Benefits of partnership track?

[thinkorswim]

What is ultimately the difference between W2 and 1099?

Say an employee job pays 600K W2 with good, inexpensive insurance and all that, other job as partner is 600K 1099 (insurance on open market vs through group etc).

Just curious if anyone can reasonable estimate three differences financially?

Depends on the monetary value of the benefits of the W2 job plus the employer portion of Social security/Medicare tax. Sometimes this can add up to ~100k in value

As mentioned above, with all else being equal, a 1099 job should pay about $100k more than a W2 equivalent. The differences roughly break down as follows:

$21k for employer portion of FICA (assuming your $600k gross income)
$38.5k for employer portion of 401k
$15k for malpractice insurance
$24k for health insurance

So to answer your question, a $600k job as a W2 is better than $600k as a 1099. Again, this assumes that everything about these jobs are the same.

But if you're looking at $500k W2 versus $600k 1099, I would say the latter is better. Sure you have to pay your own benefits and employer taxes, but you also have the ability to deduct a lot and lower your taxable income.

The whole spouse thing sounds just plain dumb and ripe for an audit.

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[GravelRider]

As mentioned above, with all else being equal, a 1099 job should pay about $100k more than a W2 equivalent. The differences roughly break down as follows:

$21k for employer portion of FICA (assuming your $600k gross income)
$38.5k for employer portion of 401k
$15k for malpractice insurance
$24k for health insurance

So to answer your question, a $600k job as a W2 is better than $600k as a 1099. Again, this assumes that everything about these jobs are the same.

But if you're looking at $500k W2 versus $600k 1099, I would say the latter is better. Sure you have to pay your own benefits and employer taxes, but you also have the ability to deduct a lot and lower your taxable income.

The whole spouse thing sounds just plain dumb and ripe for an audit.

The best option if you are 1099 is to have your spouse actually work. You can then get health insurance through your spouse. Your spouse would also likely have access to an employer sponsored retirement plan.

 

[Hoya11]

I'm a CA3 and am very grateful to have 3 job offers currently. But they are ... wildly different.

First is private practice, no partnership track. Straight $400k per year no real opportunity to make more. Home call but very busy OB so you get called in often. Staff seems happy and has been there a long time.

Second is academic tied to a major university system. Pay is $375k, in house call, but a ton of time off for "academic encounters". Which staff say is vacation time. Or moonlighting time. Most staff make around $500k with moonlighting. Twice as much time off as other jobs, but way more academic B.S. to deal with. Probably more risk too working with trainees. 2x the commute time compared to the other two jobs.

Final is private practice with partnership track. $325k first three years, then $500k as partner. Profit sharing into 401k, fully funding HSA, by far best benefits. But also work the hardest by far. In house call and you are busy.

I'm more or less split between the second and third. I'm fine being academic but never truly saw myself staying in academic medicine. They approached me. I do enjoy teaching those junior to me, but I also enjoy being the one driving the needle. I think I like driving the needle more than talking others through how to drive it.

My biggest question is, what are the main benefits of becoming partner? I've asked my mentors and none of them have been in a practice with a partnership. It seems in that job you make significantly less your first three years but more than make up for it afterwards. And while your salary says $325k, after all of the retirement money and other benefits the package is closer to $380.

what are the downsides of the partnership? that should be the question

for basically the same money, you get ownership in a practice.

the end of that 3 years will result in:

- possibly 10+ years of >500k income
- unbeatable job security and benefits
- the ability to work like you want (ie manage yourselves to ensure you have decent lives)
- possibly be part of a sale at some point

sure there are some partnerships that are scams or are not true and equal partnerships - but you have to be the judge of that..

there are good ones out there , but lots of people who have "employee" mentality who think they are always being victimized for that initial reduced wage, and fail to see the upside long term, you'll more than completely make back that initial reduced wage in one or two year-end bonuses

 

[GravelRider]

- possibly be part of a sale at some point

This mentality and the aftermath of it across the country is exactly why some people are skeptical of partnership tracks…rightly or wrongly.

 

[ERRES2288]

unbeatable job security and benefits

Is this really true though? People losing contracts left and right. It doesn’t even seem like practices sell anymore, they just get undercut by the AMCs.

 

[D P356]

job security = underpaid + overworked

Your skills are easily transferable and are in demand right now.

The more profitable a group from commercial insurance/payor mix, volume and subsidy, the more outside competition is coming for that contract = less job security.

