Looking for a job and need some education/advice regarding private practices

[osoprop28]

Hey guys, I'm finally a CA-3 and looking for jobs, and I'm little lost so was hoping for some education/advice regarding how to evaluate some of these private practice models.

One place I'm interested is a small private practice, MD only, 3 year partnership track, no buy-in.
What's the major benefits of making a partner other than higher salary? Is it worth taking lower salary for 3 years for that jump? And if this practice gets sold to an AMC ( was told, what happens to my partnership & my job?

The other places I'm looking for are owned by MedStar (which is not AMC from what I understand?) They offer competitive salary with good benefits and seem like I would be happy at these places.

My main concern is going to a small practice, make partner, then being sold and everything changing (although I'm not sure what happens after?) versus going to a place with stable employer model. Is there any reason I should go after the partnership track? Seems like making partner is a big deal from talking to other people but I'm not sure I understand all the benefits.

Thanks so much for all the help!

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[okayplayer]

I’d you’re paid less during the partnership track than partners are paid, that’s a buy in.

 

[deleted171991]

I’d you’re paid less during the partnership track than partners are paid, that’s a buy in.

Or a sucker's job, and you will have a real buy-in when you become eligible for partnership.

 

[dhb]

Three years is kind of long but it also depends on what's waiting at the end: if it's a great group making 95th percentile pay with 12 weeks vaca or more then it's probably worth it.
The only way to protect yourself in case of a buy out is to have a written clause in your contract that will grant you a % of the buyout relative to time spent on the partnership tract.

 

[Twiggidy]

Hey guys, I'm finally a CA-3 and looking for jobs, and I'm little lost so was hoping for some education/advice regarding how to evaluate some of these private practice models.

One place I'm interested is a small private practice, MD only, 3 year partnership track, no buy-in.
What's the major benefits of making a partner other than higher salary? Is it worth taking lower salary for 3 years for that jump? And if this practice gets sold to an AMC ( was told, what happens to my partnership & my job?

The other places I'm looking for are owned by MedStar (which is not AMC from what I understand?) They offer competitive salary with good benefits and seem like I would be happy at these places.

My main concern is going to a small practice, make partner, then being sold and everything changing (although I'm not sure what happens after?) versus going to a place with stable employer model. Is there any reason I should go after the partnership track? Seems like making partner is a big deal from talking to other people but I'm not sure I understand all the benefits.

Thanks so much for all the help!

Depending on the compensation model, making partner simply could mean higher salary (or it may not) and a seat at the voting table. That's pretty much it. As said above, if there's even a sniff of the practice being sold and you want to be a part of that practice then you should have a cut of the buyout written into your contract. Asking for that could be a potential deal breaker with the employer, but if that's the case it tells you everything about the people you would've been working with. I think in todays anesthesia job market and economy, job stability, even if it comes with lower pay, may be a bigger positive than the potential for big money from a small practice. I argue it's a reason why some stay in acadamics, ie, for the stability.

 

[IMGASMD]

How big is the jump? How many partners? Are there super/senior partners? Call structure? Plenty of things that you need to learn about.

Some people are okay being an employee and being told what to do, at the end of the day with a stable paycheck. Some people want a seat at the table and be able to make decisions later.

 

[B-Bone]

As a partner in a private practice, I think people are underestimating how much self-determination means. I have watched and listened to so many people over the years talk about how things outside of their control in an employee model drive them crazy, and they end up with no options other than voting withv their feet to start another employee job. This includes academic practices. Getting told that you have to cover x/y/z on top of your existing practice (and sorry! we won't be hiring for this!) and having your hours/call/day-to-day job change (usually for the worse) at a moment's notice sucks real hard. Not that there aren't challenges when you're steering the ship; it's definitely tough to run a profitable business, deal with contracts/changing coverage needs/personnel/etc. My group is constantly doing a balancing act between making money and lifestyle concerns, all while providing a top-notch clinical service and navigating hospital/system/payor/etc politics AND trying to grow and avoid corporate takeovers. That all requires a significant committment and effort from my partners, but it's absolutely worth it. At the end of the day, I make great money, take a ton time off, and I have a thriving, stable business that I helped build and maintain. The fleixibilty to do what we want, when we want, how we want is the most satisfying thing about my job. If we decide to run lean, we can do that and make serious, serious bank. If we decide we want more time off (or be less busy day-to-day) and are okay with making less money, we can hire up and split the pie more ways.

I don't remember much from college these days, but I do recall a bunch of psych experiments that demonstrated that lack of control/self determination in a given scenario is one of the most potent stressors there is. Of course I can't control everything, but every little bit goes a long way to happiness/satisfaction and staves off the burnout I hear so much about in medicine.

 

[deleted171991]

As a partner in a private practice, I think people are underestimating how much self-determination means. I have watched and listened to so many people over the years talk about how things outside of their control in an employee model drive them crazy, and they end up with no options other than voting withv their feet to start another employee job. This includes academic practices. Getting told that you have to cover x/y/z on top of your existing practice (and sorry! we won't be hiring for this!) and having your hours/call/day-to-day job change (usually for the worse) at a moment's notice sucks real hard. Not that there aren't challenges when you're steering the ship; it's definitely tough to run a profitable business, deal with contracts/changing coverage needs/personnel/etc. My group is constantly doing a balancing act between making money and lifestyle concerns, all while providing a top-notch clinical service and navigating hospital/system/payor/etc politics AND trying to grow and avoid corporate takeovers. That all requires a significant committment and effort from my partners, but it's absolutely worth it. At the end of the day, I make great money, take a ton time off, and I have a thriving, stable business that I helped build and maintain. The fleixibilty to do what we want, when we want, how we want is the most satisfying thing about my job. If we decide to run lean, we can do that and make serious, serious bank. If we decide we want more time off (or be less busy day-to-day) and are okay with making less money, we can hire up and split the pie more ways.

I don't remember much from college these days, but I do recall a bunch of psych experiments that demonstrated that lack of control/self determination in a given scenario is one of the most potent stressors there is. Of course I can't control everything, but every little bit goes a long way to happiness/satisfaction and staves off the burnout I hear so much about in medicine.

+1000.

When the British did the famous Whitehall study about what type of jobs are associated with early mortality/morbidity among civil servants, at first, the answer seemed to be the stressful jobs. Except it wasn't the CEOs who were getting the heart attacks, it was their secretaries. The low-level people (e.g. messengers) had 2 times the cardiac mortality of administrators (when after controlling for all the right things). So then they figured out that the highest form of stress for an individual is lack of control. The most stressful jobs are the jobs where you don't know what you'll do next (when the phone/pager rings). It's the uncertainty and lack of control that causes much more stress than predictable and self-adjustable high workloads (e.g. intensivists prefer the ICU to the OR).

And that's probably why anesthesia is one of the specialties with the highest early mortality rates. Being someone's bitch, instead of being your own boss, takes a toll.