This. They write editorials and blogs about how "value based care" is so much better for all the stakeholders. Smoke and mirrors.
One thing i cannot reconcile is that at least subjectively these PE practices seem to have a lot less associate turnover than standard private practices. I am not sure why that is.
Yep, it's what
@Boba Foot said basically... they pay you a decent base the first year (150-180k usually), then they make it straight 30%.
The associate usually doesn't have their budget and their student loans figured out that first year and/or has grace period. So, that
seems like a lot of money. It's the frog in boiling water.
They get comfortable, some even
"buy" mortgage houses or
"buy" borrow cars/trucks or lay roots like friends or clubs or kids in school or whatever... and then they are basically trapped. On straight 30% collections, it's then pretty hard to even take much vacation without taking an income hit ($500k collect per year to keep even $150k income), so they're stuck on the hamster wheel for decades... seeing the schedule and doing the "protocols" the supergroup gives them. Their "career" peaks a few years into working at these supergroups. It's just like PharmDs working at Walmart, CVS, etc.
...Even in places with
out non-compete, you'd be surprised how many podiatrists don't have better options than these supergroups.
NMex, where I practice, has no non-competes. It's like Cali where they don't hold up in court at all, but that doesn't stop some groups from trying to put it into the associate contracts anyways... to discourage associates going to competitor groups or solo or hospitals. The biggest pod group here changed control to PE last year; new contracts were issued. They have about a dozen docs in this state (and more in other states).... and 2 of their best 3 docs quit almost immediately for hospital job and other PP group work. The only solid one left working in that supergroup now got ABFAS cert this year, so that doc might be gone soon also if they have better options. We'll see.
PP associate in a normal small/medium pod group is always an option, but that is not as attractive as supergroup first year pay for most podiatry grads with $300k or $400k or maybe even $500k debt if they took private or max loans or didn't pay interest in residency/fellowship. Even if most regular PPs have higher % collections pay like 35% or 40% or whatever, they usually have a bit lower guaranteed base early ($100k-$150k usually), they are usually variable and would take a couple years to pass the supergroups in pay. The vast majority of new grads will just take highest guaranteed base that they can find. Supergroups set their carrot on this stick.
A surprising amount don't have too many options, though. Tons of "foot and ankle surgeon" grads every year now.
The replacement docs for the outgoing ones in example NM above situ had pretty low level training.
Many won't pass ABFAS, so hospital jobs, even VA or something, are pretty much out (and competitive regardless).
Some of them buy into the noncompete, even if it's a paper tiger. They're afraid of lawsuit, even if they'd win.
A few know the non-compete is fake or could get a better job outside radios, but they're too lazy to move and "start over."
Many buy into the supergroup grift of "doctor X in the group made $400k on his 30% doing ABC protocols, and you can too!"
Quite a few are beta personality and happy enough simply making $160k-200k or whatever and paying minimums on student loans.
A lot of people fear doing solo PP because it's time consuming or though to be expensive.
Most of all, a lot just can't find anything better (solo or other PP jobs may be better for pay/partner possibility, but they start low/"risky").