However, I don’t like the mindset of thinking about a sale. A lot like entrepreneurs building a business with the short term thinking of hoping to get bought out. Go long or get out; maybe my mindset will change, hopefully not. Getting the rugged pulled out from under you by older partners sucks.

You know how suits will treat and view you. Surprisingly, Docs can treat you better OR worse than that.

 

[Hoya11]

yeah I mean just look at the other thread about wisconsin hospital replacing their anesthesiologists. Do you think the partners there get big payout? the hospital decided to give the contract to AMC

becoming a partner can have a few different outcomes

1. the group sustains and you do well like >500k per year for your entire career
2. the group sells and you are part of a buy out
3. the group dissolves (loses contract) - worst case scenario. do you know what happens in that scenario? the partners continue to collect on income coming into the group for months to come. that could be 100k per partner as the group dissolves and winds down. its not like you just walk away with nothing. oh and then you sign on with the AMC and get a sign on bonus as well as that old partner money.

in every scenario, once you make partner in an equitable group, it is superior financially to employment .
i do understand some shady groups out there but its worth looking into partnership if you are in it for the long-term.. worked out great for me is all i can say

 

[Status Sciaticus]

becoming a partner can have a few different outcomes

1. the group sustains and you do well like >500k per year for your entire career
2. the group sells and you are part of a buy out
3. the group dissolves (loses contract) - worst case scenario. do you know what happens in that scenario? the partners continue to collect on income coming into the group for months to come. that could be 100k per partner as the group dissolves and winds down. its not like you just walk away with nothing. oh and then you sign on with the AMC and get a sign on bonus as well as that old partner money.

in every scenario, once you make partner in an equitable group, it is superior financially to employment .
i do understand some shady groups out there but its worth looking into partnership if you are in it for the long-term.. worked out great for me is all i can say

what about in the scenario where your group loses the contract, and the AMC doesnt want to hire you or is paying you half of what you were to make as a PP partner?

 

[Hoya11]

what about in the scenario where your group loses the contract, and the AMC doesnt want to hire you or is paying you half of what you were to make as a PP partner?

thats what i tried to describe in #3.. your group dissolves and you collect on the old AR for months to come. even while you are working at your new job, hey some old money came in to the old company coffers, heres a check for you old partner.. thats what happens. that old money can trickle in for a year... old money comes in for a while before it completely stops and the old partners all split it. hey ill take it (i know this from first hand experience)

 

[Mman]

Is this really true though? People losing contracts left and right. It doesn’t even seem like practices sell anymore, they just get undercut by the AMCs.

I'm willing to bet there has been a net reduction in AMC jobs the last 2 years. AMCs used to be taking over everything. Now more places are kicking AMCs out.

 

[ERRES2288]

I'm willing to bet there has been a net reduction in AMC jobs the last 2 years. AMCs used to be taking over everything. Now more places are kicking AMCs out.

I hope this is true it’s just not what I’ve seen around me. More like kicking one AMC out for another.

 

[pjl]

As mentioned above, with all else being equal, a 1099 job should pay about $100k more than a W2 equivalent. The differences roughly break down as follows:

$21k for employer portion of FICA (assuming your $600k gross income)
$38.5k for employer portion of 401k
$15k for malpractice insurance
$24k for health insurance

So to answer your question, a $600k job as a W2 is better than $600k as a 1099. Again, this assumes that everything about these jobs are the same.

But if you're looking at $500k W2 versus $600k 1099, I would say the latter is better. Sure you have to pay your own benefits and employer taxes, but you also have the ability to deduct a lot and lower your taxable income.

The whole spouse thing sounds just plain dumb and ripe for an audit.

We give our 1099 numbers for salary AFTER all that stuff is taken out, ~100k benefits.

 

[Mehd School]

I wanted to give an update on the path I chose since I recently created another thread asking for new attending advice.

I went with #2, the "academic" gig. Academic is in quotations because while it will take place in a medium sized academic hospital with a residency program, about 2/3 of my time will be medically directing CRNAs instead of residents. I will take most of my call in the women's/children's wing of the hospital, doing OB (fairly busy) and healthy peds (very much not busy). I get a little over 12 weeks off. My final pay was $390k with a $25k bonus. Second year salary goes to $405k. Given this is for less than 9 months of work each year, I am happy. With my spare time I plan to take around 8 weeks of vacation and spend the other 4 weeks moonlighting at our off site medical school owned surgical center where I will make $4900 for each 24 hour shift (10 hours in house and 14 hours home call with very rare callback)

I'm very happy that it worked out. I start in August after written boards. Benefits of this academic group is not nearly as nice as the PP offers, but the work will be less intense and I will have way more time off. Thank you all for your help and guidance.

