Private Practice with support from local hospital

[0ncogene]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

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[deleted941485]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

That seems weird. The money might be seen as some kind of kickback?

 

[LunaOri]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

It’s not uncommon. You would want to know what the expectations for on-call are, whether there are other ortho practices in the area (are you being brought in to compete with them?) Do your due diligence to figure out whether the community can support your practice after the first year.

 

[anonperson]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

What is your penalty for not staying the full four years?

Is there another group you are competing with?

Who covers the ER? Are they requiring you to cover ortho call? What is the call requirement? They should be paying a stipend for that.

You do not want to be covering all the time.

Who will cover call for your own practice when you go on vacation?

You are in a highly in demand lucrative specialty (especially for the hospital)..

You have a good amount of leverage so please use it to your advantage to get a fair deal.

 

[0ncogene]

That seems weird. The money might be seen as some kind of kickback?

Seems like there is a way around this. There is no quid pro quo in any of the conversions I've had with them, and I think that's how they avoid violating the anti-kickback law.

Thanks everyone for the response. I am going to do more research and update this thread in the future. Starting a solo practice out of fellowship is scary but I think I'll enjoy the autonomy.

 

[Wordead]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

This is a typical arrangement that I encountered when I was interviewing. Usually they offered income, block time, bought OR equipment, etc if you stayed a certain period but usually I encountered 2 years. 4 seems high but I dont know what the range is. Im sure there's some other annoying caveat or "catch" at some point though.

Would definitely have a contract lawyer look it over and do some negotiating. And get the major equipment needs in writing.

 

[Saddleshoes]

Currently doing an orthopedic fellowship and plan to go start a solo private practice (not hospital employee) after I am done with training. A community hospital is willing to financially support my practice and give me an income guarantee my first year to help me get going, as long as I stay in the community for 4 years. Has anyone gone through with this and willing to share their experience? What are things I should know before signing the contract?

I am NOT a ortho guy but I had a very similar deal coming out of dental school with a small farming town.

It worked out great for the first 3 years but there was a limit to the growth. I learned a lot and was happy for my first 3 years. After 5 years it became obvious that I was not going to move up anymore. I sold out and moved on.

My shoot from the hip advice... Take the deal! But plan on going to bigger community with a group pratice at the end of your commitment.