Private practice partnership track position in southeastern state, small town, general surg path and Cyto (doesn't need to be Cyto trained).

[Mx300]

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Hi guys,

My group is looking for a pathologist who is will to sign out general surg path and cyto (doesn't have to be boarded necessarily but willing to sign out). We are a really supportive group in a small town in the south-eastern US. We have partnership track (4 years) and more flexible opportunities available. All experience levels are considered. We are located 1-3 hours from 4 larger cities and the cost of living is very low. I would say our volume is moderately high with low-medium complexity. We are at one location (no driving around to different hospitals), frozen are low complexity and volume. Pay is based on experience level, non-partners start with 8 weeks off. I started here as a new grad and really love the work environment, it's very supportive and I have been impressed with how pretty the town is and the surrounding area. Cost of living is dramatically lower and people are very kind, down to earth and non-judgmental (I'm part of a minority group, so don't feel hostility here that I have felt in other areas of the country). Strong history of people making partner. Most partners this was their first and only job. Staff is great and with low turn over, have many staff members that have been working in the position >10 years. Relationship with clinicians is very good.

Honestly this place is a hidden gem, I think that the biggest drawback is it being in a small town, however I have found it to be a great change in pace ( I grew up in a metropolitan area). I encourage people to check us out! Please DM me for additional details.

 

[KeratinPearls]

Sounds like a good job where, most importantly, there are pleasant people to work with. How come so long to partnership though? I would think 1-3 years is sufficient time.

 

[Mx300]

Sounds like a good job where, most importantly, there are pleasant people to work with. How come so long to partnership though? I would think 1-3 years is sufficient time.

There is no money buy in for starters it's completely a time buy in. For the amount that the partners make which is above average for partners it's about average. My experience on the job hunt was that 1-3 year partnership opportunities were either involving a monetary buy in or the partners were making less than what this group does.

 

[Pathprimer]

Four years is a long time. A lot of things can happen. I wouldn't consider anything more than 2 years. Particularly given the current nationwide shortage of pathologists.

 

[Sawback3]

2-3 years is reasonable. Four years is too long. I’ve heard too many bad stories about uprooting to start at a practice like this only to do it all over again a few years later.

There’s a low level of trust out there. I’m more trusting of our administrators at this point (who “manage” all the docs in the hospital system), than a couple of the pathologists that I work with.

Not knocking this group, though. Might be good, who knows.

 

[Mx300]

That’s interesting, from myself and my co-residents and fellows job search. I haven’t heard of majority of partnership track jobs having that few partnership track years. The one that was had a significant monetary buy in. The other person I’m aware of their track is longer that mine. I know of a couple very lucrative practices that also do a time buy in that was 5-7 years. I would like things to be quicker to make the kind of money the partners do but I don’t see that represented in the job market. Also I am very debt averse so I don’t like the idea of taking out a business loan to buy into a practice. I guess it’s what people are comfortable with.

 

[KeratinPearls]

4 years is better than what I saw when interviewing. It was five years to partner. One group had 6-7 years until full shareholder but they gave you incremental increases in salary.

 

[KeratinPearls]

Four years is a long time. A lot of things can happen. I wouldn't consider anything more than 2 years. Particularly given the current nationwide shortage of pathologists.

Shortage of pathologists? I think regionally in some areas there are shortages like rural or semi rural areas (2-3 hours out from large city) but when people getting offered 250 to start in the NE, I’m not sure there’s a shortage. But it sure beats the 170-180 to start five or so years ago.

 

[octopusprime]

I'd rather have partnership track commensurate with experience level than compensation, unless you're paying me near partner level of compensation.
The inherent point of a partnership track for a job in which there is zero or marginal overhead or assets is to gauge mutual interest/fit, and ensure a candidate is capable of the work, and as a means to acknowledge "time-in-service". Surgeons have partnership tracks d/t to assets, imaging and outpatient facilities; GI docs have partnership tracks d/t outpatient endo suites; IM has partnership tracks d/t pools of established patients. Pathology in 2024 has partnership tracks either because there are actually significant tangible assets in which to become vested (which is less common) or as a means to slowly graduate people into the group, generally right out of training, as their contribution to the group is slow right out of the gate, their liability is higher, and they require more supervision. A probationary period. If anyone with several years of experience is interested, I'd seriously consider modifying the partnership track accordingly, say shave a year off for every ~2 yrs of practice experience. Eg. 6 yrs of experience, 2yr track, with sliding scale compensation.

