Private Practice Interview: First meeting etiquette

[ACN]

I asked about income, ancillary income, buy-in/out, call pay, prior employees not making the partnership, etc. all on the first phone interview.  I made a question sheet and went down the entire sheet filling in answers as we talked.  If it didn't come up in the conversation, then I asked. Don't waste time traveling without asking important questions.

[Dr P]

I would agree.  Having at least an understanding of the ballpark salary is important before dedicating time, effort, and money to an interview.

If they are unwilling to discuss the numbers, that would raise a red flag for me.

[Tim]

After phone interviews, both parties have information and an interest in an employment contract.

Due diligence and negotiations are part of business. How compensation is anticipated to be structured
and ballpark totals are important to both parties. No reason not to ask the question of the employer.
Most interview trips are disruptive in terms of time and expense, let alone if relocation is involved.
Is it worth exploring before or after a trip?
1)How is compensation structured and any ballpark figures for this position you would care to share?
2) Pause
3) We can work through that later, what dates work for you?
If you don’t ask the question, you maybe wasting a day or two.

[Zaphod]

No way. Dont waste your time traveling etc...without knowing what at least the ballpark expectation is.

People say all kinds of things about fit, etc....but no one will care if the pay and expectations dont line up first. If it's a horrid practice you may not know until too late but pay wont matter.

I'd consider the recruiter saying that a red flag, they probably pay awful or he has had a hard time delivering interviewees etc...this is the market and how they learn. Practices with poor hiring skills will suffer as they should. better for everyone in the end.

What other professions are salaries and the like so taboo or you're blind to pay even after starting? Not too many, and usually that means someone is trying to take advantage of you.

[CordMcNally]

iUSeverything wrote:

I just went on my first interview at a private practice and the recruiter basically told me that I should refrain from talking about money on the first visit. Refrain from asking about benefits and all the nitty gritty stuff. First ask them about their practice, where it’s going, how it’s different. Only after you think it’s a good fit do you “hash out the details”.

Click to expand...

Part of it being a good fit includes salary, benefits, and all the "nitty gritty stuff". I'd try to lose the recruiter if I were you, they will only get a piece of your hard-earned money.

[ENT Doc]

iUSeverything wrote:

I just went on my first interview at a private practice and the recruiter basically told me that I should refrain from talking about money on the first visit. Refrain from asking about benefits and all the nitty gritty stuff. First ask them about their practice, where it’s going, how it’s different. Only after you think it’s a good fit do you “hash out the details”.

Click to expand...

Agreed.

[iUSeverything]

I just went on my first interview at a private practice and the recruiter basically told me that I should refrain from talking about money on the first visit. Refrain from asking about benefits and all the nitty gritty stuff. First ask them about their practice, where it’s going, how it’s different. Only after you think it’s a good fit do you “hash out the details”.

[Sid16]

Great list !!

[TheLocumsLife]

These were my questions when I considered private practice, I realized this is old thread but think this list could be very helpful to others!

 

Group

Number in group?

Ages?

Salary Range?

Interests/niches of partners?

Recently Departed (Why) (wary of solo MD with several departures)?

Is a senior partner “about to retire”?

Planned additions?

Any plans to merge with other groups?

 

Compensation

Base salary

1^styr?

2^ndyr?

Productivity bonus

Starts at what number?

Get what percentage (graduated scale)?

Any guarantees if productivity exceeds salary? When received?

Note: if groupreaches an incentive quota, you should receive your

percentageof that excess based on your contribution in receipts

(accounts receivable, not reimbursements)

When is productivity disbursement (usually 6-12mos)?

 

Expenses

Department overhead

Total amount?

Equal payments from each partner to cover overhead?

Expenses excluded from overhead that are individual’s responsibility?

How is gross income divided between net income and expenses?

How is net income divided between partners? (Equally?)

Meeting expenses paid? For everyone?

Note: usually annual allowance for travel to meetings.

Membership dues:, section specialty society?

Parking expenses?

Cell phones?

 

 

Benefits

Health, dental, vision (can be several choices)?

For dependents?

Pension?

Carved out from salary, or in addition?

 

Malpractice

Who pays mine?

If malpractice higher for certain partners, who pays difference?

 

Partnership

How many years (usually 2-3 yrs)?

Requirements to meet?

Buy-in amount? (may need to sign promissory note for this)

What does buy-in buy?

 

Contract

Restrictive Covenant

Range?

Note: negotiate for a restriction for facility/hospital ONLY, avoid

geographical radius restrictions

If terminated, no applicable restrictive covenant?

Pay penalty to void covenant (usually very expensive)?

Tail ?

Who pays tails of departing partners?

How many days notice for termination of contract (for both parties)?

 

Additional Income Stream?

 

Call Schedule

Who takes call during week?

How are weekends divided?

How does it change from 1^styear to 2^ndyear to partnership?

Total ERs covered?

Location of ERs?

Level I Trauma?

