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  • #16
    Originally posted by AnonMD View Post
    The senior partners each have annual productivity placing them in the 85-90th percentile of wRVU volume. There is the opportunity for significant ancillary income through pathology, pharmacy, etc.

    The group was part of a recent private equity transaction with the “second bite” anticipated in approximately five years.

    yikes

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    • #17
      PE is quite new and I’m unaware of any “second bites” yet, at least in my specialty. I would tread carefully. The chance for significant equity has likely passed given the sell. I would evaluate these jobs on QOL metrics more than financial at this point. I would assume the big pay-day has likely passed for the PP job.

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      • #18
        Someone can correct me if I’m wrong but, from what I’ve heard from others involved in the PE deals, it seems the senior partners make out like bandits (with millions to add to their retirement portfolios) and the young, new docs get the sort end of the stick (big upfront salary but no ability to earn the huge salaries of partners past). When I talk to current residents, a lot of them express these sentiments when looking for jobs. They see “good jobs” out there but, then find out it’s a PE backed entity, and quit exploring........and this actually impressed me because I thought a lot of younger docs wanted a job where they check in and check out. That was my misguided notion fed by social media. Instead, many of the residents I talked to want the opportunity to join a practice, work hard to grow it, and reap the benefits of a hard working equal partner

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        • #19
          Originally posted by Eye3md View Post
          Someone can correct me if I’m wrong but, from what I’ve heard from others involved in the PE deals, it seems the senior partners make out like bandits (with millions to add to their retirement portfolios) and the young, new docs get the sort end of the stick (big upfront salary but no ability to earn the huge salaries of partners past). When I talk to current residents, a lot of them express these sentiments when looking for jobs. They see “good jobs” out there but, then find out it’s a PE backed entity, and quit exploring........and this actually impressed me because I thought a lot of younger docs wanted a job where they check in and check out. That was my misguided notion fed by social media. Instead, many of the residents I talked to want the opportunity to join a practice, work hard to grow it, and reap the benefits of a hard working equal partner
          PE/CMG- higher floor way lower ceiling, but like the VA and hospital employed- a lot depend on local leadership. Also expect all the senior partners to leave once the buyout period (5-6 years usually) ends, so expect turnover with the possibility of not being able to replace fast enough if you are before that timeframe. For the most part salary wise its up to the local leaders to divvy up the allotted salary allowance as they see fit- Got x amount for y employees, pay them what you want but you only have X amount.
          PE will hire to margins- so you will not be overstaffed.
          BUT- not all PE/CMG is bad- you just need to know what you signed up for. My second job was PE, and honestly I was ok with it because I wanted to just punch in and out, and with anesthesia that's easy to do. Was it the highest paying offer? no. Was it the lowest? no. But it came with no BS about buy in time, or "paying ones dues", or vague language in a contract. HR things were amazingly handled well (FMLA, benefits, credentialing). But you will only get what you sign up for, you are an employee.

          Private practice- depends on how fair the PP is to its new hires. Some are great, others preditory. The worst scenario imho is a PP that eats its young, and where there is no equal partnership path. That's the worst of both worlds. But a truly democratic group, with a path to partnership where all partners are equal once they are partners, that's the golden ticket.

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          • #20
            Originally posted by Eye3md View Post
            Someone can correct me if I’m wrong but, from what I’ve heard from others involved in the PE deals, it seems the senior partners make out like bandits (with millions to add to their retirement portfolios) and the young, new docs get the sort end of the stick (big upfront salary but no ability to earn the huge salaries of partners past). When I talk to current residents, a lot of them express these sentiments when looking for jobs. They see “good jobs” out there but, then find out it’s a PE backed entity, and quit exploring........and this actually impressed me because I thought a lot of younger docs wanted a job where they check in and check out. That was my misguided notion fed by social media. Instead, many of the residents I talked to want the opportunity to join a practice, work hard to grow it, and reap the benefits of a hard working equal partner
            That's refreshing to hear. I admit that I've always had the impression my fellow young docs preferred an easy clock in/clock out gig, which is fine. I just want people to be aware of the trade offs in those situations. I used to preach about those things to derm residents when I was a dermpath fellow. Lots of PE in that specialty, and it seem like it's growing into others.

            It's interesting to see how PE affects other specialties. Doesn't seem like the docs win in the long-term. Old docs make out like bandits, but it's hard for me to blame them when that much money is on the line. Not hard for me to despise the view that pathology is just another revenue stream via de facto kickbacks. PE loves to exploit any Stark law exemption they can

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            • #21
              This input is greatly appreciated.

              For what it's worth, the senior partners anticipate retiring in the next five years. At this time, I have yet to receive sufficient clarity regarding the nature of the equity I will be eligible for. The contractual language is vague.

              I have also followed up with a mentor from residency who advised me not to pursue this opportunity due to "shadiness," excessive emphasis on profit, and geographic location.

              This has steered me towards the multi-specialty group opportunity.

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              • #22
                Originally posted by Kamban View Post

                What exactly was the recent private equity transaction? Did the senior partners make money selling to a PE firm and you might have to work to make money for that PE firm since they have paid out money and expect to see some returns on it.

                Years ago a colleague joined a single specialty group and 1.5 years into the 2 year track for partnership the group sold to a hedge fund. The partners made millions. My colleague got $200K. Another 6 months and he would have been an equal partner getting a much bigger piece of the pie.

                Make sure you are not used as a sacrificial lamb.
                Yeah I agree with Kamban. Heard of this happening too often. Some people put clauses in their contract that if their future employer is bought by PE they can get out of the contract.

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                • #23
                  Originally posted by SerrateAndDominate View Post

                  That's refreshing to hear. I admit that I've always had the impression my fellow young docs preferred an easy clock in/clock out gig, which is fine. I just want people to be aware of the trade offs in those situations. I used to preach about those things to derm residents when I was a dermpath fellow. Lots of PE in that specialty, and it seem like it's growing into others.

                  It's interesting to see how PE affects other specialties. Doesn't seem like the docs win in the long-term. Old docs make out like bandits, but it's hard for me to blame them when that much money is on the line. Not hard for me to despise the view that pathology is just another revenue stream via de facto kickbacks. PE loves to exploit any Stark law exemption they can
                  I don't know. I am a current resident and I would say the majority of my co-residents and those that graduated before me are looking for the easy clock in/clock out gig where they expect to get paid 500k a year putting in 30 hours a week. And when their employer comes knocking because their productivity doesn't match the ludicrous salary they asked for, they get upset and find another job.

                  Old docs DO make out like bandits and I can think of specific examples in my area in the specialty you mention. PE is a plague to new doctors.

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                  • #24
                    Originally posted by AnonMD View Post
                    This input is greatly appreciated.

                    For what it's worth, the senior partners anticipate retiring in the next five years. At this time, I have yet to receive sufficient clarity regarding the nature of the equity I will be eligible for. The contractual language is vague.

                    I have also followed up with a mentor from residency who advised me not to pursue this opportunity due to "shadiness," excessive emphasis on profit, and geographic location.

                    This has steered me towards the multi-specialty group opportunity.
                    Contractual language should not be vague. Protect your future self. I'd look elsewhere and sounds like you are. Good luck.

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