay/levels of partner etc. And I would interview at a local AMC. But yes pack your bags and move home to either try partnership or the AMC, because if you dont do it shell alwys be on you and it could cause major problems.

 

[Planktonmd]

Leaving an academic job for a private practice job is a huge mistake at this time, don't do it!

 

[ghastly75]

Lol how hard is your wife pushing?

It sounds like you're pretty happy at your current job. Moving to a busier practice while making 100k less and still have a lot of student loans would be hard to swallow for me. Also, how prevalent are AMCs in that area? That uncertainty could be hard on you during that couple years of non-partnership (hopefully not >2 years). Once you become partner, are you going to making significantly more than what you are making right now (including benefits and everything)? I wouldn't worry too much about working with adults, keeping CRNAs happy, etc. You'll pick it back up easily.

I've been lucky enough to have a wife who've support me dragging her all over the place. There's been jobs though that I would have taken, but she did not want to live in those area, and I understand you have to take that into consideration as well.

thanks for

Leaving an academic job for a private practice job is a huge mistake at this time, don't do it!

what are some specific reasons why? curious for insight.

 

[GA8314]

My take is the following:

Partners selling to an AMC is more likely if the number of partners versus employed physicians (including those on partnership tracks) is LOW. Also, if MOST docs in the practice are equal partners, but MOST are nearing retirement, then both of the above scenarios greatly increase your chances of selling out to an AMC.

If MOST people have over 10 years to practice (7 years is often the "break even point") AND are not excessively worried about the future (this could mean a lot of things), then the likelihood of an offer looking good to them (i.e. better than their current gig) is much less, and thus they are less likely to sell out.

Again, low numbers of partners or older "super partners" +/- lots of folks nearing the very end of their careers= high risk of selling out from under you.

Otherwise, I can tell you that these offers are not that great for equal partner groups (equal shares) and where most anesthesiologists have shares. So, much less worry in that scenario.

 

[IlDestriero]

I have a good academic job. It sounds like you do as well. While academics has some downsides, and it lacks some of the perks available to non W2 employees, if you're partnered with a good hospital/system, it's about as safe as can be. And I don't know about you, but I work a lot less than people I know in AMC and PP jobs, and my per hour income is probably not dramatically worse than theirs. Not to mention that they are 3:1 or 4:1 100% of the time and the world would come to an end before I had to cover more than 2:1, and I like doing my own cases frequently as well. They may get more vacation time, but their day to day grind is much worse.
The X factor is your wife's happiness. That might be worth more than anything else.
Good luck with your decision.
The grass is always greener, but you may regret not settling for an E class while working your ass off to pay for your S class.


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Il Destriero

 

[Planktonmd]

thanks for

what are some specific reasons why? curious for insight.

The good days of private practice are over and the good old private group model is rapidly disappearing.
Private practice of the future will be AMC employment and to a much lesser degree hospital employment.
Which means the days of anesthesiologists having a seat at the table or some control over their work conditions are over.
Without that autonomy and control private practice becomes a terrible choice because your future employer will do everything to squeeze out as much work from you for the least amount of money possible, not a great situation to say the least.
At least in academia you still have some protection because you are a faculty member and other faculty members have an inherent interest in keeping the abuse under control.

 

[criticalelement]

The good days of private practice are over and the good old private group model is rapidly disappearing.
Private practice of the future will be AMC employment and to a much lesser degree hospital employment.
Which means the days of anesthesiologists having a seat at the table or some control over their work conditions are over.
Without that autonomy and control all practice models become a terrible choice because your future employer will do everything to squeeze out as much work from you for the least amount of money possible, not a great situation to say the least.
At least in academia you still have some protection because you are a faculty member and other faculty members have an inherent interest in keeping the abuse under control.

I modified your post. BUt spot on.

 

[criticalelement]

I have a good academic job. It sounds like you do as well. While academics has some downsides, and it lacks some of the perks available to non W2 employees, if you're partnered with a good hospital/system, it's about as safe as can be. And I don't know about you, but I work a lot less than people I know in AMC and PP jobs, and my per hour income is probably not dramatically worse than theirs. Not to mention that they are 3:1 or 4:1 100% of the time and the world would come to an end before I had to cover more than 2:1, and I like doing my own cases frequently as well. They may get more vacation time, but their day to day grind is much worse.
The X factor is your wife's happiness. That might be worth more than anything else.
Good luck with your decision.
The grass is always greener, but you may regret not settling for an E class while working your ass off to pay for your S class.


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Il Destriero

The problem with academics, at least in anesthesia departments, is you are treated like a elementary school student and given busy work to do. No other reason for the work but to look or feel busy. Private practice get the work done go home.. Academics, work is done,, now mounds of paperwork.

 

[IlDestriero]

The problem with academics, at least in anesthesia departments, is you are treated like a elementary school student and given busy work to do. No other reason for the work but to look or feel busy. Private practice get the work done go home.. Academics, work is done,, now mounds of paperwork.

I'm not sure what paperwork you mean. I sit on 2 committees. One I get time off to go to, another I call in to. Trainee evals take 5 min a week. When I'm done, you better believe the 80's music is blasting in the Benz within 10 minutes.


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Il Destriero