Small group gets bought out? Now what?

[herewego]

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PGY3, knee deep in the job search so forgive my ignorance.

I'm interviewing at one of those small democratic groups that staffs a few hospitals locally. I heard there was a possibility they could be bought out by a larger group.

What happens to the docs in the small group? Does it just depend on what the larger group wants to do with them?

Any other tips in general for the job hunt?

Any help would be appreciated.

 

[bravotwozero]

Most likely they'll all get rehired by the new group - if they want to, that is, which would depend on if the pay and other conditions remain the same or better.

The only issue would be if the group that got bought out was a partnership track requiring buy ins etc, the attendings with buy in hoping to become partner might get royally screwed.


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[herewego]

The small group has a partnership track, don't think its buy in though. Essentially, if I were to join this small group, get paid diddly while working toward partnership, then this new group comes in, my slave labor was all for nothing?

 

[sum dude]

The small group has a partnership track, don't think its buy in though. Essentially, if I were to join this small group, get paid diddly while working toward partnership, then this new group comes in, my slave labor was all for nothing?

Yup. What you are describing is sweat equity. Big hint--there is always a buy in. If you get less per hour and less desirable shifts for a certain amount of years, that is your buy-in. EVERY group has some sort of buy-in. Some groups have an additional cash out-lay once you do buy in, which basically "buys out" the partner whose seat you are taking.

10 years ago, we were all gung-ho about democratic groups, and told to stay away from CMG's (with good reason). Unfortunately, the ACA passed and market-pressures have forced consolidation of groups, hospitals, etc. Add to that low interest rates, and we are seeing multiple decent-sized groups being bought out (the latest was FEP in Orlando, which was the largest independent group in Florida). If your group gets bought out before you make partner, you will not make back the money lost in sweat equity. I'd be very wary when interviewing about (1) small groups with only 1-2 hospitals (they'll lose contracts or get swallowed up), (2) any group with a select group of senior partners, as these are the ones most likely to sell out (not that I blame them).

Probably the only independent groups that will survive in the next 5-10 years are the large, multi-hospital groups (say about 80-100 physicians) which have multiple partners with equal equity and voting rights. These are few and far between these days, so please know what you are getting in to (ask explicit questions to multiple people).

 

[herewego]

Yup. What you are describing is sweat equity. Big hint--there is always a buy in. If you get less per hour and less desirable shifts for a certain amount of years, that is your buy-in. EVERY group has some sort of buy-in. Some groups have an additional cash out-lay once you do buy in, which basically "buys out" the partner whose seat you are taking.

10 years ago, we were all gung-ho about democratic groups, and told to stay away from CMG's (with good reason). Unfortunately, the ACA passed and market-pressures have forced consolidation of groups, hospitals, etc. Add to that low interest rates, and we are seeing multiple decent-sized groups being bought out (the latest was FEP in Orlando, which was the largest independent group in Florida). If your group gets bought out before you make partner, you will not make back the money lost in sweat equity. I'd be very wary when interviewing about (1) small groups with only 1-2 hospitals (they'll lose contracts or get swallowed up), (2) any group with a select group of senior partners, as these are the ones most likely to sell out (not that I blame them).

Probably the only independent groups that will survive in the next 5-10 years are the large, multi-hospital groups (say about 80-100 physicians) which have multiple partners with equal equity and voting rights. These are few and far between these days, so please know what you are getting in to (ask explicit questions to multiple people).

Extremely helpful. Thanks a ton.

 

[emergentmd]

Look somewhere else. I would avoid

1 - Unstable groups
2 - groups with long buy ins
3 - groups that want a large monetary by in or large pay cut in prepartnership
4- Screw prepartners on scheduling.

My former private SDG had the partners make only 50K more a yr than pre partners. There was no difference in scheduling/holidays/nights. Partners had zero benefits other than making 50k more a yr. 2 yr prepartner and 100K at time of buy in.

So you prepartners lost out of 200K but made it back in 4 yrs. I thought we had a fair model.