I was wondering what the norm is in PP regarding salary/benefits increases. Been with the same group for >2yrs, non partner, good track record, equal workload as those on partnership track. Stale contract at this point. How do I broach the subject?
Question about private practice
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I asked one of my PP friends this very question at the ASA, as we get an adjustment (2-3%) every year, but go many years without adjusting the starting salary. It just went up a whipping $1000 BTW, though I think it is fair. His group evaluates the non partner track salary "every few years" and adjusts as necessary across the board. All non partners get paid the same, it doesn't matter if they're a new hire or 10 year veteran. The partner track people get killed with what I believe is an insane buy in. I would never do it, but the reward is a stable group in a reasonable location and 90+% income.
As stable as any PP group can be anyway.
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What do you consider an insane buy in?
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>$1m.
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It's robbery or maybe a kickback unless their accounts receivable approaches 1m
D
deleted126335
In the past it was undoubtedly a very wise investment for many. Less likely to be so going forward.
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I imagine going forward the only ones with an interest (or ability) in a buy in that steep will be hospitals, AMCs or some new ACO model.
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?
People line up for a chance for the rare partner track openings in his group.
You work hard for several years for comparably bad pay, doing the same load as the partners, and one day, hooray, you're a partner. Magically your income more than doubles overnight.
At least they have the ethics to tell the weak ones that they're not going to make it after a year to limit the damage. You know who's a good fit or not by then. They take their pound of flesh, but they run lean and don't get rich off of people they know won't make it.
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My buy in was over $1.5 million. I wouldn't recommend that course in this health care environment.
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Here is the question blade. We know what your buy in was, but when you decide to leave how much is the buy out? IS it 1.5 million or more? it should be!!!
No, a buy in should be based on accounts receivable. As in you are buying into your future income that was generated by the partnership before you became partner. Your buyout should be based on the accounts receivable as well, as that is what you have already "earned" buy haven't been paid.
If a group is efficient in collections, their buy in/out should be relatively small. Our groups buyins have drastically shrank in size over the last 20 years because of improved collection efficiency (and per partner income up as well).
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Are you aware of people working buy outs in their contracts upon signing? Seems like that should be worked out. If you slave away in a three year partner track and decide to leave after a year seems like you should get some money upon your exit.
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Nope. Buyout is about $120k. Back in my day long partnership tracks were the norm and starting salaries were in the low 100s. If I didn't take the job there were 3 others who were waiting to do so.
These days you all know better and the market is very different. Starting salaries are much higher but most jobs don't pay as well either after making partner. Still, there are great jobs out there with starting pay at $300K and partnership over $600K. Even then the buy-in can still be more than $800K.
The crazy is is what if u don't make partner?
I have posted a few times that my sister got hosed on a 5 year partnership.
Well in excess of 1 million plus. Maybe closer to 1.5 million the more I think. Cause partners were making $450k- back than (late 90s-early 2000s) and make $500-600k these days.
And they were paying partnership track people 120,140,160,180, 200k.
And it wasn't her who didn't get partnership. Probably half of them or more didn't make partner.
Lesson learn. Make group pay your tail if you don't make partner. It's a red flag if group top cheap to pay ur tail if you don't become partner. Big red flag in my opinion.
I have posted a few times that my sister got hosed on a 5 year partnership.
Well in excess of 1 million plus. Maybe closer to 1.5 million the more I think. Cause partners were making $450k- back than (late 90s-early 2000s) and make $500-600k these days.
And they were paying partnership track people 120,140,160,180, 200k.
And it wasn't her who didn't get partnership. Probably half of them or more didn't make partner.
Lesson learn. Make group pay your tail if you don't make partner. It's a red flag if group top cheap to pay ur tail if you don't become partner. Big red flag in my opinion.
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No. Buyout should be standard amongst partners. There is no buyout if you leave and aren't a partner and hadn't bought in. The buyin doesn't start until after you make partner.
I think my group is fair. Without specific numbers I got paid roughly 1/3 of what partners total pay was during my partnership track. Buyin ended up being half my partnership track salary. So in genertic terms...
Partnership track salary = 2X
Buyin = X
Partner salary = 6X
My sister's former group was in the mid-Atlantic state. I would out them out, but this isn't a place for it yet. They've actually gotten better the past 5-6 year, mainly cause most of the partners are nearing the end of their careers (lots in their late 60s/early 60s). So most people do become partners these days with that group.
Unfortunately for my sister and probably 6-7 other people who joined the group in her time, they got screwed over.
If groups were honest, "hey this isn't working out" after 1-2 years, it would be courtesy. Some groups in a 5 year partnership track do this for their partnership tracks and they pay their tail also.
My sister's current group which she is a partner does tell people by the 21st month whether they will be partner or not. They pay the tail for their employees if they don't become partner. They split the tail if employee leaves within 12 months. Very fair.
Anesthesiology is just another business. Buyer beware.
Honestly in this day and age, a 1-1.5 million dollar buy is probably a poor choice to make. There really isn't "stability" even in partnership groups these days with constant hospital negotiations every 2-3 years. Hospitals are leveraging management companies against local anesthesia groups. The fight can get very nasty unless all the partners of the local anesthesia group are in unison and 100% back each other to just "walk" from the contract.
Hospitals are counting on a lot of infighting with anesthesiologists who just want the status quo since they are nearing the end of their careers.
