Job offer

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psychma

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I work independently through my LLC and do autism evaluations and counseling, mostly with neurodivergent folks. The last few years, I’ve been working from my home office doing things via Telehealth.

I began working collaboratively with a psychiatrist about 6 months ago. We hit it off as friends. Last week, he offered me a 1099 job through the group practice he owns. I can keep my practice and also work out of his office and get referrals from his group.

The upsides are being around people again as well as working in-person with clients. The Downside is that they would pay me roughly $50/hr less than what I earn in my practice. My going rate for testing is $250/hr.

I feel very flattered by this offer and I think it would be great to work with people again. If they have a lot of referrals, the $50 wouldn’t matter because I wouldn’t have to advertise. It would be a wash.

What should I be thinking about before making a decision? It should be a no brainer. I should do it, but I’m hesitating. Even though I technically would have my autonomy, I’d be working for a group practice as a 1099 so no benefits. I feel proud of my business and this feels like I’m giving it up. Am I overthinking it?

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I don't think you're overthinking it at all. Right now you work for you and you're considering become employed without benefits. Is there anyway for you to do both? Like sign on as a 1099 M-W and keep your own practice Th/F or something like that? How well do you know this clinic and staff other than the doc?
 
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I work independently through my LLC and do autism evaluations and counseling, mostly with neurodivergent folks. The last few years, I’ve been working from my home office doing things via Telehealth.

I began working collaboratively with a psychiatrist about 6 months ago. We hit it off as friends. Last week, he offered me a 1099 job through the group practice he owns. I can keep my practice and also work out of his office and get referrals from his group.

The upsides are being around people again as well as working in-person with clients. The Downside is that they would pay me roughly $50/hr less than what I earn in my practice. My going rate for testing is $250/hr.

I feel very flattered by this offer and I think it would be great to work with people again. If they have a lot of referrals, the $50 wouldn’t matter because I wouldn’t have to advertise. It would be a wash.

What should I be thinking about before making a decision? It should be a no brainer. I should do it, but I’m hesitating. Even though I technically would have my autonomy, I’d be working for a group practice as a 1099 so no benefits. I feel proud of my business and this feels like I’m giving it up. Am I overthinking it?
What's your overhead %? Are they covering all overhead as part of the 1099 offer? Does that include any support staff?

You could counter-offer by suggesting you do your own billing and scheduling but rent space from them (colocate/sublease.)
 
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You're not giving up anything with a 1099 and you can pull out at any time. Your "no brainer" instinct was correct. If it doesn't work out perfectly, you stop doing it. Believe me, that's how the psychiatrist views this or they would make you a W2.
 
Beyond the financial, I find it very hard to believe you are not losing something doing all remote ASD evals. Those are life changing evaluations, haven't seen the data on virtual ADOS yet, but I just cannot imagine it be the same. Having a physical space to bring in the trickier evals seems like a no-brainer clinically as a pediatric psychiatrist.
 
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The nostalgia of working with people. Being around people. Small talk. Has its benefits.
But that's also wasted time. Meetings. Gossip. Or learning things about people you really didn't want to know learn.
In general, we have a tendency with time to remember the good things more than the bad.
Time is our most precious resource. If you are very efficient as a solo - keep it that way.
If this new gig doesn't skew the scales strongly in your favor, not worth the risk. Unless you are bored and truly want something more to do...
 
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Beyond the financial, I find it very hard to believe you are not losing something doing all remote ASD evals. Those are life changing evaluations, haven't seen the data on virtual ADOS yet, but I just cannot imagine it be the same. Having a physical space to bring in the trickier evals seems like a no-brainer clinically as a pediatric psychiatrist.
I work with adults using the MIGDAS-2. I assessed children earlier in my career and could not do that via telehealth.
 
Thanks for the thoughtful responses. I can’t help but feel like I’m doing fine on my own and people are overrated. I totally hear that about meetings, gossip, and office politics, My overhead would not be covered btw. I think it was just nice to be wanted. I’ve enjoyed a good relationship with this physician. How can I gracefully bow out and maintain the same rapport?
 
It's just business. They should not take in personally if you politely decline. Or else negotiate for them to pay you your usual rate. They could charge more for your services so they're still making something out of this arrangement.
 
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Thanks for the thoughtful responses. I can’t help but feel like I’m doing fine on my own and people are overrated. I totally hear that about meetings, gossip, and office politics, My overhead would not be covered btw. I think it was just nice to be wanted. I’ve enjoyed a good relationship with this physician. How can I gracefully bow out and maintain the same rapport?
Say the truth.
Friends are the ones we can/should be most truthful with.
 
