Current Anesthesia group getting Merged with an anesthesia management company, what is a reasonable offer?

[LifeofGas]

Quick questions for those of you who have experienced this. I am currently working as an independent contractor all MD group in California. I’ve been here for 2 years, not a partner. Although I’m one of the more senior people at the particular hospital I’m working at. I was informed that there was a merger that is about to happen. My boss is told me that with this merger, I’d get a certain cash incentive over 3 years. We will continue to be independent contractors, but the national group will take ~10% of everyone’s monthly collection. (ex, if monthly is 30k, then 3k-3.3k will go to the group)

So the question is with the 10% deduction in monthly income in near foreseeable future, what is a reasonable cash incentive? (Is this a bad deal and I should start looking for backup? Or is this a decent deal that I am actually getting something.The cash incentive is basically roughly 2/3 of my yearly income divided over 3 years.) Input appreciated.

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[Deanmonster]

You are getting taken. They are making a 15% return on their investment plus controlling your group forever. Pretty sweet deal for them... not for you.

 

[nimbus]

Typical deal is 6-8x multiple. So if they are taking 10% going forward, then 60-80% of annual income is the general range. 2/3 is in the lower end of the range. Since you are a contractor, you have no say in the matter. Staying or going depends on how much you like the job.

 

[Mikkel]

It's a terrible deal if you're working there for longer than 3 years. Get out while you can.

 

[LifeofGas]

Thanks! Yeah. I guess I am bitter since I am almost at the point to make partner. Boss is paying everyone some cash incentive. (sure, because who will be willing to take 11% pay cut out of nowhere.)

I am bitter because I am working my butt off. Taking on all the risky cases, taking bunch of calls, one of the highest earners. I am just feeling really gypped. Sure I can take the payout and leave after the specified time, but then I could've switch job to another group where I can work to gain seniority again?

Maybe making my way back to academic? Move out of state...I don't know if I can continue working with people I know who were somewhat equal (who work a lot less than I do) but now made tons of money from the merger. It becomes super frustrating when the boss try to sell "Now calls is more valuable so more people will be willing to take calls!" All I can think of is - I already take a bunch of calls, and now they assume I will take more calls when the last thing I want to do is to take more calls.

 

[Noyac]

When will you become a partner of the current group? It will take a year to merge so maybe you will be one of the cash receiving members. Or maybe you can negotiate partnership befor ehte merger if you are not in line to be beforehand.

But remember, the younger you are the worse this deal is even if you get a cash buyout. Because the AMC will take a greater portion of your earning in perpetuity. They will most likely take 30% of your earning once it’s all said and done. But their contracts will drive up your billing somewhat.

What is the current average unit price for your group?

 

[LifeofGas]

It's 2 years. And I am at the 2 year mark. Its seems like this merger is almost a done deal. In my group after two years we can get share of the group...like own part of the equity of the group. Never had a chance to discuss this and my boss is bringing up the merger. Our unit value is currently about $30, not very high, you mean the unit value will go up?

 

[deleted941485]

That unit value says it all. 30/unit

 

[Mman]

if you are already being told a merger is imminent, you are 100% being left out of it.

Stay if you are being paid what you feel is fair, look for something else if you don't think it is fair. In the long run the job just got worse.

 

[aneftp]

Remember guys. All MD group buyouts are low. Plus it’s california which makes it even worst.

Usap “purchased” a big east coast group primarily all MD. Each partner only got around 650k cash plus the mythical usap “stock” option which is about worthless cause they can’t find an ipo pricing. They sell it was “potential $500-1 million more” They are relying on future dumb future partner track people to buy into the internal stock are inflated prices. It’s valued between $1-3

My advice is take as high as a price straight cash as u can. Forget the stock options.

That’s what one southern group did. They took Sheridan 4 million offer per partner (but they have crnas and less partners)

But all MD groups are just not lucrative buyouts especially in California.

 

[deleted941485]

Remember guys. All MD group buyouts are low. Plus it’s california which makes it even worst.

Usap “purchased” a big east coast group primarily all MD. Each partner only got around 650k cash plus the mythical usap “stock” option which is about worthless cause they can’t find an ipo pricing. They sell it was “potential $500-1 million more” They are relying on future dumb future partner track people to buy into the internal stock are inflated prices. It’s valued between $1-3

My advice is take as high as a price straight cash as u can. Forget the stock options.

That’s what one southern group did. They took Sheridan 4 million offer per partner (but they have crnas and less partners)

But all MD groups are just not lucrative buyouts especially in California.