D
deleted126335
Agree. But ten years from now I would bet that some of the current desirable private practice partership jobs will still be desirable private practice jobs. Some currently desirable private practices will be acquired or dissolved. The former will be worth the steep buy in for new grads. The latter won't. There is no way to know which will make the cut. The risks have never been higher for a big buy in.
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How long is the exclusive contract predicates whether I would give a dime to another anesthesiologist to let me do some of their cases.
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you will all have to forgive me for not having business sense in this post, my training excluded it. But lets say I start a job on a "partnership track". Lets just say partners in this particular practice make 500K, those on a partnership track make 250k for 4 years. After 4 years, I have essentially paid 1 million to become a partner. As far as I know, this is my "buy in" to the practice. So after 4 years, they say "Sorry Doc, its not going to work out", shouldnt I get that million back? I mean I was BUYING part of a practice. If you now are not going to give me what I paid for, arent I due a refund?
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Thats the question I posed to blade. If there is a buy in? What is the buy out? No answer!!
II posed that question when i was inquiring about partnership positions. No answer. So i never took a partnership track position . No thanks. Pay me the market value, when im done with you i will leave.
When you start asking fiscally intelligent questions, they will no longer be interested. My advice is wait for them to make a job offer, then start asking nitty gritty questions
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Correct. The risks have never been higher and the groups likely to survive and not sell out are hard to predict.
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I answered you. Many groups including mine didn't have a formal buyin or buyout. You served you partnership track at a fraction of the partnership salary (mine was very low but these days 1/3 to 1/2 partnership income) for 3-4 years. At the end of this time they allow you to become a partner. Some groups also want you to put up accounts receivable income as well which can be substantial.
Buy-outs vary from group to group with some just giving you your accounts receivable while others give you much, much more money.
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Your buy in does not compute. How many years were you in track?
Seems to me your buy in is 4x*track years. A sizable amount of money by my standards.
Or are you saying you took a crap salary for a few years and on top of that had to shell out half that salary to become partner? If so, you got royally screwed.
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Look a his post again. Think "x" is about $125k. So, his salary was $250K for 3 years followed by a $125k "buy-in" after making partner. Then, partnership income is $730K or so plus benefits.
So, was his total buy in was over $1.3 million but look at the final salary.
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The two PP groups I considered had you buy a "share" in the group when you made partner. One was $10k and the other was $25k, both said you got it back when you left. That's about all I'd expect, other than my prorated share of the quarterly bonus that I'm due for work already done.
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I did this. Instead of answers to probably legitimate financial questions, I was told the offer is rescinded as someone else was hired. I found a job, so it worked out.
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If they won't answer basic financial questions, at least with ballpark figures, run Forrest run!
Groups these days (or at least everyone I ever talked to) don't count your lower salary before your partner days as part of the buy in. The "buy in" as I've understood from speaking with 15-20 mid to large size groups is the amount of cash you buy in to the accounts receivable. But then again they all come with a "buy out" when you leave, so really there it's more like a loan to your future self. The prepartnership income disparity is whatever they offer, you can take or leave it.
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That probably sounds like a reasonable deal, but I would hate to work for the 3 years then find out I am not partner after losing the 1.3 million plus lost opportunity cost of investing that money. Depending on what interest rate you can earn on your earnings there is a set # of years to make your money back. Also, with this new obamacare, it may become impossible to make that $730k. So when should really think about making bets about the future, especially in the world we are in right now. I actually recommend making as much money as you can today because you don't know what tomorrow will bring. In my group a nonpartner can make close to 500k with a little bit of overtime, and figure you save the 1.3 million, invest at 10% so you get an extra 130k/year for a lets say a yearly salary of 630k, for the extra 120k of which half or more will go to tax next year, you are looking at an extra 1k week after taxes going for the partnership. Personally for me, not worth the risk. Just make the money today.
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I'll give you 3% for all the 10% you can find
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From skimming all the responses, it seems there is a lot of negativity towards partnership track jobs. Unfortunately there are a lot of groups who will use and abuse you for a few bucks. But also, there are plenty of groups who want to be fair and treat non-partners as equals.
I graduated in 2010 and interviewed in IN, GA, AL, NC, and SC at about 10 practices. Besides one group (the large Charlotte based practice), all of them seemed fair and reasonable. My current practice offered a 2 year track. I made about $150,000 less than the partners. I was eligible for profit sharing in 401k after 1 year. Call and holiday duties were split up equally.
The AL group I interviewed with offered an 18 month partnership track at maybe $60-80,000 less with everything split up equally. I knew with 100% certainty that they were extremely fair
The IN group offered a 1 year partnership track. I think the difference in salary was less than $150,000.
I could go on and on. Yes, there are bad groups out there but also, many fair and reputable groups who just want a hard working, solid colleague they can trust.
I graduated in 2010 and interviewed in IN, GA, AL, NC, and SC at about 10 practices. Besides one group (the large Charlotte based practice), all of them seemed fair and reasonable. My current practice offered a 2 year track. I made about $150,000 less than the partners. I was eligible for profit sharing in 401k after 1 year. Call and holiday duties were split up equally.
The AL group I interviewed with offered an 18 month partnership track at maybe $60-80,000 less with everything split up equally. I knew with 100% certainty that they were extremely fair
The IN group offered a 1 year partnership track. I think the difference in salary was less than $150,000.
I could go on and on. Yes, there are bad groups out there but also, many fair and reputable groups who just want a hard working, solid colleague they can trust.
