transparency regarding group finances

[DrBrown]

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So an attending at my program (who used to be in private practice) said it it not typical to know what the partners are making before you join a group. To me this sounds incorrect. I have talked to several groups and everyone seems pretty open about pay during partnership track and then afterwards as partner. It would seem silly to work 1-2 years towards "partner" without know what "partner" really means. Any thoughts from those in private practice? Am I off base here, or is it pretty reasonable to know what you are getting into.

Thanks

 

[coprolalia]

I recently went on my first interview and one of the partners showed me his W-2 form for '07. The other one I interviewed with didn't.

-copro

 

[militarymd]

I recently went on my first interview and one of the partners showed me his W-2 form for '07. The other one I interviewed with didn't.

-copro

I'm not saying that this guy wasn't honest with you, but the W-2 doesn't really mean a whole lot.

A corporation can be structured in such a way that the W-2 only reflects a fraction of what "owners" of the corporation take home.

Employees get the W-2 income.....owners get other income which does not have to be disclosed to employees if the corporation is not a public entity.

 

[urge]

That's why many of us choose not to be in pp. Pp is the only business which you buy into but you don't really know what you are buying into. Seems to me if you are buying a few hundred grand by takinga reduced paycheck that you should know all the finances of the business.

 

[coprolalia]

I'm not saying that this guy wasn't honest with you, but the W-2 doesn't really mean a whole lot.

That may be, but that W-2 I saw was still pretty goddamn impressive. 😉

-copro

 

[2ndyear]

Usually they'll give you some idea, but as stated above, hard numbers aren't easy to come by. The group could have a good year by being very busy, landing cases with an ortho surgeon with a great payor mix, or adding a pain guy that brings in bank. Or they could have lost a contract with an ASC.

One important thing to ask is if every partner gets the same basic cut. Some groups are organized into 'tiers' so that there are super partners that take a bigger chunk than the rest. I found a few great deals that were hospital employed as well so don't discount this route. All were in places I didn't want to be however. But total transparency, you know exactly what your pay is and everyone else's.

 

[militarymd]

When you finish schooling in some advanced engineering degree....and you go and get a job from some successful engineering firm.....do you think that you are going to have "transparency" in your pay?

Do you think that the owner/engineer who started that firm is going to tell you what his take is?

Would you expect it?

Everyone else who goes looking for a job from an employer don't expect "transparency"....why do all you new grads?

Do you all think you're special...or say better than other people looking for a job?

You think new Harvard grad lawyers expect "transparency" when they sign with that big firm?

 

[DrBrown]

Interesting points, Mil. Thanks for your reply.

 

[med2010]

When you finish schooling in some advanced engineering degree....and you go and get a job from some successful engineering firm.....do you think that you are going to have "transparency" in your pay?

Do you think that the owner/engineer who started that firm is going to tell you what his take is?

Would you expect it?

Everyone else who goes looking for a job from an employer don't expect "transparency"....why do all you new grads?

Do you all think you're special...or say better than other people looking for a job?

You think new Harvard grad lawyers expect "transparency" when they sign with that big firm?

I'm a student, so don't kill me if I'm wrong, but I think there are substantial differences between new residency grads and new engineers and lawyers. Most of the latter two will sign with large, multinational law firms and Fortune 500 companies. There's an inherent, and significant, hierarchy, and it takes many years, a series of promotions, and selection over hundred, or maybe thousands of other employees, to make partner or join the top executives. There is a great deal of difference between a new hire and those in upper management. Also, given the size of the firms, there is a lot more information available with which to judge a job offer, and often, reputation alone is enough of an assurance.

In medicine, you're either a partner or you're not, but should be in X number of years. You're probably dealing with a handful, or a couple dozen, doctors, not hundreds, and certainly not thousands. The main difference between you and the partners is how long you've been with that practice. Sure, the partners are more experienced, but once you're licensed and certified, you are more or less equivalent. There's no real hierarchy here. There are good and bad practices, and unlike most companies, these don't have a reputation outside of a small circle, and certainly don't have a large number of current or former employees to talk to. I don't see what's wrong with wanting to know what kind of money you can expect in a couple of years, and I don't understand why any good practice would hide that information from applicants they were seriously considering.

 

[urge]

When you finish schooling in some advanced engineering degree....and you go and get a job from some successful engineering firm.....do you think that you are going to have "transparency" in your pay?

Do you think that the owner/engineer who started that firm is going to tell you what his take is?

Would you expect it?

Everyone else who goes looking for a job from an employer don't expect "transparency"....why do all you new grads?

Do you all think you're special...or say better than other people looking for a job?

You think new Harvard grad lawyers expect "transparency" when they sign with that big firm?

Partnership track is a different animal. We get paid the same regardless of your experience, name, or outcome(so far). Not like lawyers. Pp people charge you a buying in fee over time by paying you less than a regular employee, most of the time less than a CRNA. The only problem is that you don't know what you are buying and you don't have any guarantee. Take my experience as an example. I interviwed at the local university program. Was offered around 230 plus all benefits, including occurence base malpractice. Then I interviewed at a pp. I was offerd 160 with no benefits and claims based malpractice which came out of my pocket at the group rate. 4 yrs to make partner. They voted on the very end of the 4 yrs. They would not cover my tail either. Partners would not disclose how much the were making. So, you can see. They wanted me to buy into the group by short changing me around 400k, without any guarantee or without me knowing fully what I was buying into. Would you imagine any businessman falling for that trap?

The whole partnership model is a scam. You should be paid for what you do. Nothing else. The head of the group should be compensated for his time out of the OR by the other anesthesiologist.

I would love Mil to defend his stance now.

 

[militarymd]

There is nothing to defend.

Being part of a group is more than just pushing propofol and sitting on the stool.

As with any corporation, there's more to it than just doing the "end job"...in our case sitting on a stool.

Stuff you generally don't learn about in medical school and residency.

As a locums, that stuff is done for you by the locums company, who makes money off you, just like a "partner" in a group.

If you don't believe that there is more than just passing gas, then there is nothing more for me to tell you.

Partnerships (employers who are also anesthesiologists) came about for a reason....yes, there are those who pay themselves more than they are worth, but who's fault is that?

The greedy "employer"....or the fool willing to work for him?

 

[militarymd]

..........Then I interviewed at a pp. I was offerd 160 with no benefits and claims based malpractice which came out of my pocket at the group rate. 4 yrs to make partner. They voted on the very end of the 4 yrs. They would not cover my tail either. Partners would not disclose how much the were making. So, you can see. They wanted me to buy into the group by short changing me around 400k, without any guarantee or without me knowing fully what I was buying into. Would you imagine any businessman falling for that trap?

........now.

How can you say what you just said?????

If you don't know what the employers are making, how can you say in the same breath that you are getting "short" changed for around 400k???

That's just crazy.

 

[urge]

There is nothing to defend.

Being part of a group is more than just pushing propofol and sitting on the stool.

As with any corporation, there's more to it than just doing the "end job"...in our case sitting on a stool.

Stuff you generally don't learn about in medical school and residency.

As a locums, that stuff is done for you by the locums company, who makes money off you, just like a "partner" in a group.

If you don't believe that there is more than just passing gas, then there is nothing more for me to tell you.

Partnerships (employers who are also anesthesiologists) came about for a reason....yes, there are those who pay themselves more than they are worth, but who's fault is that?

The greedy "employer"....or the fool willing to work for him?

For posterity. Let this be the day when everyone agrees partnertship is for fools.