I get it it's not always a good fit...someone with 7 yrs academic experience could come in and just not be a good fit if they're easily bogged down in minutia and academic questions and not budget conscious...but 4 yrs 'no exception' is too long. Unless you only want to attract new hires or people desperate to live in the area.

 

[Zarniwoop]

Nowadays it is highly unlikely that the reward/risk ratio is high enough to make a "partnership" position a wise choice.
I put partnership in quotes because the definition is different from group to group, and changes over time even within a single group.
Usually even when people become "partners" they are still far from equal.
You can't use information about the current partners in a group to help make your decision, because the process for them was probably totally different than it will be for you.
I would only recommend taking the "partnership" plunge if a close family member or a close friend is a partner in the group already - some cool senior resident from your training program doesn't count for me.

 

[octopusprime]

Nowadays it is highly unlikely that the reward/risk ratio is high enough to make a "partnership" position a wise choice.
I put partnership in quotes because the definition is different from group to group, and changes over time even within a single group.
Usually even when people become "partners" they are still far from equal.
You can't use information about the current partners in a group to help make your decision, because the process for them was probably totally different than it will be for you.
I would only recommend taking the "partnership" plunge if a close family member or a close friend is a partner in the group already - some cool senior resident from your training program doesn't count for me.

true points..."partnership" is always relative to the group, and rarely "equal". But regardless of what what it actually entails, it is almost universally more money, and that's almost always the bottom line.
partnership track, employee, jr attending: X dollars.
partner: 2X dollars.

In pathology, historically, "partnership" meant stability and voting rights and higher income. If you're a small group, why would you not want those things? I'll take the bumps and lumps of an imperfect partnership over the indentured servitude of Quest or the 4-6 weeks of vacation and nitpicking minutia of a hospital employed position (unless there's a massive pension attached).

 

[Euchromatin]

If the pros of the group, hospital and location are as you state, I don't think that 4 years is really all that unreasonable for a partnership track that does not involve a monetary buy-in. Would depend somewhat on assets owned (does the group own their own AP lab? the real estate their office is located in?), billing arrangements, contracts, stability, etc. Would be even more palatable if there was a gradual vesting process that started earlier than that and completed at the 4 year mark. I had a 3 year partnership track, but I had take out a loan to pay 1/x (x = number of partners) the value of the business as a buy-in.

It would depend somewhat on what specific state it is located in, but I personally would be reluctant to move anywhere in the south or southeast as a woman of childbearing age at the moment (or if I were the spouse/partner of one). A lot of physicians and other professionals tend to wait until later in life before trying to start a family, increasing risk of miscarriages, chromosomal anomalies, need for IVF, etc. I would not want to be stuck waiting for a medically necessary D&C until fetal heartbeat ceases or I am sick "enough" that some politician would agree my life is at risk (or having to travel to another state to get one, where care might be out of network for health insurance provider), etc.

 

[Pathprimer]

"I’m more trusting of our administrators at this point (who “manage” all the docs in the hospital system), than a couple of the pathologists that I work with."

Words of wisdom. I wish I'd known this earlier.

 

[Dave CX]

"I’m more trusting of our administrators at this point (who “manage” all the docs in the hospital system), than a couple of the pathologists that I work with."

Words of wisdom. I wish I'd known this earlier.

Administrators can be serious idiots, but they are less sneaky than pathologists.

 

[mike-sheree]

Administrators can be serious idiots, but they are less sneaky than pathologists.

Not my experience at all.

