evaluating a private practice job

Started by ScotchBonnet
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ScotchBonnet

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Couldn't find this information with a search...apologies if I missed it.

I do not want this to turn into a discussion of the state of the job market. Let's assume you are in discussion with a private group about a job. What aspects of the job do you need to evaluate closely...group structure, benefits, hospitals/clinics served, etc? What are red flags in the ares that you should evaluate closely? Please enlighten me. Thanks.
 
Try to find out through your own connections as much as you can about the work ethics and personalities of your potential future colleagues. Others can chime in about benefits- one suggestion from me is the contract should stipulate that the group pays your malpractice tail if you leave.
 
I'm assuming this is a partnership-track position. If not, the specifics of the job don't matter as much because you will not be there long, anyway.

First you need to assess your prospective partners. Can you work with these people for the long haul? It is not like putting up with repellent students or residents for a specified limited number of years. Partnerships are longterm relationships, and you need to determine whether the relationship is worth investing in. Partners you get along well with will not necessarily make up for other job deficiencies, but a malignant work environment cannot be offset by other factors, at least not longterm. Do not take a job with people you do not trust, no matter how good it looks or how desperate you are. If the group recently lost a prospective or established partner to anything besides death or retirement, find out why and move heaven and earth to talk to him or her. Even if he/she is a jerk, you will find out information you can't get from anywhere else.

Group structures and buy-ins vary, but the key is a basic sense of fairness, or at least an attempt at it, in terms of work and compensation. In general, you'll find senior partners will always take at least some liberties they feel are due to their station, but if you can convince yourself that they are really minding the business side, that's okay. Large disparities in workload and compensation across partners are a red flag, however. They will not improve over time. Three years is plenty to make partner. Longer periods of servitude demand an explanation.

Where are your specimens coming from? Back in the day, a large locked-in referral base such as your hospital was enough. Nowadays, it's important that a potential group is actively seeking increased volume from a variety of sources. Is the group's volume growing steadily? How is group responding to economic pressures?

Pathologists just getting started tend to fetishize trivial stuff, like benefits during their indentured servitude period and current workload specifics, but they don't realize that that stuff means zilch after you make partner. Ditto job contracts, which are only useful if the relationship ends. You need to think longterm and assess where this group will be in five, ten, fifteen years, not how many CME trips you get the first year. How much do partners make for doing what, period.
 
Pathwrath said:
Pathologists just getting started tend to fetishize trivial stuff, like benefits during their indentured servitude period and current workload specifics, but they don't realize that that stuff means zilch after you make partner. Ditto job contracts, which are only useful if the relationship ends. You need to think longterm and assess where this group will be in five, ten, fifteen years, not how many CME trips you get the first year. How much do partners make for doing what, period.
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Very true. The trivial stuff is essentially meaningless if it is the right group.

If it is not a partnership track position, that could be because the partnership group is not looking to add new partners - this is a red flag. It could also because the group are employed though - this is not always a bad thing - large group practices or multispecialty groups. But if a partnership group wants to hire you as an employee (non partner track) this essentially does mean, as pathwrath said, that they don't foresee you as a long term hire. Theoretically that could change if you truly prove your worth and they change your track, but if they were a truly honest group they would be hiring you with the expectation up front that you would be a partner (groups range from 2-3 years up to 6-7 years). 3 years or so is a pretty standard amount for a fair group, that's enough time for everyone to figure out whether they are good fits as well as good pathologists.

In truly ethical groups, every partner will have the same income, with the possible exception of bonuses for those who are the chairman or something like that. There won't be "senior partners" and "junior partners" and especially not "retired partners." Does your income gradually rise until you are equal to partner income? Or do you stay at the same flat rate until you become a partner?

How about work load? Does everyone work the same schedule, same amount of call, responsibilities? Or do new hires take 2x the call, travel more, do all the autopsies, etc?

Therefore, some ways to get at red flags are finding out what has happened to all the group's new hires in the past decade or so. Do new hires all seem to leave the group after 2-3 years for various reasons? Red flag. Do group meetings exclude the non partners from all meaningful discussions? Red flag.
 
CAP has (or used to have) a Professional Relations Manual which goes into this area in depth. also covers hospital contracting.
 
There is a CAP book out now called "Lab Administration for Pathologists" or something like that, there is a chapter in the back about getting a job, what to look for in contracts, things like that.
 
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