 

[chocomorsel]

I wanted to give an update on the path I chose since I recently created another thread asking for new attending advice.

I went with #2, the "academic" gig. Academic is in quotations because while it will take place in a medium sized academic hospital with a residency program, about 2/3 of my time will be medically directing CRNAs instead of residents. I will take most of my call in the women's/children's wing of the hospital, doing OB (fairly busy) and healthy peds (very much not busy). I get a little over 12 weeks off. My final pay was $390k with a $25k bonus. Second year salary goes to $405k. Given this is for less than 9 months of work each year, I am happy. With my spare time I plan to take around 8 weeks of vacation and spend the other 4 weeks moonlighting at our off site medical school owned surgical center where I will make $4900 for each 24 hour shift (10 hours in house and 14 hours home call with very rare callback)

I'm very happy that it worked out. I start in August after written boards. Benefits of this academic group is not nearly as nice as the PP offers, but the work will be less intense and I will have way more time off. Thank you all for your help and guidance.

Good. That was the best gig.

 

[GassYous]

pacific/VM/matrix?

 

[UscGhost]

becoming a partner can have a few different outcomes

1. the group sustains and you do well like >500k per year for your entire career
2. the group sells and you are part of a buy out
3. the group dissolves (loses contract) - worst case scenario. do you know what happens in that scenario? the partners continue to collect on income coming into the group for months to come. that could be 100k per partner as the group dissolves and winds down. its not like you just walk away with nothing. oh and then you sign on with the AMC and get a sign on bonus as well as that old partner money.

in every scenario, once you make partner in an equitable group, it is superior financially to employment .
i do understand some shady groups out there but its worth looking into partnership if you are in it for the long-term.. worked out great for me is all i can say

Except the buy in is generally a high risk investment with low ROI.

If you decide the location isn't for you, then you lose your investment. It generally takes 10 year or so to make up for what you lost in the buy in. So you are betting on the fact that this job will be the job you want to keep for the ,next 10 years or you are SOL. That's assuming the economics remain the same and the group wants to keep you. If the job market shifts and the group can hire cheaper labor, you better believe they will.

 

[Hoya11]

Except the buy in is generally a high risk investment with low ROI.

If you decide the location isn't for you, then you lose your investment. It generally takes 10 year or so to make up for what you lost in the buy in. So you are betting on the fact that this job will be the job you want to keep for the ,next 10 years or you are SOL. That's assuming the economics remain the same and the group wants to keep you. If the job market shifts and the group can hire cheaper labor, you better believe they will.

That was not my situation at all.

There was no buy in other than a slightly lower salary compared to local AMC. At the time it was 325 vs 350. Plus I think the AMC worked you more.

You make partner in (what was) my group and you are immediately an equal partner, thats it no buy in. But im sure every situation is different.

But again, I asked all that before I signed up. I knew there was no buy in. I knew my chances of making partner were high. I knew the stability of the group was strong. Every situation is different. But the key point is that its not a SURPRISE, or a SUDDEN LIE. You have to thoroughly investigate the group you may be joining.

 

[chocomorsel]

That was not my situation at all.

There was no buy in other than a slightly lower salary compared to local AMC. At the time it was 325 vs 350. Plus I think the AMC worked you more.

You make partner in (what was) my group and you are immediately an equal partner, thats it no buy in. But im sure every situation is different.

But again, I asked all that before I signed up. I knew there was no buy in. I knew my chances of making partner were high. I knew the stability of the group was strong. Every situation is different. But the key point is that its not a SURPRISE, or a SUDDEN LIE. You have to thoroughly investigate the group you may be joining.

So why did you leave if they were so fair?

 

[Hoya11]

So why did you leave if they were so fair?

I have an interesting story.

My group ended up leaving the hospital and becoming completely ambulatory due to situations surrounding covid.

I am still a partner and doing very well and very fortunate to have no call or weekends/holidays, but it wasnt an easy road.