They only way to make money in gas now is supervision and a small number of partners. That’s it. Especially in saturated areas.

 

[Mikkel]

But their contracts will drive up your billing somewhat.

I always hear this, but it seems like it doesn't pan out most of the time. If it does, it's usually because they went out of network to screw the patients over.

 

[deleted941485]

I always hear this, but it seems like it doesn't pan out most of the time. If it does, it's usually because they went out of network to screw the patients over.

They get some leverage but a lot of them esp the VC ones pull the OON card because it’s the fastest way to make money and scare commercial payouts back to the table. If they are unsuccessful, youll be expected to surpervise starting at 1:2 and obviously they jack it up from there. of course any benefit of enhanced billing or supervision ratio will likely not be reflected in your salary.

 

[LifeofGas]

Thanks for all the great responses! In the short term, it shouldn't affect me. In the meantime, I get to plan out my future as remaining in a national company is not part of my plan. I see no upside potential. In fact, I don't really see much upside potential at all for the specialty. Our income is pretty much the same whereas at most jobs, people get raises.

 

[Mikkel]

Our income is pretty much the same whereas at most jobs, people get raises.

You're thinking in terms of salary.

If you're not just an employee, you can make more year after year if your group has surgicenter ownership, non-medical investments, additional contracts, utilizing mid-levels in select areas, better insurance negotiated rates, higher volumes, better insurer mix, cosmetic surgery.

If you think like a business, you'll make more money. Salaries exist so you don't have to do the thinking.

 

[UscGhost]

Does the 10% they take cover all of the overhead costs? Billing is 5-6 %...plus other costs like legal fees, cpa, chief stipends, etc.

If all of that is included in the 10% then that is pretty reasonable. The larger group profit margin may be 2-4% in that scenario, which is nothing to quit over if other aspects if the job are fine. If the larger group can get slightly better unit rates, then it will shrink that difference even more.

 

[secretasianman]

Can someone explain to me why big physician groups would sell out for that little ?

 

[AdmiralChz]

Can someone explain to me why big physician groups would sell out for that little ?

If the blended unit value is really $30, then they are barely treading water. In fact, they probably are only surviving with a heavy subsidy from the hospital and if the payer mix sucks that bad I’d wager the hospital is looking to axe that. It’s not an attractive purchase and the price reflects that.

 

[secretasianman]

So it's always about the hospital stipend. With all these buyouts, and an alleged physician shortage coming up, how is this profession sustainable with decreased salaries and less autonomy? Something's gotta give.

 

[LifeofGas]

Does the 10% they take cover all of the overhead costs? Billing is 5-6 %...plus other costs like legal fees, cpa, chief stipends, etc.

If all of that is included in the 10% then that is pretty reasonable. The larger group profit margin may be 2-4% in that scenario, which is nothing to quit over if other aspects if the job are fine. If the larger group can get slightly better unit rates, then it will shrink that difference even more.

Unfortunately, I asked that. It’s not included. We will continue to use our current billing company.

For the unit value, it appears to be standard in the area I’m at.

Being bitter aside. I do enjoy working with the crew at work. I like the area and I would say my relationship with surgeons and other colleagues is very good. We help each other out when needed. I enjoy the case variety. I feel like we do a good mixture of cases that keep my skills up. Few important things for me is that I want to have more balance as I’m taking a lot of calls. Of course, thinking about the future is also something that’s on my mind. This is one of those times where I am self evaluating how much my time is worth. I definitely feel I bring tons of value to the group, and I am not sure the “bonus” I am being presented is a reflection of that. I mean, when people join national groups, the sign on bonus is like what I’m getting right now right? What is the average sign-on bonus? I mean I think I’m getting more than the usual sign on bonus, then again, I was not told how much the partners are getting so I have no reference.

Pro
- Possible increase in unit value
- Cash “bonus” over 3 years
- Continue working with people that I know.

Con
- Being associated with a national anesthesia company
- Unknown future after 3 years.
- Possible increase in hour work as people may leave the group. (One thing that I am afraid of)
- Decreased work-life balance.

 

[LifeofGas]

if you are already being told a merger is imminent, you are 100% being left out of it.

Stay if you are being paid what you feel is fair, look for something else if you don't think it is fair. In the long run the job just got worse.

Okay, so apparently the deal is still in negotiation. My boss isn't aware that I am qualified. He said something along the line, the group share has no value unless we get acquired. And instead of allowing me to get share of the group, he will give me stock from the National company instead.

