Changes after AMC Buyout

[bobg504]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

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[Mman]

honestly I'd look for other job opportunities and then talk with whoever is head of your department/location and ask them why you should stay. If they can't give concrete hard evidence of why things will imminently get better then you don't have much reason to stay.

 

[Hoya11]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

Look at other options.

Its most likely not going to turn around. This is how they make their margin.

I personally would rather do mommy track for 250-300k than do Q4 call for probably not a lot more.

Look at the other options in your area and make a calm decision.

 

[Man o War]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

Leave, or demand a new contract with additional pay for them running short on docs. This is what they do....
You should have defined work hours, and you get additional pay on top of any hours worked past a certain time (say for example an hourly rate past 5:00 pm).
You should also receive additional call stipend for any call taken beyond what you would normally take if they were running at full capacity.
Also extra pay for working post call.
If they will not do this, walk. It won’t get better or change.

 

[Mikkel]

Leave, or demand a new contract with additional pay for them running short on docs. This is what they do....
You should have defined work hours, and you get additional pay on top of any hours worked past a certain time (say for example an hourly rate past 5:00 pm).
You should also receive additional call stipend for any call taken beyond what you would normally take if they were running at full capacity.
Also extra pay for working post call.
If they will not do this, walk. It won’t get better or change.

Exactly this.

You're not happy. If they don't want to make you happy with more money, it's time to walk.


You probably shouldn't share location, but if you're in a "desirable" location, management can act like they have the upper hand because they think they'll always find some schmuck to fill in. Until they can't. And care will suffer. And maybe they lose the contract.

I would highly discourage you from waiting it out. It won't get "better" to the point that you're net positive. But, they will always promise some kind of improvement to get you to stay (we're planning on hiring more, we're discussing with hospital on better scheduling, we might have some money in the pool next year for bonuses, etc), but for some reason those promises never work out. Shocker.

The telltale sign is them saying "high expenses" is the reason for a lower unit value. You can't trust anyone who spouts that clear BS.

 

[Maverikk]

Never went through this but have friends who have. It doesn't get better: you lose all control over your group, if you're not in a supervision model you will be with the goal of 4:1, no control over new hires, no incentives to make the group/hospital relationship better or be in any leadership positions..my friends group had an exodus of quality anesthesiologists after the required time to stay on after the buyout

 

[IMGASMD]

my friends group had an exodus of quality anesthesiologists after the required time to stay on after the buyout

That means these people got a buyout, and required to stay x years.

OP probably didn’t get any money.

 

[ProRealDoc]

Exactly this.

You're not happy. If they don't want to make you happy with more money, it's time to walk.


You probably shouldn't share location, but if you're in a "desirable" location, management can act like they have the upper hand because they think they'll always find some schmuck to fill in. Until they can't. And care will suffer. And maybe they lose the contract.

I would highly discourage you from waiting it out. It won't get "better" to the point that you're net positive. But, they will always promise some kind of improvement to get you to stay (we're planning on hiring more, we're discussing with hospital on better scheduling, we might have some money in the pool next year for bonuses, etc), but for some reason those promises never work out. Shocker.

The telltale sign is them saying "high expenses" is the reason for a lower unit value. You can't trust anyone who spouts that clear BS.

If there is no more money on the table, walk. Don't buy the "we'll give you more next year" line. you either get it now or forget about it.

 

[Mikkel]

That means these people got a buyout, and required to stay x years.

OP probably didn’t get any money.

He says he had his partnership buy-in returned to him, so he was net neutral.


The quality docs will always leave for better roads, because they're usually smart and usually hard-working. They know what's best for them and their families.

The ones who stay are not bright enough to realize what's happening, or they're too lazy to jump ship, or they're geographically locked (or at least feel like they're locked... There's nothing stopping people from moving, changing schools, etc). Positives and negatives for everything, but 90% of the time, the docs are worse off long term.



The longer you facilitate the predatory companies, the longer they stay alive to torment everyone else.

 

[Mikkel]

If there is no more money on the table, walk. Don't buy the "we'll give you more next year" line. you either get it now or forget about it.

They're really good at persuading people to stay too, it's sociopathic. They know they can't deliver, but they'll still say "it's early in the process, we're still working out the kinks, we're really optimistic, the trajectory is good, etc". 100% BS, and what's it to them if you find out they're a liar a year from now? They managed to string you along and get a free $100k-200k+ off your hard work.