 

[Mman]

Except the buy in is generally a high risk investment with low ROI.

except you get a buy out on the way out so it's a no risk investment (or at least we do and the others I have seen do)

 

[abolt18]

except you get a buy out on the way out so it's a no risk investment (or at least we do and the others I have seen do)

One group I interviewed with, you did not get your buyout upon leaving. I guess it was their way of making all the partners feel like they had skin in the game that they didn't want to lose. It was $150K total over the first 2 years.

 

[DirtDocMD]

One group I interviewed with, you did not get your buyout upon leaving. I guess it was their way of making all the partners feel like they had skin in the game that they didn't want to lose. It was $150K total over the first 2 years.

I have yet to see an anesthesia group that gives you your “buy-in” back. I’m not talking about just “predatory” groups, I’m talking about extremely fair/well-run ones.

I’ve said it a number of times on here, but the same people continue to do their “those old guys are sell-outs” rant, and it is this:

You are ONE pen stroke (of a penny-pinching resume-buffing hospital CEO) away from your group (I don’t care how “well-respected” or “well-liked”) losing its’ contract, and “partnership” being worthless. THAT is why so many of these “greedy old guys” take the buy-out offer from AMC’s. There are no guarantees that your private group will have a contract, tomorrow.
Think about that, long and hard, before you do a big buy-in. If it’s a VERY lucrative group, it CAN be worthwhile, but make sure it’s a 3-5 year payoff, and not something that will take 5/7/10 years to make financial sense. Groups don’t always get “bought out”, either. Sometimes, the hospital CEO will just TELL YOU that you are going to get to “partner” with some big scam AMC, and your private group simply ceases to exist. You are either going to work for the AMC the hospital has chosen, or you can leave. NO buyout.

If you held stock/shares in a corporation (3M/Home Depot/etc) that just hired a “wild-card” CEO, you’d be tempted to “cash out” before they crashed the share price, and smart guys do the same with their anesthesia group (sell out) when they know their hospital CEO could yank their contract at any moment.

Not always “greed”, sometimes it is just a smart financial move...

 

[ambiturner]

I have yet to see an anesthesia group that gives you your “buy-in” back. I’m not talking about just “predatory” groups, I’m talking about extremely fair/well-run ones.

I’ve said it a number of times on here, but the same people continue to do their “those old guys are sell-outs” rant, and it is this:

You are ONE pen stroke (of a penny-pinching resume-buffing hospital CEO) away from your group (I don’t care how “well-respected” or “well-liked”) losing its’ contract, and “partnership” being worthless. THAT is why so many of these “greedy old guys” take the buy-out offer from AMC’s. There are no guarantees that your private group will have a contract, tomorrow.
Think about that, long and hard, before you do a big buy-in. If it’s a VERY lucrative group, it CAN be worthwhile, but make sure it’s a 3-5 year payoff, and not something that will take 5/7/10 years to make financial sense. Groups don’t always get “bought out”, either. Sometimes, the hospital CEO will just TELL YOU that you are going to get to “partner” with some big scam AMC, and your private group simply ceases to exist. You are either going to work for the AMC the hospital has chosen, or you can leave. NO buyout.

If you held stock/shares in a corporation (3M/Home Depot/etc) that just hired a “wild-card” CEO, you’d be tempted to “cash out” before they crashed the share price, and smart guys do the same with their anesthesia group (sell out) when they know their hospital CEO could yank their contract at any moment.

Not always “greed”, sometimes it is just a smart financial move...

I’m pretty sure ‘greed’ and ‘smart financial move’ are not necessarily mutually exclusive. I don’t blame partners for taking buyouts when advantageous, especially now that the era of big buyouts seems to be over and now you just lose the contract or get forced in house. The big winners seem to be the people who sold out 2010-2015.

What I do take issue with is groups that sign up people for partnership tracks, take a cut of their collections for 1-2 years, and then sell out before they become partners and don’t include them in the buyout or return the buy-in they paid. I would bet this has been the case in the majority of acquisitions. People on this forum are wise to this now and would know enough to ask for some assurances but many new grads are not.

 

[Arch Guillotti]

I have yet to see an anesthesia group that gives you your “buy-in” back.

I have.

 

[Arch Guillotti]

Groups don’t always get “bought out”, either. Sometimes, the hospital CEO will just TELL YOU that you are going to get to “partner” with some big scam AMC, and your private group simply ceases to exist. You are either going to work for the AMC the hospital has chosen, or you can leave. NO buyout.

