Group Practice Questions

[JustNoticing]

I'm considering making the switch from a few years of hospital based work to group practice and have an interview coming up at one with a surprisingly fair seeming pay rate. For those of you with experience in group/private practices, what types of things do you wish you'd known about in advance? Any questions you would ask a practice owner before accepting a position?

---

Members don't see this ad.

 

[AcronymAllergy]

A lot will probably be straightforward stuff you're already planning on asking about and/or they've already told you (e.g., pay, benefits, supports provided). But beyond that, you could ask if there are any productivity bonuses and/or what happens if you don't hit productivity goals (assuming there are any), whether you'll be classified as W-2 vs. 1099, what happens if you bring in new lines of work/referral sources for yourself, and what advancement opportunities there might be. And relatedly, what are the possibilities of you doing any side work outside the practice (this may be based on reviewing the contract and other materials rather than asking directly).

 

[psych.meout]

A lot will probably be straightforward stuff you're already planning on asking about and/or they've already told you (e.g., pay, benefits, supports provided). But beyond that, you could ask if there are any productivity bonuses and/or what happens if you don't hit productivity goals (assuming there are any), whether you'll be classified as W-2 vs. 1099, what happens if you bring in new lines of work/referral sources for yourself, and what advancement opportunities there might be. And relatedly, what are the possibilities of you doing any side work outside the practice (this may be based on reviewing the contract and other materials rather than asking directly).

As part of the advancement opportunities, if you receive a proportion of your reimbursement (e.g., 70-30 you vs the practice, respectively), is that a permanent ratio or does your share go up over time or can you renegotiate later based on your productivity, establishing new referral sources, the type of work you're doing, etc.?

That's important for the supports provided part. You could be getting a lot for what the practice is taking from your gross reimbursement (e.g., full admin and billing staff, psychometrists if you do testing, managing referral sources and networks to get you good referrals that aren't a headache and bill well), such that you can almost entirely focus on clinical tasks and don't have to much if any of the other BS. Practices at the other extreme take relatively large cuts for a pittance and often try to frame it like they're doing you a favor and that they could be taking more for what they are offering and that you're lucky that they're employing you.

For bringing outside work, some practices want their typical cut from it like their own referrals, while some others will let you use their resources (e.g., staff, office space) for a flat rate. I know some psychologists who do this in private practice and/or AMCs for forensic work. I'm not sure exactly how they negotiated their respective situations because I don't really do forensic work, well, at least not currently.

 

[smalltownpsych]

As alluded to in above posts, the questions to ask really depend on what the nature of the compensation arrangement is. A lot of group practices offer a split such as 70/30 based on billing. If it’s salary or salary plus productivity then it’s typically much different questions.

 

[GT_Neuro]

Find out what you are getting for your split. For example,

Do they provide psychometricians.
What tests do they have. This is especially important if you are an assessment psychologist / neuropsychologist. Are they willing to buy tests that you need. Do they pay for all protocols, pay per scores (e.g., MMPI-3), etc. (they should).
What are their referral sources? What type / how many patients can they get you? (I would suggest talking to the other Psychologists in the practice to find out their experiences).
How much Admin support is there; if you take insurances you need significant admin support to make it happen.
Do they include billing (they should). What are their collection rates? Do they pick up the cost of credit card fees?
Do they pay for marketing? What type of marketing do they do?
Will they help you get on insurance panels?

Do they have negotiated rates with specific insurance panels, if so what are they. This is huge. Everyone worries about the split. A better question is how much are you actually taking home. I have a Neuropsych / Assessment practice. Some of the testing codes that I have negotiated are 50% higher than the going rate. Note that if you agree to take Medicaid / Medicare those are fixed rates.

Do they pay for your Lic fee? Liability Insurance? Board Certification? Workers Comp fees? Business Lic fees?

What are the expectations in regards to the # patients / evals per month.

Is there an incentive program in place (e.g., you get bonuses or a higher split if you meet specific goals). Also, is there a punishment system in place (e.g., you get deductions if you don't meet goals); I haven't heard about this when I talk to other practice owners but probably something to ask about.