 

[GravelRider]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

Definitely leave. It’s a sinking ship. There is no way they are going to fix things in the short or medium term. You are likely way underpaid and overworked. You’ll get burnt out and cynical and that’s not good for anyone. Hopefully you have a reasonable non-compete clause (or none) and have other options in the area. I would seriously start sending your CV out this week. The new job process for physicians is at bare minimum a 6 month process. You don’t know who else already has something else being lined up before submitting their letter of resignation.

If they do reach a critical threshold in terms of staffing and you haven’t figured out an alternative yet then you should use it to your advantage and demand a lot more money. If not, resign and do locums until you get something else lined up.

 

[Mikkel]

Definitely leave. It’s a sinking ship. There is no way they are going to fix things in the short or medium term. You are likely way underpaid and overworked. You’ll get burnt out and cynical and that’s not good for anyone. Hopefully you have a reasonable non-compete clause (or none) and have other options in the area. I would seriously start sending your CV out this week. The new job process for physicians is at bare minimum a 6 month process. You don’t know who else already has something else being lined up before submitting their letter of resignation.

If they do reach a critical threshold in terms of staffing and you haven’t figured out an alternative yet then you should use it to your advantage and demand a lot more money. If not, resign and do locums until you get something else lined up.

Another option, depending on how your contract is set up:

Quit immediately (90 days notice?), and be an independent contractor to the same group. Charge them 2.5-3x what they paid you before.

They will have a hard time finding a locum and getting them credentialed in time before your absence will be felt. You're already credentialed, you're already familiar with the hospitals, you're an easy fit.

To the AMC, you'll just be a temporary expense. In the mean time you can find a job somewhere else.

It's risky, but it's a nice way to extract some of the money you earned/deserve before you leave permanently.

 

[Maverikk]

Some of the AMCs use their own locums from their company 'leadership'...one group I knew found out later that this 'locums' (who was also high up in the AMC) was being paid from their local pool, every flight to and from home on the weekends and the nice hotel during the weekdays he was there

 

[Arch Guillotti]

Bail out.

 

[nimbus]

Some of the AMCs use their own locums from their company 'leadership'...one group I knew found out later that this 'locums' (who was also high up in the AMC) was being paid from their local pool, every flight to and from home on the weekends and the nice hotel during the weekdays he was there

Perks of being a real partner/owner.

 

[kidthor]

Perks of being a real partner/owner.

Where do I sign up!?

 

[chocomorsel]

That means these people got a buyout, and required to stay x years.

OP probably didn’t get any money.

He or she said in the post that he/she did. Of course I don’t know under what catch.
Read my friend.

 

[dannyboy1]

Some of the AMCs use their own locums from their company 'leadership'...one group I knew found out later that this 'locums' (who was also high up in the AMC) was being paid from their local pool, every flight to and from home on the weekends and the nice hotel during the weekdays he was there

Again. The only way it makes sense to work for one of these companies is to have a set salary AND set hours. You are an employee. Get treated like one. I don’t give a sh1t about the “ pool “ or unit value or payor mix. That’s an owner problem. People who sign up to work for the AMC without set hours and overtime always get fu(ked. People who work set hours ( mommy track, shifts ) always seem to be happy.

 

[Mikkel]

Again. The only way it makes sense to work for one of these companies is to have a set salary AND set hours. You are an employee. Get treated like one. I don’t give a sh1t about the “ pool “ or unit value or payor mix. That’s an owner problem. People who sign up to work for the AMC without set hours and overtime always get fu(ked. People who work set hours ( mommy track, shifts ) always seem to be happy.

The problem is that mommy track is severely underpaid for the hours worked. AMCs take advantage of those people.

The only other option is FTE with no contractual hours, and obviously that arrangement is ripe for abuse as we see being done already. Good luck trying to get a special contract drafted just for you, with a huge company. They won't waste their time with you, no matter how desperate they are. They'd rather use locums than show weakness.


And I would discourage people from showing horrible work ethic just because you're an employee. When reference time comes around and you try to find a job that is worth it, your references could sink you.

 

[IMGASMD]

He or she said in the post that he/she did. Of course I don’t know under what catch.
Read my friend.

I don’t read very good.
S/He did also say they were in the middle of partnership track, and only got the buy in back. Not sure that would be enough of a reason to be tied down.
The AMC buy out I’ve seen, tie the partners for at least a year, if not more, if you received any lump sum of money. They want the guarantee of staffing the hospital.
The point I am trying to make is, OP didn’t get full share, maybe s/he didn’t have the obligation to stay.

 

[GravelRider]

The problem is that mommy track is severely underpaid for the hours worked. AMCs take advantage of those people.

