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  • #46
    Originally posted by MrWeenie View Post

    Very good question, it has...

    but I’m a firm believer that every individual has to assess their own situation and having seniority makes my position slightly more secure along with the fact that I’ve exceeded performance for the last 5 years. Now, on the other hand, if I do not continue to do that of course I could get fired and that lack of loyalty/security is troubling.

    Alas, we learned that Medicine is no different than the corporate world!
    Best of luck to you!
    Working to protect good doctors from bad advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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    • #47
      Originally posted by MrWeenie View Post

      Very good question, it has...

      but I’m a firm believer that every individual has to assess their own situation and having seniority makes my position slightly more secure along with the fact that I’ve exceeded performance for the last 5 years. Now, on the other hand, if I do not continue to do that of course I could get fired and that lack of loyalty/security is troubling.

      Alas, we learned that Medicine is no different than the corporate world!
      It sounds to me like seniority isn't worth much if the atmosphere is "dog eat dog" and you don't appear to have a track to partnership, so no real security. When I started my career I interviewed with a couple of private practice groups in town, one offered literally 2X the $ but it was obvious they just wanted an employee and there was no track to partnership. I took the job offering half the $ but a clear cut partnership track spelled out beforehand. It was the best decision I ever made. You may want to seriously consider finding a more stable/equitable place to work.

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      • #48
        Originally posted by dennis View Post

        It sounds to me like seniority isn't worth much if the atmosphere is "dog eat dog" and you don't appear to have a track to partnership, so no real security. When I started my career I interviewed with a couple of private practice groups in town, one offered literally 2X the $ but it was obvious they just wanted an employee and there was no track to partnership. I took the job offering half the $ but a clear cut partnership track spelled out beforehand. It was the best decision I ever made. You may want to seriously consider finding a more stable/equitable place to work.
        Thank you, this is really good advice and once the market improves I am going to start looking around, better to do that when times are good then not miss the ax on the next go around..it could well be me next time !

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        • #49
          As medicine becomes more corporate, the opportunities for partnership are shrinking. Im Im s fields the people who enter them no longer expect it and are not interested.

          I have a friend who runs a successful small group but cannot fund partner type people to hire. No one wants the responsibility. They want to punch a clock for a paycheck and nothing more. Perhaps they would feel different if they saw partnership as a standard option long term.

          Our junior people will still, slightly, prefer partnership tracks but many see that as the way of the dinosaurs. Why invest in a practice model that is going away.

          When groups do sell out and become employees, those junior people who were not partners also are not in on the payday. I can understand their view on the matter.

          If being a disposable employee is in reality all that is ever offered, why pretend otherwise?

          I

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          • #50
            Originally posted by afan View Post
            As medicine becomes more corporate, the opportunities for partnership are shrinking. Im Im s fields the people who enter them no longer expect it and are not interested.

            I have a friend who runs a successful small group but cannot fund partner type people to hire. No one wants the responsibility. They want to punch a clock for a paycheck and nothing more. Perhaps they would feel different if they saw partnership as a standard option long term.

            Our junior people will still, slightly, prefer partnership tracks but many see that as the way of the dinosaurs. Why invest in a practice model that is going away.

            When groups do sell out and become employees, those junior people who were not partners also are not in on the payday. I can understand their view on the matter.

            If being a disposable employee is in reality all that is ever offered, why pretend otherwise?

            I
            Good point - I was wondering why I do not see any partner positions much anymore.

            Sounds like it was not valued and it is on it's way out overall .. I was thinking it was regional for me/being held on to or not being offered.

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            • #51
              Originally posted by afan View Post
              As medicine becomes more corporate, the opportunities for partnership are shrinking. Im Im s fields the people who enter them no longer expect it and are not interested.

              I have a friend who runs a successful small group but cannot fund partner type people to hire. No one wants the responsibility. They want to punch a clock for a paycheck and nothing more. Perhaps they would feel different if they saw partnership as a standard option long term.

              Our junior people will still, slightly, prefer partnership tracks but many see that as the way of the dinosaurs. Why invest in a practice model that is going away.

              When groups do sell out and become employees, those junior people who were not partners also are not in on the payday. I can understand their view on the matter.

              If being a disposable employee is in reality all that is ever offered, why pretend otherwise?

              I
              What people dont like are the terms and costs of said partnerships. Theres zero reason why someone wouldnt want a partnership if the terms were reasonable.

              What people dont want is 3-5 years of sub average pay and crappy call, just to pay an insane premium of "goodwill" to an aging partner looking for a golden parachute, which is far too common.

              Many of these practices end up shuttered as they cant be sold at what the ego of the retiring doc wants, and its frankly cheaper for some to start their own places. Goodwill, and pt panels just arent things anymore, and really werent ever as valuable as projected, and it doesnt work anymore.

              This is the only real disconnect.

              Change the terms and you'll have takers.

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              • #52
                Originally posted by Zaphod View Post

                What people dont like are the terms and costs of said partnerships. Theres zero reason why someone wouldnt want a partnership if the terms were reasonable.

                What people dont want is 3-5 years of sub average pay and crappy call, just to pay an insane premium of "goodwill" to an aging partner looking for a golden parachute, which is far too common.