 

[deleted162650]

Your contract should be very clear on when you get to be a shareholder of the current company. It should not be up to the whims of your boss. You need to push to become a shareholder NOW. He's being shady AF and playing you for a fool.

 

[GravelRider]

I would leave, no questions asked. They are screwing you. They didn’t respect you enough to bring up the merger before it was imminent? These would not be people I would want to work with. Now they can’t get their story straight in an imminent deal? Tell your “boss” that they either make you a shareholder today and if he says no then hand him your letter of resignation.

 

[rakotomazoto]

You deserve better than this nonsense. They are not dealing straight with you. I agree that it is time to demand shareholder status, as agreed upon, or move on.

 

[chocomorsel]

It's 2 years. And I am at the 2 year mark. Its seems like this merger is almost a done deal. In my group after two years we can get share of the group...like own part of the equity of the group. Never had a chance to discuss this and my boss is bringing up the merger. Our unit value is currently about $30, not very high, you mean the unit value will go up?

This is terrible. Been there, done that. Get out.

 

[sevoflurane]

Quick questions for those of you who have experienced this. I am currently working as an independent contractor all MD group in California. I’ve been here for 2 years, not a partner. Although I’m one of the more senior people at the particular hospital I’m working at. I was informed that there was a merger that is about to happen. My boss is told me that with this merger, I’d get a certain cash incentive over 3 years. We will continue to be independent contractors, but the national group will take ~10% of everyone’s monthly collection. (ex, if monthly is 30k, then 3k-3.3k will go to the group)

So the question is with the 10% deduction in monthly income in near foreseeable future, what is a reasonable cash incentive? (Is this a bad deal and I should start looking for backup? Or is this a decent deal that I am actually getting something.The cash incentive is basically roughly 2/3 of my yearly income divided over 3 years.) Input appreciated.

Not a current partner? Not really entitled to anything being an independent contractor working for the group. That being said at “almost partner”, 500k retention over 3 years is not unheard of and it depends on your multiple. 12x multiple is top of the food chain if the group can show a good profit for the AMC... $30/unit is bottom of the food chain so you likely won’t get a 500k retention.
If your group was fair and they valued you, they would accelerate your partnership.

 

[sevoflurane]

Remember guys. All MD group buyouts are low. Plus it’s california which makes it even worst.

Usap “purchased” a big east coast group primarily all MD. Each partner only got around 650k cash plus the mythical usap “stock” option which is about worthless cause they can’t find an ipo pricing. They sell it was “potential $500-1 million more” They are relying on future dumb future partner track people to buy into the internal stock are inflated prices. It’s valued between $1-3

My advice is take as high as a price straight cash as u can. Forget the stock options.

That’s what one southern group did. They took Sheridan 4 million offer per partner (but they have crnas and less partners)

But all MD groups are just not lucrative buyouts especially in California.

This is not necessarily true in any way.
It has to do with what is there during negotiations. I mean if you are selling an efficient all MD group with a average unit value of 85/unit then you’re going to get that multimillion dollar buyout.

Like any acquisition... accounts receivables at the time of acquisition (what is already there) is 1000% what determines your multiple and buyout.

 

[sevoflurane]

Okay, so apparently the deal is still in negotiation. My boss isn't aware that I am qualified. He said something along the line, the group share has no value unless we get acquired. And instead of allowing me to get share of the group, he will give me stock from the National company instead.

Yeah... sounds like USAP and that is complete BS. You want a share not stock.
Your boss is an a$$hole if he is offering you a stock option over shares. Especially after almost 2 years. Greedy.

 

[sevoflurane]

Can someone explain to me why big physician groups would sell out for that little ?

Threat of hospital employment, competing groups, inability to focus on compliance issues, overhead... etc.

 

[sevoflurane]

I always hear this, but it seems like it doesn't pan out most of the time. If it does, it's usually because they went out of network to screw the patients over.

Correct. It all depends on what is there prior to buyout. Don’t assume an AMC can negotiate better contracts than those that are already established. This is often incorrect thinking especially with large groups that already control a geographical area.

 

[sevoflurane]

Now if an AMC already controls an area (USAP/Denver)... negotiating better contracts after an acquisition is a given.

 

[aneftp]

This is not necessarily true in any way.
It has to do with what is there during negotiations. I mean if you are selling an efficient all MD group with a average unit value of 85/unit then you’re going to get that multimillion dollar buyout.

Like any acquisition... accounts receivables at the time of acquisition (what is already there) is 1000% what determines your multiple and buyout.

