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Maternity leave - need advice for high income docs in private practice

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  • Maternity leave - need advice for high income docs in private practice



    Group 1 maternity leave policy is unpaid leave for up to 12 weeks when employed for the first two years. They don't know what they will do about it once I become a partner.

    Group 2 maternity leave policy is a reduction of income by a fixed percentage of my annual income.

    Is there anyway I can negotiate for better terms? Does anyone have any advice on how to not have such a significant financial set back while on the leave?

    Thank you for your advice.

    edited to leave out some details. After reading the comments below, I will go with group 1 most likely and just be grateful to have a high paying job.
    Last edited by XGPkidney; 05-18-2021, 10:23 AM.

  • #2
    This is always a very tough conversation and detail to iron out. Typically the person wants to be paid while not bringing in revenue during that time which essentially means the other partners pay you for not doing any work and covering your share of overhead. One option is to get paid less throughout the year and then still receive some income during the leave although that’s not really any different from a financial standpoint of getting paid normally and then not getting paid during the leave. Depending on the person, that may be a better solution from a cash flow standpoint. It may all sound unfair to you but I promise your partners see it as unfair to them, too. Best of luck on coming to an agreeable solution for all parties because that’s usually difficult.

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    • #3
      As a partner, youre responsible for the overhead regardless of how much you work. Income is dependent on collections.

      If youre not working, fixed overhead - zero collections = net loss

      Ive never heard of a group subsidizing a partners maternity leave, although I could be wrong about that

      EDIT: That said, I would think you have some more negotiating leeway as an employee as I would assume there is a margin the partners are collecting from you

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      • #4
        As an employee, you may be able to use your vacation concurrent with the leave so you get paid for some of it- for example if you have 6 weeks paid vacation/PTO/sick time, and take 12 weeks off, you are paid for 6 of them. But then you have no paid vacation the rest of the year.
        As a partner, I'd assume you are eat what you kill plus a split percentage off of employees collections minus a set overhead, so any time off is in a sense unpaid.
        Look at your state's benefits- some will provide (an albeit small amount comparatively to your salary) benefits during a fmla or maternity leave event.

        Why is group 2's set at 3% annual salary per week on leave? Shouldn't a fair percentage be # weeks taken/# total weeks in the year? Seems punitive, considering 1.9-2% would be what you lose not being paid at all. As an employee, you shouldn't be responsible for your overhead. Based just on that I would consider group 1 over group 2.

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        • #5
          Group 1 sounds pretty normal and I think FMLA legally required 12 weeks unpaid for companies with over 50 employees.

          Group 2 sounds punitive.

          But my biggest concern when joining a private practice is whether or not they will really offer partnership after 2 years, and the terms. I know too many friends of mine who have been screwed over. The loss of income for maternity leave will be relatively small in the long run.

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          • #6
            Related question for all — should I get short term disability insurance for possible complications from pregnancy? I have an occupation specific disability insurance already but wondering if I need to get a short term disability insurance in case I cannot return to work in 3 months or something.

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            • #7
              If you go on leave the other physicians in the group either have to either pay someone else or give up their own vacations to fill in the gap.

              What do you think is fair?

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              • #8
                Originally posted by zlandar View Post
                If you go on leave the other physicians in the group either have to either pay someone else or give up their own vacations to fill in the gap.

                What do you think is fair?
                rationally it makes sense.

                it is just disheartening that I put off having a child for a long time for my education and training. I worked as hard as men in my field and I have to take a significant financial set back to have a family. As a trainee, I have not been aware of the huge pay cut I will need to trade for wanting to have a family.

                My male colleagues already have 2-3 children but I have been holding it off because of my training and to reduce burden on my co residents. Now I have to choose to have kids at my own financial loss. It is something that my male colleagues don’t even have to think about.



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                • #9
                  Originally posted by XGPkidney View Post
                  I am discussing terms with my future employers/partners in a high income surgical subspecialty. I am interested in private practice.
                  ..........
                  This has been discussed in past threads and somehow it becomes contentious after a few posts. I hope this one does not turn out to be the same.

                  Academics usually pays some paid maternity leave. Most PP don't offer paid maternity leave. There are issues on both sides - children are the future payors of our SS, they are the future of our country etc. On the other side is why a childless single person or couple should bear immediate burden when they will not see immediate benefit.

                  I recommend Option one and saving up some cash for the time you will be off work.

                  One solution I suggested in the past is to offer a 6 week off every 3 years as paid leave for everyone, built into the financials of the workplace. That way one can take paternity, maternity, child adoption, sabbatical and anything one wishes to take - no questions asked. And no one is burdening the others by taking paid leave.