The only other option is FTE with no contractual hours, and obviously that arrangement is ripe for abuse as we see being done already. Good luck trying to get a special contract drafted just for you, with a huge company. They won't waste their time with you, no matter how desperate they are. They'd rather use locums than show weakness.


And I would discourage people from showing horrible work ethic just because you're an employee. When reference time comes around and you try to find a job that is worth it, your references could sink you.

dannyboy1 is not saying show poor work ethic. What he is saying is make sure you are compensated for everything you do as an employee. Make sure that stuff is spelled out explicitly in the contract. How many calls per month? Pre-call, post call expectations? Work hours on non-call days? How are you compensated if you work beyond a certain hour? You want him to attend committee meetings for the department then pay him for it. Our time is valuable and it should be compensated. If your contract doesn’t say anything about committee meetings then guess what, no committee meetings.

 

[dannyboy1]

The problem is that mommy track is severely underpaid for the hours worked. AMCs take advantage of those people.

The only other option is FTE with no contractual hours, and obviously that arrangement is ripe for abuse as we see being done already. Good luck trying to get a special contract drafted just for you, with a huge company. They won't waste their time with you, no matter how desperate they are. They'd rather use locums than show weakness.


And I would discourage people from showing horrible work ethic just because you're an employee. When reference time comes around and you try to find a job that is worth it, your references could sink you.

References? Around my neck of the woods ( northeast) they are so desperate for bodies they will take anyone with a pulse, and probably some without (like in the final scene of the revenant . The first question I got asked on my interviews was “ when can you start “. I’m not exactly advocating a horrible work ethic, just standing up for yourself. Example, an sudden hole in the weekend call schedule. “Sorry, I got plans”. Can you work post call last minute? Nope, was up all night or I have something planned. Feeling sick? Call in, the world will keep on turning. Also FWIW the people who work unlimited hours usually end up with less/hour then the mommy track...

 

[kidthor]

References? Around my neck of the woods ( northeast) they are so desperate for bodies they will take anyone with a pulse, and probably some without (like in the final scene of the revenant . The first question I got asked on my interviews was “ when can you start “. I’m not exactly advocating a horrible work ethic, just standing up for yourself. Example, an sudden hole in the weekend call schedule. “Sorry, I got plans”. Can you work post call last minute? Nope, was up all night or I have something planned. Feeling sick? Call in, the world will keep on turning. Also FWIW the people who work unlimited hours usually end up with less/hour then the mommy track...

I totally agree.

If they aren't giving you something for working beyond your obligation (e.g. an ownership stake or some form of overtime), then you're being exploited as soon as you agree to anything extra.

 

[Consigliere]

Any advice from experienced folks is welcomed.

Leave immediately if not sooner. You're welcome.

 

[jwizle]

if you want an opportunity to be your own boss/partner in an extremely far and equitable group, shoot me a message

 

[Twiggidy]

Leave immediately if not sooner. You're welcome.

He's right.

 

[deleted171991]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

You should have started looking for another job the second you became unhappy with the current one.

Can you think of any reason why the job would ever get better? Stop thinking like a slave, think like a cold-hearted and blooded businessperson.

 

[Lurch]

In the advent of making this post fairly short and not revealing too many details, our private group was bought out last year by an AMC. I was in the middle of my partnership track (my personal nightmare). I recieved a "retention bonus" (cash and some "stock") that basically returned the cash I paid for the buy-in.

We are a productivity model and still are. We were an MD only model. Since the buyout, 6 CRNAs have been hired, our unit value has decreased exponentially more than promised (from expenses they say), we have lost 2 docs and haven't managed to hire another in over 8 months of actively recruiting. The workload has increased exponentially to the point that we are now on call Q4 (OB or OR) with zero flexibility in our schedule. I literally don't know what time I'm leaving the hospital, even on the days I should get off work early. I can't plan anything. Our lack of manpower has started affecting the number of people who can take vacation. Multiple partners in our other divisions have resigned recently. It's getting hard for me to want to be here. The job I once loved now has me feeling overworked, undervalued with no autonomy and it sucks.

Has anyone here gone through a buyout and had these experiences? Anyone ever feel this way? Did it turn around?

At this point, I'm entertaining the option of leaving, I just dont want to make an irrational decision. Any advice from experienced folks is welcomed.

Will get worse. Watched it happen real time in my area to another group. Things deteriorated under AMC after buyout. CRNAs jumping ship. Docs feeling like they have to stay to avoid clawback of buyout. Surgeons and administration all pointing fingers at anesthesiologists even if they didn’t vote for the buyout. Toxic work environment. Not good for anyone. You need to cut your losses.