By sheer numbers its true.

All MD will always have to split the revenue equally. Act model is where the huge buyouts occurs. My friend averaging $90/unit in teaxas got offer 1.5 million all MD practice. While act model got 3 million plus stock options. (Total 5 million which many have cashed out internally....cough cough we know which practice I’m talking about)

Name me one practice location where the buyout number is even 2 million plus per partner in an all MD practice. Straight cash buyout. None. It happens in act model. Even in Florida. Big act model. One of the big AMCs gave main guy 7 million. The others 3 million each. Of course the main guy committed suicide last year but that’s for another story so money doesn’t buy you happiness.

 

[sevoflurane]

By sheer numbers its true.

All MD will always have to split the revenue equally. Act model is where the huge buyouts occurs. My friend averaging $90/unit in teaxas got offer 1.5 million all MD practice. While act model got 3 million plus stock options. (Total 5 million which many have cashed out internally....cough cough we know which practice I’m talking about)

Name me one practice location where the buyout number is even 2 million plus per partner in an all MD practice. Straight cash buyout. None. It happens in act model. Even in Florida. Big act model. One of the big AMCs gave main guy 7 million. The others 3 million each. Of course the main guy committed suicide last year but that’s for another story so money doesn’t buy you happiness.

Yes. My point is that there is a difference btw/ ACT buyout at 35/unit and MD only @ 85/unit. Those ACT models at 35/unit are trying to paint lipstick on a pig. That doesn’t always work out and AMCs have been burned by that.

I can personally name several MD groups that sold @ 2+ million per partner at high multiples. I can also name those who sold for 800k per partner in an ACT model with a crappy multiple. Those who achieved a multiple of 10-12x in MD only can do well, but make no mistake, those groups are on top of their regional atmosphere.

Again... it’s what is there at the time of acquisition that makes a difference.

 

[narcotics999]

Yes. My point is that there is a difference btw/ ACT buyout at 35/unit and MD only @ 85/unit. Those ACT models at 35/unit are trying to paint lipstick on a pig. That doesn’t always work out and AMCs have been burned by that.

I can personally name several MD groups that sold @ 2+ million per partner at high multiples. I can also name those who sold for 800k per partner in an ACT model with a crappy multiple. Those who achieved a multiple of 10-12x in MD only can do well, but make no mistake, those groups are on top of their regional atmosphere.

Again... it’s what is there at the time of acquisition that makes a difference.

85$/unit in California?

 

[aneftp]

Yes. My point is that there is a difference btw/ ACT buyout at 35/unit and MD only @ 85/unit. Those ACT models at 35/unit are trying to paint lipstick on a pig. That doesn’t always work out and AMCs have been burned by that.

I can personally name several MD groups that sold @ 2+ million per partner at high multiples. I can also name those who sold for 800k per partner in an ACT model with a crappy multiple. Those who achieved a multiple of 10-12x in MD only can do well, but make no mistake, those groups are on top of their regional atmosphere.

Again... it’s what is there at the time of acquisition that makes a difference.

Yes. Like my former practice act model where there was a $750k buyout more like a forced buyout we are gonna to take the contract whether you like it or not type of negotiations. 80-85% Medicare/Medicaid payor mix so that’s average less than $30/unit with a 2.7 million hospital subsidy. The amc took the ED contract along with anesthesia in a bundle deal with hospital.

But for the most act model with greater
Than 50% private payor mix will always generate more than buyout money than all MD group with same 50% private payor mix.

 

[PieOHmy]

. Of course the main guy committed suicide last year but that’s for another story so money doesn’t buy you happiness.

He was probably depressed about something.

 

[Noyac]

I would leave, no questions asked. They are screwing you. They didn’t respect you enough to bring up the merger before it was imminent? These would not be people I would want to work with. Now they can’t get their story straight in an imminent deal? Tell your “boss” that they either make you a shareholder today and if he says no then hand him your letter of resignation.

I don’t disagree however, if there are others in your position then you are highly unlikely to get what you want because they would have to do this for the others as well.

So, you must be serious when you say you will leave and you had better have the next steps in order.

 

[GravelRider]

I don’t disagree however, if there are others in your position then you are highly unlikely to get what you want because they would have to do this for the others as well.

So, you must be serious when you say you will leave and you had better have the next steps in order.

I just don’t think you want to be in a place where they don’t respect you enough to keep you informed of what is happening with the group, especially if you are on track to become partner and that partner track is up now.