                Many of these practices end up shuttered as they cant be sold at what the ego of the retiring doc wants, and its frankly cheaper for some to start their own places. Goodwill, and pt panels just arent things anymore, and really werent ever as valuable as projected, and it doesnt work anymore.

                This is the only real disconnect.

                Change the terms and you'll have takers.
                A whole lot of this... include the not becoming a true partner afterwards (dif levels of partner), the continuing the crappy call while retiring partners cut back but keep full pay, and the risk of the group selling out prior to becoming a partner, the manipulation of the schedule... and yes, ill take my crappy w2 with a better floor salary and better lifestyle. For my old group it was funny when the boss called me greedy after I left after being underpaid for 2.5 years. Pot meet kettle and such.

                The truly democratic partnerships that exist are too few and far between all the crappy ones. BUT--> if you find one it will truly be worth it- for those I would put up with some sweat equity. Those jobs usually don't even have to be advertised on any media. word of mouth is enough. But all the crappy "partnership" groups have caused such jadedness that not many are willing to chance the opportunity cost of being stuck in a bad group again.

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                • #53
                  I have a hard time envisioning I would ever take a “partnership” tract private practice position in today’s day and age.

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                  • #54
                    “The truly democratic partnerships that exist are too few and far between all the crappy ones. BUT--> if you find one it will truly be worth it- for those I would put up with some sweat equity. Those jobs usually don't even have to be advertised on any media. word of mouth is enough.”
                    Particularly in sub specialties.
                    The goal of adding a partner is two fold:
                    •Split fixed expenses (lower costs mean more profit for the existing partners)
                    • Your practice is complimentary and results in more referrals ( increased revenues for the existing partners).
                    Adding a partner is mutually beneficial. The risk is can the new partner deliver. Since covid-19 one PP is that was lucrative is dissolving and another thriving. One LCOL and one VHCOL.
                    Word of mouth finding the “right fit” is the normal method of recruiting. Risk to the existing partners and potential partner as well. Some aren’t controllable.

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                    • #55
                      Joining a PP partnership track out of training is the best decision Ive made. Sweat equity, democratic, etc. Negotiated a lower salary to expedite partnership, which took just under 2 years. Now Im able to benefit from an income I never would have gotten as an employee

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                      • #56
                        Originally posted by 8arclay View Post
                        Joining a PP partnership track out of training is the best decision Ive made. Sweat equity, democratic, etc. Negotiated a lower salary to expedite partnership, which took just under 2 years. Now Im able to benefit from an income I never would have gotten as an employee

                        would you mind reveling your speciality ?

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                        • #57
                          Remember that real money comes from owning something. Reread the Millionaire next door. If you can find a partnership ie owning something or aghast start your own you will do better over the long run.

                          Comment


                          • #58
                            Originally posted by MrWeenie View Post


                            would you mind reveling your speciality ?
                            PM'd

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                            • #59
                              Originally posted by MrWeenie View Post
                              I work for a small group of doctors with 3 group partners. A tactic I have seen in my group to knock off dead weight is to not give new contracts at your hire-annv. This avoids them from 90 day notice and you would only know for non-renew 30 days in advance. I have seen this happen before... it is haunting how hush hush this stuff can be!

                              They are doing this to a guy I work with almost every day. I keep to myself and so I have not built a friendship but am collegial with this person as much as so with others. Say hi, bye, talk about hobbies. We do not hang outside work.
                              One of the partners let it slip they are going to do this to him by leaving the budget sheets in the office printer. I was only there because I needed my DEA information for renewal and with COVID no one was there to email it to me........ so it is not a office I often go to (offsite, outside the hospital, and I def do not want to be pinned as the LEAK!).

                              I am morally torn. I guess office manager could say I came by so may be one who tipped this guy off.
                              There is nothing in it for me. ............
                              At the same time this guy JUST closed on a house with the bells and whistles pre COVID like Feb........ def not a starter house and would take months to sell with COVID and he talks about how he loves the 4 seasons here, how happy his wife and baby are and on and on. Now when he talks I literally feel sick and tell him I better get going. I have known for three weeks. I am loosing sleep over this.

                              Our renewal is on date of hire so would be in fall for him, I do not know exact date.

                              I wish there was a way to tell him with him not going in and saying I told him as I do not know him well enough to know he will not do just that in anger. I am also a loner so I would not even know how to talk. Mostly he talks to me not vice versa.. he is one of those jolly docs that asks a lot about everyone and shares his life. I am OTOH very shy and only at work to work.

                              WWWCI do?
                              Sounds like a bad work environment. I'd start planning to leave and get a new job. Since I'd leave I'd tell the guy what's coming. Also, he can probably sell his house easily if he needed to. With the rates so low, houses is on fire right now. Anyway, that's what I'd do. Hope this helps.

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                              • #60
                                Originally posted by Hatton View Post
                                Remember that real money comes from owning something. Reread the Millionaire next door. If you can find a partnership ie owning something or aghast start your own you will do better over the long run.
                                Disagree. U can amass real money as an employee, in fact it’s probably even easier

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