Additional pay for call?  Included in salary? Compensation for noninsured?

Can I moonlight or take more call for more income?

Who covers when partners are away (weedays/weekends)?

Do PAs take call?

 

Staff

Nurses?

PAs?

MAs?

Desk Staff?

Usage split equally?

Note: ask for 1) nurse/PA 2) scheduling secretary/message phone person

 

Clinic Time

Number and locations of clinics (satellites)?

Time spent at each is equal? Why not?

What are distances from offices to covered hospitals?

What is distance between offices?

When will mine be?

What staff will be dedicated?

In-office procedure availability (procedure room block time)? Same for everyone?

 

Consults

Who sees the consults/ER during business hours? At all locations?

Who sees the consults/ER during evenings/weekends? At all locations?

Divided equally during business hours? Why not?

During business hours are multiple MDs assigned to multiple locations?

 

OR Time

When will mine be (get block time)?

Dedicated staff (PA)?

 

How will I get patients

New patients divided equally?

New patients selectively distributed

By presenting disease?

By insurance status?

Volume available?

Current wait times?

 

Academics

Affiliated with any teaching institution?

Group conferences?

Weekly/monthly conference such as M&M, etc.

 

Non-patient responsibilities

What?

Time commitment?

Any expectations such as seeing partner’s in-house patients?

 

Hospitals the group operates out of

Is the equipment you need available?

Will the hospital obtain it?

How quickly can you get privileges?

Will you have privileges to perform all that you plan to?

Is there an affiliated ASC?

If so, will you receive percentage of the generated income?

 

Exclusive of Contract (I get all income)

patents, moonlighting, proctoring, speaking, consulting, research, locum tenens

 

On signing contract

Start date?

Signing bonus?

Moving expenses?

 

Things to know ahead:

Avg starting salaries in area

Avg physician salaries in area

Reps’ opinions of the groups/hospitals they operate out of

 

Financial Data to Ask For:

income statement, profit and loss (aka operating statement), balance sheet,

cash statement, accounts aging report, number of active charts, percent of managed care vs private insurance vs medicaid vs private pay

 

Hope it helps! Not needed much anymore as locums has whole different set of questions!

TLL

[Sid16]

Want to give an update about this post. Sorry for the delay and I really appreciate everyone's valuable advice. I got the contract from the owner and found a lot of red flags. He was very persistent and talked about future real estate investment and potential lab revenue. I was not convinced and politely declined his offer. I was happy with my job and LCOL location but my spouse was not as he had a long commute. We moved midway to a better location  and split the commute...40 min each. We bought a bigger and nicer house(2X income) and sold our old one(<1X ).

Our realtor that sold the house was very manipulative and tried to charge us a lot for minor home repairs. We found a different handyman/plumber and got much better work done for 50% less than what he quoted. I wanted to do FSBO but was very busy with multiple other things. Hated working with him but hopefully I learnt a lesson for future. I'm currently in the same job and have good and bad days. I miss our small and simple home and short commute. But my family is enjoying the nicer house and spouse is happy.

I have some more decisions to make...regarding public vs private school, kids activities, potentially cutting down hours etc.

I occasionally lurk and find this forum very helpful. Hope to pay it back in future and reach a position where I can offer good advice.

[Brains428]

I took the attitude that white beard doc looks for. I want to be happy where I work, so I cared that I was a good fit.

No amount of money can ensure happiness.

That being said. They offered me more than I anticipated, and were still willing to up the pay when asked. If I got burned from the financial end, maybe my attitude would be different.

Good luck.

[billy]

Occurrence malpractice does not require tail at all; its the best malpractice you can be offered.

[Sid16]

I have finished my interviews and trying to make a decision. I met the PP owner and feel like I could work with him. He plans to open a second clinic near our home and I have to split my time between his  and the new clinic. I interviewed at 3 other places. 2 are out as they are in downtown and commute is too long.

The other Private practice group wants to start a clinic in a new location with assistance from hospital. I am not interested in 4 year commitment plus the pay is low.

I received the contract and have to hire an attorney to get it reviewed. First year is income guarantee, second year: base salary plus 50% of collections minus my overhead and partnership in 3rd year.

I have not negotiated any of his terms yet. Few things which stand out are : malpractice is occurrence only(no tail coverage), non compete is 10 miles and termination without cause. Vacation is 3 weeks including sick days and CME.Partnership terms are not in the contract. He wants to add ancillary services and there is potential income from that in future but I don't know what exactly it is.

I want to ask for better vacation, tail coverage and termination with cause. Any suggestions/advice will be appreciated.

Thank you !

 

[White.Beard.Doc]

Please let us know how things work out with the interview and practice.  It sounds like you may have some interesting choices to make.

[beagler]

He should probably give you the practice for his ability to work part time. Maybe pay for the value of hard assets.

If it doesn’t work out could you then sell/join the hospital group?

Most hospital employed primary care will refer to hospital employed endocrine. So if penetration is high you can see the writing on the wall.