This is true in the sense of the way that buyouts are spoken of here in common parlance however - if you have the misfortune of this happening to you and you are a partner in a private practice then you will still have residual income from your billing although it probably dwindles pretty low after 90 days.

 

[nimbus]

I have yet to see an anesthesia group that gives you your “buy-in” back. I’m not talking about just “predatory” groups, I’m talking about extremely fair/well-run ones.

I’ve said it a number of times on here, but the same people continue to do their “those old guys are sell-outs” rant, and it is this:

You are ONE pen stroke (of a penny-pinching resume-buffing hospital CEO) away from your group (I don’t care how “well-respected” or “well-liked”) losing its’ contract, and “partnership” being worthless. THAT is why so many of these “greedy old guys” take the buy-out offer from AMC’s. There are no guarantees that your private group will have a contract, tomorrow.
Think about that, long and hard, before you do a big buy-in. If it’s a VERY lucrative group, it CAN be worthwhile, but make sure it’s a 3-5 year payoff, and not something that will take 5/7/10 years to make financial sense. Groups don’t always get “bought out”, either. Sometimes, the hospital CEO will just TELL YOU that you are going to get to “partner” with some big scam AMC, and your private group simply ceases to exist. You are either going to work for the AMC the hospital has chosen, or you can leave. NO buyout.

If you held stock/shares in a corporation (3M/Home Depot/etc) that just hired a “wild-card” CEO, you’d be tempted to “cash out” before they crashed the share price, and smart guys do the same with their anesthesia group (sell out) when they know their hospital CEO could yank their contract at any moment.

Not always “greed”, sometimes it is just a smart financial move...

Our group returns the “buyin” when you leave and return 1 share of the corporation. But it’s only about 1.5-2weeks income.

 

[nimbus]

I have yet to see an anesthesia group that gives you your “buy-in” back. I’m not talking about just “predatory” groups, I’m talking about extremely fair/well-run ones.

I’ve said it a number of times on here, but the same people continue to do their “those old guys are sell-outs” rant, and it is this:

You are ONE pen stroke (of a penny-pinching resume-

If you held stock/shares in a corporation (3M/Home Depot/etc) that just hired a “wild-card” CEO, you’d be tempted to “cash out” before they crashed the share price, and smart guys do the same with their anesthesia group (sell out) when they know their hospital CEO could yank their contract at any moment.

In the current market, it is the hospital CEOs who need to worry that their anesthesia groups will leave for greener pastures at any moment.

 

[DirtDocMD]

I’m pretty sure ‘greed’ and ‘smart financial move’ are not necessarily mutually exclusive. I don’t blame partners for taking buyouts when advantageous, especially now that the era of big buyouts seems to be over and now you just lose the contract or get forced in house. The big winners seem to be the people who sold out 2010-2015.

What I do take issue with is groups that sign up people for partnership tracks, take a cut of their collections for 1-2 years, and then sell out before they become partners and don’t include them in the buyout or return the buy-in they paid. I would bet this has been the case in the majority of acquisitions. People on this forum are wise to this now and would know enough to ask for some assurances but many new grads are not.

Agreed.

 

[DirtDocMD]

This is true in the sense of the way that buyouts are spoken of here in common parlance however - if you have the misfortune of this happening to you and you are a partner in a private practice then you will still have residual income from your billing although it probably dwindles pretty low after 90 days.

Yes, you will still have your “accounts receivable” that will provide some income for 3-4 months, as that billing comes in.

I’m sure you’ve also seen some groups that might “refund” your “buy-in” when you leave. This is certainly NOT a common practice, and should NOT be something that new applicants assume will happen.

Things HAVE changed (to our job security benefit) in the last 18 months. NOBODY seems to have enough personnel, and the “smart” hospital admins know this. There are still plenty that buy the AMC ”sales pitch”, though, and think these companies have some magical way of getting staff, that private groups don’t (and they won’t figure it out until they have destroyed their current private group, and played the “NAPA” game). It used to be possible by holding contracts (thus, controlling the job availability) in “popular” markets, but NOW there are literally jobs everywhere. I’d recommend anesthesiologists/small groups use this to their advantage, and demand higher salaries/stipends, now.

If you haven’t seen a 15-20% salary hike in the last two years, you are likely behind the inflation curve.

