Partnership from Day 1, need help with negotiations

[bababrown]

I am not a Hospitalist but I feel qualified to answer this as I, at some point, had similar aspirations you currently have.
A few points I would...

[bababrown]

What is your specialty?
I see infusions being mentioned as one of ancillaries (along with MRI). Specialty like rheum can have significantly high...

[bababrown]

There are providers around (80% are private, a few employed) however we all perceive that there is way more need than the supply in the geographic region....

[bababrown]

My plan is to get a mid level to work with me once I reach that stage, which may happen as soon as 6 month to 1 year if we acquire the retiring practice...

[bababrown]

His former patients + mine will largely be mine and I will be able to take home all the profit that I can generate after paying out the buy in / buy out...

[bababrown]

The suggestion is to pay out 100K per year + 3% interest to complete the buy out over 3 years.
DW has a stable job so I can survive without a salary...

[bababrown]

Yes correct. The retiring doc is solo and not part of the practice that I am joining. I have reasonable amount of confidence that my existing patient...

[bababrown]

So the argument there is that 2 out of the 3 existing partners are not accepting new patients currently and have already full panels. So they want me...

[bababrown]

The advantage of being with the existing rheumatology group is that they are part of the local IDN (who happens to be my current employer). That means...

[bababrown]

Thank you.
I got discouraged by the perceived troubles of starting an own practice thus far. Your point is well taken, will consider that option...

[bababrown]

I am currently an employed rheumatologist. With salary and bonus I make about 300K a year plus benefits. I am entertaining a move to a private practice...

[bababrown]

Thought of it
wouldn't it make more sense to make some money on 1099 as opposed to get a bigger paycheck on W2 by doing more productivity?...

[bababrown]

It was a wandering question since season 1 which Krazinski answers in season 2.
When I heard that response, WCI popped in my head in no time....

[bababrown]

W2 doc here
I get 6 weeks of ATO + 1 week for CME
I typically don't needs 6 weeks of vacation, so I was thinking of doing 3 weeks of locum...

[bababrown]

Jack_Sparrow wrote: It sounds like a nice gig to me. I’m biased because I dislike the northeast and love the south so it would be a no brainer for me. As other have pointed out it doesn’t ...

[bababrown]

Psyched wrote: bababrown wrote: “Rule out autoimmune” Click to expand… ok this one made me laugh out loud, “autoimmune” as a formal diagnosis!! Click ...

[bababrown]

"Rule out autoimmune"

[bababrown]

Kamban wrote: bababrown wrote: Here is the answer I got : overhead is 50-55% (including the staff needed to operate labs and imaging). From the left over 45%, the employer gets 10...

[bababrown]

Fugue wrote: 35% would be considered low in my field as well (derm), that’s more PA level. If you have any entrepreneurial spirit being a true partner would likely be better fo...

[bababrown]

Brains428 wrote: Not really a thought about the practice, but more a location question. What area of the northeast and what area of the south? It can be very different culturally, wh...

[bababrown]

CordMcNally wrote: bababrown wrote: Here is the answer I got : overhead is 50-55% (including the staff needed to operate labs and imaging). From the left over 45%, the employer gets ...

[bababrown]

EntrepreneurMD wrote: 35% of your collections in income is low. Ask for 40-45% on the salary side. Click to expand... Already did. Here is the answer I got : overhead is 50-55% (includi...

[bababrown]

CordMcNally wrote: That isn’t even close to a partnership. It’s basically an employed position with performance bonuses. Do they tell you how much other docs are bringing in so you...

[bababrown]

I am OP rheumatologist, in NorthEast, employed by hospital system making low 200s with full benefits (medical, dental, health, 401k with 6% match). I...

[bababrown]

SValleyMD wrote: Hard to know without information on your total package … When does your bonus set in? Our Nurse practitioners make more than $30/rvu so it d...

[bababrown]

Thanks. I was exploring on this matter and found this information very helpful. The protection being an employee of the state is much stronger compared...

[bababrown]

Wanted to get an idea about hospital / group employed OP Internal Medicine job scenarios Currently in Northeast, 200K base, incentive 30$/wRVU after cover...

[bababrown]

The White Coat Investor wrote: Steven Podnos MD CFP wrote: Asset protection is a complex topic and not easily explained here.  Taking into account caps on non economic damages is a good idea,...

[bababrown]

Radonlake wrote: Sounds like the cap got removed in FL which is a shame. I am in TN and to my knowledge our cap is still good. Until recently, the state published a yearly report of malpractice activi...

[bababrown]

I think personally for me the state laws will make or break a deal as I am taking up a new job. Have interviewed in TN, GA, FL. FL seems to be better...

[bababrown]

The cap on non-economic damages in FL was deemed unconstitutional on 1 occasion for wrongful death case. Does this extrapolate to all the cases?

[bababrown]

Umbrella would not cover medical malpractice pay outs. Isn't so?

[bababrown]

It was difficult to track down in most of these cases how much the plaintiffs actually ended up getting....

[bababrown]

Hi all, General question for the group. I understand that, although likelihood of being sued for an MPI claim is fairly high throughout a physician c...

[bababrown]

childay wrote: What specialty?  You say primary care but your numbers above suggest 600k in collections.. Click to expand... Yes primary care. Assumption after 1-2 years in practice: daily 4 news, 15-18 follow up, eq...

[bababrown]

ZZZ wrote: “If I sign in to partnership” How is the buy-in calculated? How is the buy-out handled? What if one of you dies? Make sure the answers to those questions are spelled out contractually. Click to expan...

[bababrown]

ENT Doc wrote: bababrown wrote: Sean wrote: Why would you be expected to shoulder half the overhead for the whole practice if you’re joining as his employee? I can understand splitting the overhead if you’re e...

[bababrown]

Tim wrote: bababrown wrote: no ancillary services on site  Click to expand… The real OH question is are you getting a fair shake. Does the staff and expenses support other revenue streams? Are there variable e...

[bababrown]

...

[bababrown]

Exactly. Since I have never worked on collection model, I have no idea what to expect for the costs. I agree with 50-50 split on the overhead part may...

[bababrown]

Yes, it is IM outpatient. The last Offer is from solo practitioner with a small office 4 rooms.

[bababrown]

Thanks for all inputs. I have been presented another offer - 1st year base , after that "eat what you kill" I was told it will be all the net physicia...

[bababrown]

Thank you. When you say "Non MCD/MCR payments may be considerably higher", do you have any reference for me to look up how much higher it would be co...

[bababrown]

B

[bababrown]

You were right on money. DCB does not stack directly up on solo 401k and reduces profit sharing to 6% of net income, confirmed from Schwab. Again, apprec...

[bababrown]

Will do that.

Will share what I learn for all of our knowledge.

Thanks again.

[bababrown]

Thanks for all your insights. Reg #2. I am not able to find that information anywhere. Can you elaborate the source? I reviewed multiple CPA / investor...

[bababrown]

Thanks WCI for the multiple 401k rules post. I learned a lot after reading it as well as going through the comments, however I still have a few queries....

[bababrown]

Thank you so very much for all your input, very helpful.

[bababrown]

I had a question regarding the tail coverage. I switched jobs in July 2017. Due to being a regular visitor of WCI blogs and podcasts, I was aware a...