Healthcare system and PE jobs

[newby000]

I am in the process of applying and interviewing for jobs.
Due to location restrictions I may consider working for a large healthcare system or a private equity owned groups for a short period of time.
I wanted to see if people can help me regarding their compensation models.
I heard it is generally a larger base and smaller productivity bonus. what would you expect in bonus structure? Similar to an associate? 30-40% of your earning. Do you know how earning is calculated? Would you typically get earning from a imaging fee and interpretation , or just your interpretation fee? Same goes for the medication you administer, do you count the 6-7% you get from the medication you administer in the office or you only get the earning from the procedure?
Does RVU vs reimbursement make a big difference in your bonus?
Is there any benefit to going with PE or health care group compared to partnership tracks? I assume future earning potential at your peak and lack of ownership and decision making, anything else I am missing?
Any tips you would give me before my interviews, so that I know what to ask and sound intelligent asking?
Thank you.

---

Members don't see this ad.

 

[dantt]

Non competes would be problematic if you're location restricted. What metropolitan area are you looking at? I don't know of any practices where large healthcare systems/PE groups operate and you'd get 40% of collections. Excess profits go to the owners.

 

[hello lady!]

I am in the process of applying and interviewing for jobs.
Due to location restrictions I may consider working for a large healthcare system or a private equity owned groups for a short period of time.
I wanted to see if people can help me regarding their compensation models.
I heard it is generally a larger base and smaller productivity bonus. what would you expect in bonus structure? Similar to an associate? 30-40% of your earning. Do you know how earning is calculated? Would you typically get earning from a imaging fee and interpretation , or just your interpretation fee? Same goes for the medication you administer, do you count the 6-7% you get from the medication you administer in the office or you only get the earning from the procedure?
Does RVU vs reimbursement make a big difference in your bonus?
Is there any benefit to going with PE or health care group compared to partnership tracks? I assume future earning potential at your peak and lack of ownership and decision making, anything else I am missing?
Any tips you would give me before my interviews, so that I know what to ask and sound intelligent asking?
Thank you.

Are you retina? Comprehensive? Medical? Surgical?

It's hard to give you a complete answer without knowing what you'll be doing.

 

[newby000]

You are right, forgot to mention, I am surgical retina

 

[MstaKing10]

40% of collections with a bonus structure seems to be the average though I have head lower. Drug is usually excluded. They should include all fees including testing and interoperation. There are some designated health services that may be excluded if you are in a multi-specialty practice (Stark law issue). Not familiar with the RVU model, would love to learn more. PE groups will usually offer higher base but ceiling is lower. There is also no expensive buy in to worry about. Lack of control is worrisome but this depends more on the owner and varies from one place to another. Most important thing to understand in my mind would be compensation structure, what's included and what's not in determining pay and bonus, non-compete, and term of contract (how many years). This of course is besides the usual things like call schedule, clinic volume, surgery centers etc.

 

[linevasel]

You should look around. There are definitely some posts out there already that address this issue (sort of). If you are going to work for Kaiser or a large healthcare system and you aren't the first Retina Doc to be employed you probably don't have a whole lot of latitude. But to answer your questions.
1. Net Collections typically lands you better reimbursement than RVUs in Retinaland.
2. PE typically will pay you salary of 400-500 (if this is your first year out) +/- bonus, which will likely be set at 30-40% of anything over 3X collections
3. Imaging Fees and Interpretation Fees - I don't have good data on this one, but from my interview season, groups (PE and non-PE ) generally liked to keep imaging fees. The argument goes that it removes the dilemma of subconsciously incentivizing yourself to order unnecessary imaging. The other argument is that its just another way to part you from your well deserved earnings. If you find a situation where you get to keep both, comb thru your contract with a fine line.... you are likely getting screwed another way.
4. In a good situation, you should be allowed to collect on some part of your injections. PE would prefer to capture all the drug money, but sometimes will create a drug pool and "allow" you to buy into it after a year or so.

Things you need to understand
1. What are your expected collections and the expected collections of your colleagues.
2. When are you eligible to buy equity *or become an equity partner*
3. When is the expected "second bite". I think they also call this a liquidity event

In general, PE proposition for a retina doc of a certain age is just too good to turn down, so it pays to understand the model, since i suspect it will be around for the forseeable future. I would arrange to have my first interview with a PE group you have no interest (or minimal interest) in joining. Ask all the dumb questions at that interview. Learn as much as you can. Read all the articles from the past 2 years on PE in Retina/Ophtho (there was a PE features this year already in Retina Today that was very insightful). Seek out a mentor or colleague or Retina Doc from your home program currently in private practice and ask the hard questions. You'd be surprised what people are willing to share. This is what I did. I am still learning. But the feedback I got on my interviews is that I was almost a little too prepared on my PE interviews. So maybe if you end up learning a lot, dumb it down a bit on the interview scene.

My 2 cents. Ultimately, I found that no matter how many ways you sliced the reimbursement cake, every PE group was pretty close in terms of my projected earnings over the next 3 years. Happy hunting