Every anesthesiologist should focus on getting his or her financial house in order the moment they finish residency. You should always be able to pull out a temporary “plan B” at a moment’s notice...even if it means doing locums for 6 months. The moment a job starts treating you like an easily replaceable commodity is the moment you show them what that looks like.

 

[sevoflurane]

Yes. Like my former practice act model where there was a $750k buyout more like a forced buyout we are gonna to take the contract whether you like it or not type of negotiations. 80-85% Medicare/Medicaid payor mix so that’s average less than $30/unit with a 2.7 million hospital subsidy. The amc took the ED contract along with anesthesia in a bundle deal with hospital.

But for the most act model with greater
Than 50% private payor mix will always generate more than buyout money than all MD group with same 50% private payor mix.

Agree. Apples to apples (same unit value, efficient use of Mds/CRNAs, subsidies, etc.). ACT wins financially although CRNAs aren’t exactly cheap.
Now if you can hold on to MD only model post acquisition and still attain a great multiple then things start getting murky as work environment starts to get better if you like doing your own cases.

One of my partners sisters sold for 800k in an ACT model in NC. That number doesn’t seem to good considering ACT/supervision.

Lots of details to consider.
Good discussion.

Sorry the OP is going through this.

Take you time, consider your options, make a rational decision not based on emotions. Taking a smaller lump sum isn’t terrible. You will have time on your side to carefully plan your next move if you decide to jump ship.

 

[pjl]

Lots of people advising you to jump ship or play hard ball. Just as they have no obligation to you, you have none to them. Definitely stick it out until the deal occurs, pushing for the best deal you can. If it ends up that they have actually not come up with something you find reasonable, screw them. Otherwise, you may find yourself pleasantly surprised.
Don’t be passive though, work the deal as well as you can, and look around for options while you wait. Just don’t bail early.

 

[Noyac]

Lots of people advising you to jump ship or play hard ball. Just as they have no obligation to you, you have none to them. Definitely stick it out until the deal occurs, pushing for the best deal you can. If it ends up that they have actually not come up with something you find reasonable, screw them. Otherwise, you may find yourself pleasantly surprised.
Don’t be passive though, work the deal as well as you can, and look around for options while you wait. Just don’t bail early.

Best advice so far (among many good posts). My fear is that you would leave a location and group that you may have built a great rapport with only to find yourself in the same position yet again. This BS is happening everywhere. You are not guaranteed anything.

 

[chocomorsel]

By sheer numbers its true.

All MD will always have to split the revenue equally. Act model is where the huge buyouts occurs. My friend averaging $90/unit in teaxas got offer 1.5 million all MD practice. While act model got 3 million plus stock options. (Total 5 million which many have cashed out internally....cough cough we know which practice I’m talking about)

Name me one practice location where the buyout number is even 2 million plus per partner in an all MD practice. Straight cash buyout. None. It happens in act model. Even in Florida. Big act model. One of the big AMCs gave main guy 7 million. The others 3 million each. Of course the main guy committed suicide last year but that’s for another story so money doesn’t buy you happiness.

Oh ****. That sucks. Was this after a divorce?

 

[PieOHmy]

Best advice so far (among many good posts). My fear is that you would leave a location and group that you may have built a great rapport with only to find yourself in the same position yet again. This BS is happening everywhere. You are not guaranteed anything.

That's why the anesthesia climate is soooo terrible.
You are not guaranteed a job past 90 days.
Try building a life around that.

 

[aneftp]

Oh ****. That sucks. Was this after a divorce?

Nah. From one of former docs there. Drinking problem.

Money doesn’t make substance abuse problems go away. Not divorce. Dude out on the boat. Alcohol etc. living the good life. Sometimes too good of a life. Maybe got depressed. For whatever reason. But 7 million plus lump payment didn’t make it go away. Neither did clearing 1 million a year BEFORE the buyout Make the problem go away. Those are real numbers.

 

[nimbus]

That's why the anesthesia climate is soooo terrible.
You are not guaranteed a job past 90 days.
Try building a life around that.

It has always been that that way. The upside is that it’s very easy to find a new job, even with red flags.