 

[Mman]

I’m sure you’ve also seen some groups that might “refund” your “buy-in” when you leave. This is certainly NOT a common practice, and should NOT be something that new applicants assume will happen.

I think that just depends on what is defined as a buy in. The majority of groups I have seen the buy in is simply a valuation of the accounts receivable that will be coming your way that were generated prior to you becoming a partner and the buy out is a valuation of the accounts receivable that will be coming your way after you leave. It's mostly just a math problem of working out the net present value.

My wild guess is that a simple pay us $X to be a partner as a buy in is on the rarer side.

 

[Arch Guillotti]

Yes, you will still have your “accounts receivable” that will provide some income for 3-4 months, as that billing comes in.

I’m sure you’ve also seen some groups that might “refund” your “buy-in” when you leave. This is certainly NOT a common practice, and should NOT be something that new applicants assume will happen.

Things HAVE changed (to our job security benefit) in the last 18 months. NOBODY seems to have enough personnel, and the “smart” hospital admins know this. There are still plenty that buy the AMC ”sales pitch”, though, and think these companies have some magical way of getting staff, that private groups don’t (and they won’t figure it out until they have destroyed their current private group, and played the “NAPA” game). It used to be possible by holding contracts (thus, controlling the job availability) in “popular” markets, but NOW there are literally jobs everywhere. I’d recommend anesthesiologists/small groups use this to their advantage, and demand higher salaries/stipends, now.

If you haven’t seen a 15-20% salary hike in the last two years, you are likely behind the inflation curve.

I get it. Asking for a stipend seems like playing a game of chicken though.

 

[repititionition]

One group I interviewed with, you did not get your buyout upon leaving. I guess it was their way of making all the partners feel like they had skin in the game that they didn't want to lose. It was $150K total over the first 2 years.

unless there’s more to the story, this creates an unnecessary tax liability for the group over time (excess cash on hand).

 

[Arch Guillotti]

unless there’s more to the story, this creates an unnecessary tax liability for the group over time (excess cash on hand).

Why? Just pay it out to the others.

 

[UscGhost]

unless there’s more to the story, this creates an unnecessary tax liability for the group over time (excess cash on hand).

Don't you just distribute it to the partners? They pay their own taxes

That's the whole reason for a buy in...make money for the partners.

 

[Hoya11]

Don't you just distribute it to the partners? They pay their own taxes

That's the whole reason for a buy in...make money for the partners.

yes i didnt understand that comment either

 

[GravelRider]

Just for discussion purposes: Would it be advisable to take a PP partnership track job in the current environment? The No Surprise Act is threatening a lot of PPs and hospitals are currently paying top dollar for per diem type work. Under what circumstances in the current environment is it advisable to take a risk on a PP partnership track? I get there is a “I know it when I see it” aspect to this, but what are some concrete details that would make partnership track worth the potential risk?

 

[Arch Guillotti]

unless there’s more to the story, this creates an unnecessary tax liability for the group over time (excess cash on hand).

Can you elaborate? Money comes in, you pay the bills and salaries and stuff then you split the rest. Don’t know why you would hoard cash unless you have a large liability coming due like a big retirement plan payment or whatever. Unless the OR comes to a standstill (like COVID).

 

[GassYous]

Can you elaborate? Money comes in, you pay the bills and salaries and stuff then you split the rest. Don’t know why you would hoard cash unless you have a large liability coming due like a big retirement plan payment or whatever. Unless the OR comes to a standstill (like COVID).

I think you want to be slightly negative at the end of the year to avoid excess taxation on profits for the corporation

 

[UscGhost]

Just for discussion purposes: Would it be advisable to take a PP partnership track job in the current environment? The No Surprise Act is threatening a lot of PPs and hospitals are currently paying top dollar for per diem type work. Under what circumstances in the current environment is it advisable to take a risk on a PP partnership track? I get there is a “I know it when I see it” aspect to this, but what are some concrete details that would make partnership track worth the potential risk?

It's a significant gamble. Assuming all else is equal (call, location, etc)

You have to compare the PP partnership income year 1-5 and years 5-10 versus the non partnership group and assess your risk vs return.

Assume 1000 units per month for each group

Then determine at what point you will break even, year 5-7? And what point you will make a positive return. Don't forget to account for the lost returns on your lost potential income in the partnership track years. For example..

