So, what happens when groups dont offer partnership? Do they outright tell you this is not partnership track, you take job and leave in a few years? Do they outirght lie to you that this is a partnership track and then kick you out the back door in a few years when they are supp to decide if you become partner.
The only way to find out about the group is to talk to previous employees and find out what is actually going on?
all the above
currently:
1.) groups offer a partnership track position with hopes of getting the best possible candidates and then string them along for years, even decades. This can take the form of such stuff as "junior partners" (ie non-founding partners or non-voting partners) or small interest share partners as most medical groups are now S-corps, they might break off 10 out of 1000 shares to give you.
2.) the no1 scenario but they basically never discuss partnership at all with you, hoping you are too much of a wimp to ask. Once you start pressing, they try to string you along. Once they are bored with that, they kick you to the curb.
3.) group tells you outright that partnership isnt to be had, ever. more groups are doing this now, sadly this was quite unusual 10 years ago (most did 1 or 2).
Ive heard of some fairly intense permutations of the above:
~situation I call the "Running Them Dry" where the group drops the salary, the benefits like time off or both with each consecutive yearly contract to get the non-partner to leave.
Ive heard of some groups actually run hires down to 1/2 their starting salary or less! trying to get them to leave voluntarily. Crazy. If they dont leave, then you have a pathologist working 40hrs/week for less than your PA.
~Some groups actually use a "Treacherous Git" where they begin covertly rounding up cases from the employee and reviewing them in some secret meeting, even sending them to academic places specifically to get disagreements to use as evidence should their clinicians/admin ? why they booted the person. Then they ask the person to voluntarily leave or else the evidence will be "outed" to Hospital QA (this is usually a boldfaced bluff as the Treacherous Git is hardly stealthy to anyone with common sense and an openly disgraced pathologist will harm them almost as much as it would the employee).
Groups dont want to outright fire someone for cause, this obviously reflect quite poorly on them. (After they have to do alot of
'splain to do to clinicians whos cases were read by said fired peon)
4.) Groups offer partnership but with crazy high buy ins and no real property/assets to show for it. These are called "Blue Sky" buyins. Often even after you Blue Sky in (taking out a MAMMOTH personal equity line from a bank to do so), you can still get relegated to a jr. partner level by careful use of S-corp bylaws. To be fair, some groups let you Blue Sky after 3-4 years by taking your wages and applying those to the money you own them. Sadly if you leave or they boot you via a Treacherous Git, you often lose that built up buy in. This way they can actually pay you LESS after youve been there for 3-4 years and you might stupidly feel good about it...
5.) Groups offer partnership with no buy in but pay you practically nothing for several years first. This is actually the most reasonable solution for me. I never interviewed with a group who did this, but have many friends who went this route.
6.) Buy ins where the group owns real property...I like this alot, but it also scares me. Real property is difficult thing to assess the value of now and you are very very likely to be overcharged for a building which the elderly partners are relying on to retire to Palm Springs on.
hope that helps.
I think for most, just a paying job should be the goal at this point.