Practices still exist that are fair and successful. You may have to be flexible geographically though. We have such a practice and take great pride in it. We took a large contract away from one of these AMCs in recent months because they created an untenable situation like you described. Hospital administrators are starting to realize these corporations are big on promises and short on delivery. These situations are great opportunities for proactive and engaged groups-those that want to work and contribute to a good product in a collegial way.

Nobody handed it to us but we decided not to relinquish control of our market to the national corporations in large part because we heard stories like yours and did not want a similar fate. It took some legwork but we got it done. I said this in another thread but these stories should serve as a wake-up call. We’re hiring up so feel free to PM.

 

[deleted171991]

References? Around my neck of the woods ( northeast) they are so desperate for bodies they will take anyone with a pulse, and probably some without (like in the final scene of the revenant . The first question I got asked on my interviews was “ when can you start “. I’m not exactly advocating a horrible work ethic, just standing up for yourself. Example, an sudden hole in the weekend call schedule. “Sorry, I got plans”. Can you work post call last minute? Nope, was up all night or I have something planned. Feeling sick? Call in, the world will keep on turning. Also FWIW the people who work unlimited hours usually end up with less/hour then the mommy track...

I don't advocate anything like this for partners-owners, but, as an employee, it should be tit for tat. Treat them the way they treat you. Be a gentleman with gentlemen and a hustler with hustlers. Con the con man.

 

[IMGASMD]

I don't advocate anything like this for partners-owners, but, as an employee, it should be tit for tat. Treat them the way they treat you. Be a gentleman with gentlemen and a hustler with hustlers. Con the con man.

If can’t beat them join them.

 

[deleted171991]

If can’t beat them join them.

The Prisoner’s Dilemma and the "Virtues" of Tit for Tat

What does research in game theory say about tit for tat vs. the golden rule?

www.psychologytoday.com

"In Axelrod’s tournaments, of all the strategies (many of which were quite intricate) later assessed by him, the one that regularly culminated in the most successful outcomes was, unexpectedly, tit for tat. This simple strategy, devised by mathematical psychologist Anatol Rapaport (Univ. of Toronto), involves cooperating with your partner on the first round, then adjusting your behavior to match your partner’s (as in, you do to them what they just did to you—admittedly, a less selfless tactic than the golden rule would prescribe). If, reciprocally, your partner cooperates, you continue to cooperate; if they defect, you respond in kind by immediately retaliating against them. This formula has, ironically, been characterized as “conditional niceness,” since it advocates for a kind of provisional golden rule.

And it’s a constant winner. No completely selfish strategy (and many ingenious ones have been contrived!) is able to beat it."

 

[zyovka]

Just started my CA-2 year and reading all this makes me worried. Unfortunately, nobody teaches you about all the complexities of job hunting, hiring, contract negotiation, models etc.... it's like the other side of the moon, you never think about while in training... Holy sh..//!!!

 

[abolt18]

Just started my CA-2 year and reading all this makes me worried. Unfortunately, nobody teaches you about all the complexities of job hunting, hiring, contract negotiation, models etc.... it's like the other side of the moon, you never think about while in training... Holy sh..//!!!

Real life, most of my attendings have only ever done academic medicine and no idea about most of those things. Thank the heavens for SDN and all you amazing people on here!

 

[aneftp]

Was this a forced buyout of the group? Or friendly buyout?

There are two buyouts from AMCs
1. Forced (where the partners get a little something (usually 250-300 k cash each) just to maintain status quo (like a force resignations)

2. Friendly buyout (usually 1-1.5 million in all MD practices)

The force buyout is the AMC basically saying we are gonna to take over the contract from the hospital whether you like it or not. And had the hospital admin backing. So the partners take something rather than nothing

 

[caligas]

Was this a forced buyout of the group? Or friendly buyout?

There are two buyouts from AMCs
1. Forced (where the partners get a little something (usually 250-300 k cash each) just to maintain status quo (like a force resignations)

2. Friendly buyout (usually 1-1.5 million in all MD practices)

The force buyout is the AMC basically saying we are gonna to take over the contract from the hospital whether you like it or not. And had the hospital admin backing. So the partners take something rather than nothing

What are the typical requirements to stay on after each? What are the penalties for leaving before that term, pay back the buyout?