Year 1-3
Non partner group 500k per year = 1.5 mil
Partner group 400k (100k buy in) = 1.2 mil

Year 4-6
Non partner group 500k annual = 1.5 mil
Partner group 600k annual = 1.8 mil

So in this example, it will take 6-7 years to break even. Will you be in the group that long? Will the group have the contact that long? What if you want to move? Will they grant you partner or just take your money?

 

[IMGASMD]

It's a significant gamble. Assuming all else is equal (call, location, etc)

You have to compare the PP partnership income year 1-5 and years 5-10 versus the non partnership group and assess your risk vs return.

Assume 1000 units per month for each group

Then determine at what point you will break even, year 5-7? And what point you will make a positive return. Don't forget to account for the lost returns on your lost potential income in the partnership track years. For example..

Year 1-3
Non partner group 500k per year = 1.5 mil
Partner group 400k (100k buy in) = 1.2 mil

Year 4-6
Non partner group 500k annual = 1.5 mil
Partner group 600k annual = 1.8 mil

So in this example, it will take 6-7 years to break even. Will you be in the group that long? Will the group have the contact that long? What if you want to move? Will they grant you partner or just take your money?

This is exactly how I calculated out what the opportunity cost is for being a partnership.

I suppose a 20% difference of your annual income is a lot.

From what I’ve seen, the AMC will always make you do more with less. At least in a “equitable” partnership track (the only difference is money, but not workload), if the partners are skimping out on hiring appropriate personnel to cover, they also suffer with you.

As I’ve said before, I also have seen AMCs treat their nurses better than physicians. Think on that for a moment. They value their cRNas more than YOU. Because they know and the nurses know, they’re making money off them, not you.

Sure some “partners” of the MD only AMCs will disagree. But they’re the exceptions rather than the norm.

As some of us see the drama unfold for that group in NJ, I wouldn’t be surprised that part of the fallout has something to do with how the two groups, MD/DO and cRNas are being treated by corporate. Pure speculation based on my experience.

 

[UscGhost]

This is exactly how I calculated out what the opportunity cost is for being a partnership.

I suppose a 20% difference of your annual income is a lot.

From what I’ve seen, the AMC will always make you do more with less. At least in a “equitable” partnership track (the only difference is money, but not workload), if the partners are skimping out on hiring appropriate personnel to cover, they also suffer with you.

As I’ve said before, I also have seen AMCs treat their nurses better than physicians. Think on that for a moment. They value their cRNas more than YOU. Because they know and the nurses know, they’re making money off them, not you.

Sure some “partners” of the MD only AMCs will disagree. But they’re the exceptions rather than the norm.

As some of us see the drama unfold for that group in NJ, I wouldn’t be surprised that part of the fallout has something to do with how the two groups, MD/DO and cRNas are being treated by corporate. Pure speculation based on my experience.

Yup.

I am a partner with Envision, MD only, and have zero issues with upper management. They let us run ourselves and our pay matches and exceeds the other local PP groups. So I can't complain.

But I I know Envision handles each site differently depending on the region. Similar to some large PP groups though if they cover hospitals in different zip codes.

I just look at it as a business decision.

 

[IMGASMD]

I just look at it as a business decision.

I’ve come to accepting that as a valid reason for a lot of what’s happening to anesthesia…. It’s ultimately about the Benjamins.

If you’re profitable for the higher ups, they’re more likely to leave you the fuk alone.

 

[GravelRider]

It's a significant gamble. Assuming all else is equal (call, location, etc)

You have to compare the PP partnership income year 1-5 and years 5-10 versus the non partnership group and assess your risk vs return.

Assume 1000 units per month for each group

Then determine at what point you will break even, year 5-7? And what point you will make a positive return. Don't forget to account for the lost returns on your lost potential income in the partnership track years. For example..

Year 1-3
Non partner group 500k per year = 1.5 mil
Partner group 400k (100k buy in) = 1.2 mil

Year 4-6
Non partner group 500k annual = 1.5 mil
Partner group 600k annual = 1.8 mil

So in this example, it will take 6-7 years to break even. Will you be in the group that long? Will the group have the contact that long? What if you want to move? Will they grant you partner or just take your money?

It just seems like there are a lot of unknowns going forward with No Surprise Act and whatever else looms on the horizon. Past performance doesn’t guarantee future returns and all. It seems as though selling to AMCs has quieted down in recent years, but I wonder if we see a spike in practice sales over the next year or two. These AMCs benefit from the fear of the unknown and there is definitely some of that going on right now.