Thanks for the thoughtful responses. I can’t help but feel like I’m doing fine on my own and people are overrated. I totally hear that about meetings, gossip, and office politics, My overhead would not be covered btw. I think it was just nice to be wanted. I’ve enjoyed a good relationship with this physician. How can I gracefully bow out and maintain the same rapport?

I really don't understand the downsides of trying this out when you get to keep the business you currently own. If you were like 100% full during the week then yes i understand it makes no sense.

But if your like 50% full why not get income for the other 50% while continuing to build your other business. Your right the PP exposure will help grow and market your own business anyways. In a few years you could simply bow out if your main business is too big.
 
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I really don't understand the downsides of trying this out when you get to keep the business you currently own. If you were like 100% full during the week then yes i understand it makes no sense.

But if your like 50% full why not get income for the other 50% while continuing to build your other business. Your right the PP exposure will help grow and market your own business anyways. In a few years you could simply bow out if your main business is too big.
why work full time when part time is plenty?
 
why work full time when part time is plenty?

Well unless poster is later in career and has already built up FIRE money, its a wasted opportunity that could ultimately increase their part time work volume and allow them to charge more per hour in the future even if they did a short term trial with the 1099 work. You also don't want to take these opportunities for granted when in the future everyone can do some course online and be able to prescribe and what not

Imo it's great to maximize your efforts in your 30s and early 40s so you can naturally build a cushion and wind down how you see fit and allow compounding to best be maximized. At least for me my hard work isn't just for me to utilize. I also think of future kids needing help, parents, family members, charities etc.
 
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Well unless poster is later in career and has already built up FIRE money, its a wasted opportunity that could ultimately increase their part time work volume and allow them to charge more per hour in the future even if they did a short term trial with the 1099 work. You also don't want to take these opportunities for granted when in the future everyone can do some course online and be able to prescribe and what not

Imo it's great to maximize your efforts in your 30s and early 40s so you can naturally build a cushion and wind down how you see fit and allow compounding to best be maximized. At least for me my hard work isn't just for me to utilize. I also think of future kids needing help, parents, family members, charities etc.

Person is a masters level therapist who does solo entirely virtual adult autism assessments apparently. Same issues don’t apply here.
 
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Well unless poster is later in career and has already built up FIRE money, its a wasted opportunity that could ultimately increase their part time work volume and allow them to charge more per hour in the future even if they did a short term trial with the 1099 work. You also don't want to take these opportunities for granted when in the future everyone can do some course online and be able to prescribe and what not

Imo it's great to maximize your efforts in your 30s and early 40s so you can naturally build a cushion and wind down how you see fit and allow compounding to best be maximized. At least for me my hard work isn't just for me to utilize. I also think of future kids needing help, parents, family members, charities etc.
you realize how paranoid that sounds? Need to overwork now in case you can't overwork later? Chill out, man. Work the amount you want to work and be glad you're in a profession where you can do that comfortably.
 
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I’m a mid-50’s therapist married to a Doctor. Our retirement is fully funded and finances are good: house paid off, kids’ college funded. My practice is pretty full. I would be trading my referrals for theirs. I feel like I’m pretty busy.
 
Person is a masters level therapist who does solo entirely virtual adult autism assessments apparently. Same issues don’t apply here.
Somehow this comes off derogatory. I use the MIGDAS-2, RIAS-2, WCST, BTA, SRS-2, ABAS-3. and DREF-Adult for autism/adhd testing. I was trained in the MIGDAS by the test developer. I have 5 years of supervised training by a neuropsychologist.
 
you realize how paranoid that sounds? Need to overwork now in case you can't overwork later? Chill out, man. Work the amount you want to work and be glad you're in a profession where you can do that comfortably.
I mean, yes and no. C/L psych and I'm constantly dealing with families who didn't plan for major life event A/B/C and are now in dire straits. Not saying one should kill themselves with work early to address this, but I'd question anyone who says it isn't easier to work harder when you're young. Especially with the compounding benefits of having money early and the options it can open up for life later.

I’m a mid-50’s therapist married to a Doctor. Our retirement is fully funded and finances are good: house paid off, kids’ college funded. My practice is pretty full. I would be trading my referrals for theirs. I feel like I’m pretty busy.
Then do what makes you happier. If giving up administrative duties to work for someone else is easier, do it. If you value your independence and autonomy as your own boss, then don't. If money isn't an issue then that takes a huge consideration out of the picture.
 
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