Private practice and benefits

[Wings3496]

Hi everyone - I'm a third year family resident in the middle of interviewing for jobs. At this point I've interviewed almost exclusively for employed positions with large systems who offer traditional institutional benefit packages (i.e. 401/403, 457s, HSAs).

I have several interviews with private practices coming up, and I'm at a bit of a loss on how to compare valuations of their benefit packages. I know even in larger groups with small business 401s, the fund options might not be that great. And I assume the 457s will be out, and the health insurance offerings would be quite different.

I've been reading around and talking with people, but almost all my mentor physicians are employed docs, so they have limited to no experience in the private world. Any tips on how to compare the total compensation/benefits between the employed vs private options?

Thank you!

[Dreamgiver]

Excel spreadsheet with detailed columns for every job you interview at. Put everything down, from CME, vacation days, detailed pay structure, relocation expenses, loan repayment programs, every benefits you can think of, and such.

[Hatton]

Of course ask about partnership buy in.

[Zaphod]

Dreamgiver wrote:

Excel spreadsheet with detailed columns for every job you interview at. Put everything down, from CME, vacation days, detailed pay structure, relocation expenses, loan repayment programs, every benefits you can think of, and such.

Click to expand...

also crime rates, economic strentghs, schools, amenities particular to you, cost of living/home prices index compared to your baseline, how you felt the people at the practice seemed from a personal impression standpoint (nice, honest, guarded, transparent, easy going, shrewd, etc...). lots of stuff.

[VagabondMD]

The greatest benefit of private practice is that the partners can run the business side, expecially with respect to benefit packages, in the best interest of the partners. If you work for a big system, that will not be the case. You are working for The Man.

The other aspect, which has both pluses and minuses, is that in private practice, you are responsible for generating revenue, and, to a great degree, the more you (and the other partners) work, the more the practice makes.  If you have a slow week (month, quarter, year,..), you will bring home less.

You also decide where to invest and how to spend your money.  If you make bad business decisions or have bad luck, you can be out of business. If you make good decisions or have good luck, you can make a fortune.

[mobilehomegurl]

Coverage and vacation time is always an issue in private practices especially for partners. As with anything, there are always pros and cons. Good advice here so far. Figure out what your priorities are and the type of lifestyle you want to lead (i.e. time off, holidays, number of hours per week, etc.) to help with your decision. Just be sure you know what you're getting into before you take the plunge.  

[Wings3496]

Thank you everyone for the advice!  I'll be implementing it going forward in my interviews!

[akmd]

i have given this a lot of though, and i think the best is independent contractor arrangement through an employer long term and negotiating a good contract.

that way you are not responsible for managing any of the headaches of running a business, you can defer a lot more money in pre tax accounts (solo 401 k or SEP, whichever), and you also have full control

 

 

 

[SValleyMD]

Agree 100%

I'm an independent contractor in a group that has a professional service agreement. We are paid strictly by rvu

I don't have to run a business or manage a. Office. No assets with partners.

I can then do the 401k/dbp and tuck a ton pre tax

I'm treated as a quasi employee (have to play by their rules) but still have full autonomy on my schedule

I work as much as I want to make

More docs should push for this imo

[jhwkr542]

I'd mostly ignore fund choices in retirement plans when comparing jobs. They can change fairly easily. Also, in the short run, the small differences in basis points won't make that much difference compared to the rest of the compensation package.

[jfoxcpacfp]

Make a list of your priorities on a piece of paper or spreadsheet and head up a column for each position. Rate each row 1 - 10 for each job benefit, compensation, scheduling issues, future opportunities, etc. (everything you can think of that matters to you; the list can be quite long) and tally the columns. The final scores won't necessarily determine your decision, but will give you some analytical perspective on which position best suits your short- and long-term goals. This will also force you to think through all of the details. If applicable, I'd recommend you involve your spouse or SO.

[DocMD]

i have given this a lot of though, and i think the best is independent contractor arrangement through an employer long term and negotiating a good contract.

that way you are not responsible for managing any of the headaches of running a business, you can defer a lot more money in pre tax accounts (solo 401 k or SEP, whichever), and you also have full control

I am glad to read your post, akMD and SValley MD. The more I research about private practice and IC, the more I am convinced that IC is a better situation in my opinion, for all the reasons you both stated. Can I ask if you get paid by a percentage of collections, what would be a fair percentage? I read anywhere from 40-70%. I personally believe the IC should get a higher percentage being the one who is generating the service. Also, do any of you have your own employee? I am considering hiring my own MA and was wondering how much additional cost that would be for me. I figured MA salary+health insurance +workcomp+FICA tax? I am not sure if I am missing any additional cost I need to prepare for.

[afan]

Remember that many private practices are bought out by larger groups or corporate medicine. You may find a practice you would like to join, only to have it no longer be an independent group. Many of our trainees are devaluing the independence since they are skeptical that it will persist.

[jfoxcpacfp]

Zombie thread, shutting it down. Both of you are welcome to start new threads on this topic, though!