Senior partner, no call?

[Future Fire]

Hi all, I am negotiating a buy-in for a dermatology practice with one other employee MD and the owner. It would be an equal partnership between the three of us in terms of decision making (33% voting each).

The current sticking point is call. The owner current doesn't take call (the other MD and I split call). However, once the other MD employee and I become partners, we want to only take 1/3 call each.

How have others handled this situation?

Senior partners out there.... what is your reasoning for feeling justified in not taking call and also being "equal partners"?

Junior partners: Anyone out there successful in negotiating senior partners taking call?

We have a few ideas... i.e. mid-levels taking call for the owner. But I'd love to hear other's experiences. Thanks in advance!

[G]

I'm EM. The old guys essentially pay to not work nights. Most of the specialty groups around here do the same.

For those of us that rarely encounter a dermatologist, could you frame why call wouldn't be split equally?

[jfoxcpacfp]

Senior partners often believe they have put in their time on call and that is one of the perks of building a practice alone. That said, it is definitely a point of negotiation and you have picked the right time, before you sign, rather than after you are a partner and have signed an Employment or Partner Agreement that specifies something different.

As a senior partner, I can definitely see your senior’s POV. I am finished with 7-day workweeks (I hope) but would still bust my a$$ for our practice and clients again if it was needed. I feel like I birthed these practices - hopefully, your senior partner feels the same.

[Hatton]

As a retired OB I cannot imagine that derm call is anything to be upset over. How often do you get called? Do you ever leave the house inthe middle of the night? Obs of course argue about call because it is a real issue in life quality.

[CordMcNally]

I don’t think our dermatologists would even answer the phone if I tried to call them after hours from the ED.

If it’s going to be equal votes couldn’t you and the other MD vote to share call equally afterwards? Clearly, it would be an a-hole move but it’s still a move. I agree with @G about what’s typically done. If he doesn’t want to take call then it’s going to cost him some $$$.

[Sampter]

I think you are going to have to decide what to do when the senior partner states they will not take call and they won't pay for the pleasure of not taking call.

Either move forward or move on.

[zlandar]

Who is going to do the administrative work of running the practice? I assume the current owner is the one doing it. Not sure how much work that entails for a 3 doc practice but it should be compensated.

[Bmac]

As a retired OB I cannot imagine that derm call is anything to be upset over. How often do you get called? Do you ever leave the house inthe middle of the night? Obs of course argue about call because it is a real issue in life quality.

While I wholeheartedly agree, in my 25+ year experience, call is in the eye of the beholder. Everyone complains about their call regardless of specialty.

[childay]

While I wholeheartedly agree, in my 25+ year experience, call is in the eye of the beholder. Everyone complains about their call regardless of specialty.

Lol true. Any call sucks but obviously having to go in at 3AM for emergency surgery is way worse than talking to ER doctor
I admit I am enjoying sleeping all night in my no-call new job!

[Kamban]

It is one thing if the senior partner took calls for < 5 years before you and the other doc came in vs him/her taking calls solo for 25+ years and then you both came on aboard. In the former case he should take call equally. In the latter case he has busted his rear starting the practice and taking call and paid his dues and you two can take calls. If he refuses to take calls or cut his pay then you can become partners and live with it or move on to another practice where this is not an issue. Who blinks first ....

[JWeb]

Scrubs for the win. A dermatologist has been paged!

https://www.youtube.com/watch?v=dgupJ2WN0Zw

[Bev]

1. Everybody takes call.
2. If the senior partner balks, then the other two partners should expect more monetary compensation.
3. I would also have a realistic conversation about the number and types of dermatology emergencies that actually occur.
4. I would also have a planning session regarding vacation planning/days off.

[Notsobad]

Call us a flash point for us. A ton of stress but not a huge driver of revenue. Once a senior doc wanted indefinite No call and that caused a lot of strife. We decided that nobody could stay a partner without taking call. we were all partners making the decision

What is fair is what the three of you decide is fair. Of course the founder deserves some perks? How long have you two been in the practice and how much value have you added? How expensive is the buy in? How long will the founder stick around?

if you two give him freedom from call then you need to get something that makes you feel that the deal is evened out.

of course, if you walk away, maybe you could do better, maybe not.

[MPMD]

there has to be a price for his not taking call or you are not equal partners.
if he is able to unilaterally over-rule decisions and make rules, what is the point in having an "equal" stake?
if he sticks to his guns on this, i would get some bylaws written that this is a carve out and the ONLY exception to decision making. i would also spend quite a bit of time agreeing to staffing stuff and getting it in writing.
next thing you know he's the senior guy and so the two of you kids are splitting clinic while he takes a week off at tday, xmas, 4th, etc etc

[White.Beard.Doc]

Kids these days, sheesh!