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Does anyone else struggle with not being on partnership track despite other positives

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  • Does anyone else struggle with not being on partnership track despite other positives

    Background: ~1.5 years out from training. I interviewed at several private practices near my parents as it is a desirable area to live and I have a family of my own. I ended up joining a practice where there is currently no partnership option (one owner and 6 other providers) due to a variety of other factors. Some of the other jobs I interviewed at stated they'd offer partnership in 2-3 years, yet less than one year into working at my other practice and some of those other groups already sold out to private equity. Fast forward 1.5 years at current position. Live 15 minutes from work and my parents which we see about once per week. I generally really like my job - part of it being the specialty, part of it being first job post-residency and anything would be better, part of it being that I think it is a pretty good place to land post-residency (former resident of my program also works here). In terms of income, I work exceedingly hard but my income has reflected it and has been very good for my first year out (>500k which is above average for specialty).

    The "issue" if you want to call it that is that currently there is no option for partnership. The solo owner is in early 50s so likely won't retire for 10-15 years. While the practice has largely been positive, there have certainly been a few things that have come up that are one of the downsides of not being an owner or involved in decisions making. They've hired a few extra docs who have "diluted the patient pool" meaning my volume will come down, there have been some mismanagement of staff, and in generally the communication from the top down has been "meh" (especially now during coronavirus). I suppose those in the academic arena at big hospitals can sympathize with similar management issues but this is all new to me.

    As I mentioned above...the income is good (for now, hopefully in perpetuity but who knows), the location is great (near family, good schools), and overall is generally a good environment. If I were to join a different group with partnership track (or start my own) I'd likely have to be farther from some of those things and there's no guarantee the grass is greener. But there is definitely some allure of controlling your own destiny, being involved with decisions (pros/cons to that too), and the possibility of further increasing income down the road after sweat equity.

    Question to the group: For those who are in private practice, how much did "partnership" and the ability to have more control weigh into their decision making process. Are there some people who just knew they couldn't work for someone else? Am I overthinking it and enjoy what I have and focus on other areas of life since it largely has been a good experience? Just looking to air out my thoughts and gain some perspective form people who have been both positively and negatively impacted by some of those decisions.


  • #2
    Originally posted by JK View Post

    Question to the group: For those who are in private practice, how much did "partnership" and the ability to have more control weigh into their decision making process. Are there some people who just knew they couldn't work for someone else? Am I overthinking it and enjoy what I have and focus on other areas of life since it largely has been a good experience? Just looking to air out my thoughts and gain some perspective form people who have been both positively and negatively impacted by some of those decisions.
    I have mentioned it here a few times in the past. One owner of a multispeciality group who managed in a haphazard way but it was all good as long as he made money.. Promises of partnership but never materialized.. Kept the real estate separate, which he never allowed anyone to get a piece of.

    I saw the writing on the wall. I decided to quit on year 5 but took a couple of years of make sure my patients came with me. I had opened a S corp with a PO box. Told owner I will pay for expenses but will bill under my name. The checks came to the PO Box. When the amount from the accounts receivable from earlier on dropped and he wanted me to pay more than my fair share of the expenses, I said no.. He asked me to get out. I called his bluff and moved out. Best decision I made. He tried desperately for me to stay but I was determined to start out on my own.

    There are ups and downs on a solo practice but if you have a good referral base you can succeed easily. I have made more in the past 20 years on my own than if I had stayed with him. He sold out to a hospital finally when all his specialists had quit. And three years later when that hospital system merged with a larger system, they did a cost cutting and shut the main clinic and multiple sub clinics down. All physicians lost their jobs, including the owner and his wife.

    One day your owner will sell to the hospital or a private equity when he decides to retire and you will get nothing for all those years of work. Except your income, which might even go down.

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    • #3
      There's a lot to be said for owning your own job. There's also a lot to be said for having a great location with family close by.

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      • #4
        I want to say because of current stability & location & high current income, you should stay. I personally place a lot of weight on being geographically close to my immediate family. "A bird in the hand is worth 2 in the bush."

        Being your own boss is like investing 100% in stocks. The higher rewards are pretty much guaranteed over the long term. But there will be market slow downs & crashes (staff quits, you get sick, some new nightmare state law, competition opens up, state & federal compliance, etc...). It's a lot. It's regretful at times. I could never have a boss. I'm a micro managing control freak about some things.

        I didn't take a much higher earning position out of residency because I wanted to stay in my area (the position was 90 minutes away from my parents & siblings) & I wanted to make my own schedule, anytime I want, & answer to no one. That position years ago, was offering higher pay than what I earn now. I don't regret it...(except when I have a ton of administrative work to do & I have no spending money left, which is quite often lately!!!).

        I tell everyone, any field, you will probably regret not opening your own practice more compared to closing your own practice a few years in.
        "Oh look another bajillion point declin-Ooooh!!! A coupon for pizza!!!!" <--- This is what everyone's IPS should be. ✓✓✓

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