 

[coroner]

For pp partnership, I've seen a range from as low as zero and as high as 5 years (maybe an odd job that exceeded 5+, but I don't quite remember).

If I had to break the frequency encountered of various partnership track lengths me and other colleagues have encountered (strictly anecdotal), it would go as follows:
a) 0-1 years: Least common, about 10% of jobs
b) 2-3 years: Most common, about 70-75%
c) 4-5 years: Less common, about 15-20%

At this stage in my career, I'm not motivated enough to wait for a 4-5 year partnership track unless it was obscene dollars being thrown around (7-800K+), with proportionately incremental raises, and no low-balling on the starting income either i.e. must start at 4-500K. Not, "250K and work your way up!" But that's me. For others, their expectations, patience, and career timeline may be totally different.

As mentioned above, the term "partnership" can mean various things and you must know EXACTLY what this means before accepting a job and if you're ok with that i.e. do you get to see the accounting books, voting rights, ownership of any assets, your name as a shareholder in the LLC or S corp., etc. Oftentimes, most people think of money and getting raises as they reach partnership; but that isn't always the case. A better term to use when thinking along those lines would be reaching "financial parity".

 

[mike-sheree]

For pp partnership, I've seen a range from as low as zero and as high as 5 years (maybe an odd job that exceeded 5+, but I don't quite remember).

If I had to break the frequency encountered of various partnership track lengths me and other colleagues have encountered (strictly anecdotal), it would go as follows:
a) 0-1 years: Least common, about 10% of jobs
b) 2-3 years: Most common, about 70-75%
c) 4-5 years: Less common, about 15-20%

At this stage in my career, I'm not motivated enough to wait for a 4-5 year partnership track unless it was obscene dollars being thrown around (7-800K+), with proportionately incremental raises, and no low-balling on the starting income either (starting at 500K). But that's me. For others, their expectations, patience, and career timeline may be totally different.

As mentioned above, the term "partnership" can mean various things and you must know EXACTLY what this means before accepting a job and if you're ok with that i.e. do you get to see the accounting books, voting rights, ownership of any assets, your name as a shareholder in the LLC or S corp., etc. Oftentimes, most people think of money and getting raises as they reach partnership; but that isn't always the case. A better term to use when thinking along those lines would be reaching "financial parity".

These must all be considered and are valid points. Most situations have some honey with some vinegar. Just for an example- I was hired in 1988 after 10 1/2 yrs U.S. Navy. Triple (forensic at AFIP) with 2 years experience. Clinical internship with 2 yrs “g.p.”. Hired thru a Navy connection. Group had “honorable “ hx. Took low ball offer of 100k due to strong geographic/wife desires. No promises but 3-4 years (almost all 4) standard to partner. I was told “the buy in isn’t cheap” Got raises over the 4 yrs up to 160k. Benefits outstanding at all times. Got my own hospital. Made partner at yr 4 with $160,000 buy in. There was SUBSTANTIAL physicial infrastructure ownership. We ALL13 partners had financial/voting parity and were equal owners of the P.C. I became secy/treasurer after 2 yrs so I KNEW. Largest A.P. Histo lab in state of which I also became med director. Became partner in July 1992 and made $750,000 in that year. Until we sold to Ameripath in 1996 (before it was a publically traded entity) I made $550,000-750,000. We participated in the IPO of Ameripath with stock options and production bonuses. Salary cut to about $275 with less generous bonuses. My job stayed the same although I had to give up histo lab director because my hospital was too busy. Quest bought Ameripath around 2004? Took advantage of stock options in Quest at the time. My job and income stayed the same. When I retired from Quest I made $425,000 in 2012. Was med director at same hospital for about 25 years.

So, you see, there ain’t no crystal ball. You take your best shot and go with it. I lucked out but positioned myself well with lots of “delayed gratification “.

My military connections were critical and we hired many others. Connections, one way or another, seem to be the name-of-the-game.

Did some folks several years behind me not do as well? Certainly. Did I do as well as the partners who had preceded me by 5+ years- hell no.

I rolled the dice and took my chance.

YMMV.