 

[chocomorsel]

This sounds exactly like what the old group in Vegas that had about 100 docs who sold out to USAP in 2016/2017 are going through now. People are unhappy and overworked and money ain't was was promised, etc. And the overhead keeps increasing for some reason. LOL

Quite frankly, when you are a group that large and want to sell out when you have the capability to negotiate very well with the insurance companies makes no sense to me.

I guess plenty of people want "fast money" but it comes with a price.

 

[IMGASMD]

This sounds exactly like the old group in Vegas that had about 100 docs who sold out to USAP are going through now. People are unhappy and overworked and money ain't was was promised, etc.

Quite frankly, when you are a group that large and want to sell out when you have the capability to negotiate very well with the insurance companies makes no sense to me.

I guess plenty of people want "fast money" but it comes with a price.

If I was at the end of my career and just need to sign a piece of paper, few more years of my life..... $1 million bonus, f all of you youn’ens. Ain’t my problems no mo’

What’s going on in Vegas now? It was pretty hot (job wise and also weather I know) a few years ago.

 

[chocomorsel]

If I was at the end of my career and just need to sign a piece of paper, few more years of my life..... $1 million bonus, f all of you youn’ens. Ain’t my problems no mo’

What’s going on in Vegas now? It was pretty hot (job wise and also weather I know) a few years ago.

Except those few years of your life will be even harsher. And almost half of that mil goes to Uncle Sam. And the other half is given to you in stock shares. So what you take home is really far from a mil.

 

[chocomorsel]

If I was at the end of my career and just need to sign a piece of paper, few more years of my life..... $1 million bonus, f all of you youn’ens. Ain’t my problems no mo’

What’s going on in Vegas now? It was pretty hot (job wise and also weather I know) a few years ago.

I don't live there anymore but keep in touch with old friends and colleagues. I don't think the market is doing as well as it used to be, but I don't think reimbursement has ever been that good either. I think it's because it consists of so many independent small groups who don't have the negotiating power in numbers. Thing is that in Vegas, it's really the Wild West. And it has a lot of independence. Link up with the right surgeon or interventionalist and you could make some money. But many make their numbers but doing high value cases or lots of volume because reimbursement is not that good in general from my experience. I am sure there are some groups who get good rates, but I think those are not the norm.

 

[deleted162650]

And almost half of that mil goes to Uncle Sam.

Nope. Buyout money is taxed as capital gains, not as income. That’s part of the appeal.

 

[chocomorsel]

Nope. Buyout money is taxed as capital gains, not as income. That’s part of the appeal.

Hmm, wasn’t aware. Spoke to the spouse of a now USAP partner and this is what he said as far as the taxes.

Tell me though, have you guys been approached by an AMC? You seem to be in a lucrative market.

 

[deleted162650]

Tell me though, have you guys been approached by an AMC? You seem to be in a lucrative market.

My market is fairly devoid of any AMC presence. I think we may have been casually approached once or twice, but nothing that ever resulted in a formal offer being presented to the group. In an equitable MD only group like mine, it’s just too hard to make the math work out to the point that makes it worth it. The buyout pie has to be split too many ways. The demographic in my group is still a little too young (on average) also.

 

[deleted171991]

My market is fairly devoid of any AMC presence. I think we may have been casually approached once or twice, but nothing that ever resulted in a formal offer being presented to the group. In an equitable MD only group like mine, it’s just too hard to make the math work out to the point that makes it worth it. The buyout pie has to be split too many ways. The demographic in my group is still a little too young (on average) also.

That's the most important, by far. It's the old farts who usually want to close the deal and retire.

 

[nimbus]

Buyout doesn’t make sense for anyone with a time horizon more than 8-10 years unless they believe the world is ending. The “buyout” is really just an advance for future earnings that they will take back from you. Typically the multiple is 7-8x. In the end, the AMC gets all their money back and they own the practice.

 

[dannyboy1]

That's the most important, by far. It's the old farts who usually want to close the deal and retire.

One day we will also want to retire. It’s not a crime....

 

[deleted171991]

One day we will also want to retire. It’s not a crime....

I almost wrote "old farts like me", except that I am not that old. But I would retire if I had the money.

 

[deleted162650]

I almost wrote "old farts like me", except that I am not that old.

Pretty farty though.

 

[IMGASMD]

I almost wrote "old farts like me", except that I am not that old. But I would retire if I had the money.

Now, if you had a practice to sell...... then you would have the money.....

A-ha!

 

[deleted50478]

One day we will also want to retire. It’s not a crime....

The crime is robbing Peter to pay Paul.

 

[caligas]

The crime is robbing Peter to pay Paul.

...and Paul is yourself.