 

[IlDestriero]

The fact that the deal is about done before you heard word one about it tells you all you need to know. You’re working your ass off to make partner, they’re happily taking you up on that offer to work harder for a dream that is already dead. It’s not DOA it’s long dead. These guys are giving you the head, the shaft, and the balls hard with no lube. F them. If I were you, and able to leave, I’d start looking today. I don’t know your arrangement, but I’m sure your “partner track” independent contractor income is significantly less than theirs, perhaps very significantly, and without the other ownership perks. One group I looked at pays non partner track a “very fair” 50% of their income. Of course they don’t know that. This deal didn’t appear overnight. They’ve been stringing you along for many months if not years. They might have been courting offers before you joined your “partner track”. You very well may have been hired as an independent contractor so they wouldn’t have problems with you when they sold out.
You’re swimming with sharks and snakes.
They won’t care much either when the check cashes, and they probably get a better 3 year deal too. They’ll try to make you think your $250k settlement was a really fair deal, they’re not getting a lot more, etc. Sure. Ok.
When my friends practice sold out they all made over $2M each and got a fat retention bonus for 3 years in a renewing 1 year contract. The non partner track guys got zero buy out and less than 1/2 the retention bonus for a 3 year contract. Stay 3 or repay the bonus in full. They thought they got a fair deal and the partners all got beach houses and giant piles of blow for their side chicks.
I know another guy who is an executive in one of the big AMCs. It’s 100% about the business, buying winners, maximizing profits, and the people are replaceable cogs who get the minimum possible. They’ll low ball you then come up 20% making you think you’re a big deal negotiator and laugh all the way to the bank because you left another 20% on the table because you’re a dunce who doesn’t even know how to value your business.

 

[PieOHmy]

Nah. From one of former docs there. Drinking problem.

Money doesn’t make substance abuse problems go away. Not divorce. Dude out on the boat. Alcohol etc. living the good life. Sometimes too good of a life. Maybe got depressed. For whatever reason. But 7 million plus lump payment didn’t make it go away. Neither did clearing 1 million a year BEFORE the buyout Make the problem go away. Those are real numbers.

is this charlotte? or florida?

 

[PieOHmy]

The fact that the deal is about done before you heard word one about it tells you all you need to know. You’re working your ass off to make partner, they’re happily taking you up on that offer to work harder for a dream that is already dead. It’s not DOA it’s long dead. These guys are giving you the head, the shaft, and the balls hard with no lube. F them. If I were you, and able to leave, I’d start looking today. I don’t know your arrangement, but I’m sure your “partner track” independent contractor income is significantly less than theirs, perhaps very significantly, and without the other ownership perks. One group I looked at pays non partner track a “very fair” 50% of their income. Of course they don’t know that. This deal didn’t appear overnight. They’ve been stringing you along for many months if not years. They might have been courting offers before you joined your “partner track”. You very well may have been hired as an independent contractor so they wouldn’t have problems with you when they sold out.
You’re swimming with sharks and snakes.
They won’t care much either when the check cashes, and they probably get a better 3 year deal too. They’ll try to make you think your $250k settlement was a really fair deal, they’re not getting a lot more, etc. Sure. Ok.
When my friends practice sold out they all made over $2M each and got a fat retention bonus for 3 years in a renewing 1 year contract. The non partner track guys got zero buy out and less than 1/2 the retention bonus for a 3 year contract. Stay 3 or repay the bonus in full. They thought they got a fair deal and the partners all got beach houses and giant piles of blow for their side chicks.
I know another guy who is an executive in one of the big AMCs. It’s 100% about the business, buying winners, maximizing profits, and the people are replaceable cogs who get the minimum possible. They’ll low ball you then come up 20% making you think you’re a big deal negotiator and laugh all the way to the bank because you left another 20% on the table because you’re a dunce who doesn’t even know how to value your business.

True.
keep it real.
Dont buy that house.
have plan b ready to go.
Keep medical licenses active in other states.

 

[sethco]

As an aside, does anyone else think being an independent contractor while on a "partner track" is kind of bullsh*t? I mean you are covering both the employer and employee SS/Medicare taxes, malpractice, health/dental, group life, retirement contributions, and so on. If you not making at least 350k in an all MD/DO or at least 400k in an ACT model you are getting royally screwed, and that is before even considering call frequency. Just my opinion, maybe?

 

[IlDestriero]

As an aside, does anyone else think being an independent contractor while on a "partner track" is kind of bullsh*t? I mean you are covering both the employer and employee SS/Medicare taxes, malpractice, health/dental, group life, retirement contributions, and so on. If you not making at least 350k in an all MD/DO or at least 400k in an ACT model you are getting royally screwed, and that is before even considering call frequency. Just my opinion, maybe?

Absolutely. Though if they pay enough it can be fair, and possibly advantageous re retirement savings, etc.