                  Comment


                  • #10
                    Originally posted by XGPkidney View Post
                    Related question for all — should I get short term disability insurance for possible complications from pregnancy? I have an occupation specific disability insurance already but wondering if I need to get a short term disability insurance in case I cannot return to work in 3 months or something.
                    this may come off as harsh, but no attending should ever need short term disability (to pay for the first few months before regular disability kicks in). Everyone should have regular disability, which you state you already have. What's the time period before your disability insurance kicks in? I'm assuming you are currently a resident- your first attending paycheck will be >>2-3 months of your resident's salary. Live like a resident for your first few years, build up an EF for 3 months, and you should be able to handle any short term period of losing income. Live like an attending right off the bat, and yeah you might be in financial trouble.

                    Comment


                    • #11
                      Originally posted by XGPkidney View Post

                      rationally it makes sense.

                      it is just disheartening that I put off having a child for a long time for my education and training. I worked as hard as men in my field and I have to take a significant financial set back to have a family. As a trainee, I have not been aware of the huge pay cut I will need to trade for wanting to have a family.

                      My male colleagues already have 2-3 children but I have been holding it off because of my training and to reduce burden on my co residents. Now I have to choose to have kids at my own financial loss. It is something that my male colleagues don’t even have to think about.


                      I know it is hard but as someone who has practiced for a long time,that 50K income loss will not matter much in the long run, especially for a surgical subspecialist. So don't overthink it and have the child. They are pure joy ( and sometimes little devils :-)).

                      What might affect you more is the costs of rearing the child.

                      Good luck.


                      Last edited by Kamban; 05-20-2021, 10:15 AM.

                      Comment


                      • #12
                        Originally posted by XGPkidney View Post

                        rationally it makes sense.

                        it is just disheartening that I put off having a child for a long time for my education and training. I worked as hard as men in my field and I have to take a significant financial set back to have a family. As a trainee, I have not been aware of the huge pay cut I will need to trade for wanting to have a family.

                        My male colleagues already have 2-3 children but I have been holding it off because of my training and to reduce burden on my co residents. Now I have to choose to have kids at my own financial loss. It is something that my male colleagues don’t even have to think about.
                        That's why some people don't want to be an owner. If you own a business and don't work you don't get paid. You may get paid as an employee but I can guarantee your employer won't do it at a loss to them. I think there is a separate discussion between paid maternity leave for low wage workers and your situation. I bet those low wage mothers would love to have missing 6 weeks cost them $60k. You'll find out real soon that nobody feels bad for someone in your financial situation.

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                        • #13
                          Now I have to choose to have kids at my own financial loss. It is something that my male colleagues don’t even have to think about.

                          I was in PP for 20+ years, when you don't work you dont get paid , and in fact you still have to pay other employees, rent and so on when you are not there. Thats how it works. Usually, you can get a higher rate of return when you do work , so it usually balances itself out. For years when I started , I never took a day off because it would actually cost me money not to be there. It is just unfortunate, that you are choosing to start a family and a career at the same time. But it will work out.

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                          • #14
                            Originally posted by XGPkidney View Post

                            rationally it makes sense.

                            it is just disheartening that I put off having a child for a long time for my education and training. I worked as hard as men in my field and I have to take a significant financial set back to have a family. As a trainee, I have not been aware of the huge pay cut I will need to trade for wanting to have a family.

                            My male colleagues already have 2-3 children but I have been holding it off because of my training and to reduce burden on my co residents. Now I have to choose to have kids at my own financial loss. It is something that my male colleagues don’t even have to think about.


                            If the male colleagues are married to spouses who also earn an income they certainly do have to think about it—either their spouse’s income will decrease, or they will be hiring lots of help, or sometimes both. If they are married to a spouse who doesn’t earn an income and doesn’t plan to, then they take the economic loss in that form.

                            This is just another example of the cognitive bias of loss aversion.

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                            • #15
                              No system is going to satisfy everyone or be fair to everyone. Take hospital employment with a base and production incentive. You still get your base but lose the production incentive. In this situation you are still taking a pay cut. The only one where you don’t is straight up salary with maternity leave benefits. But in that situation others are getting paid less (as are you when not on maternity leave) to subsidize those benefits.

                              On the private side I’d see if you can negotiate a base salary plus bonus based on collections. Then negotiate a reduction in your base for maternity leave. You can then make it back with the bonus later. Better than straight up salary with a reduction.

                              As for males not having to make this decision, keep in mind you don’t need 12 weeks off. I don’t think any study has been done that suggests at 12 weeks your parental instinct to want to be around your child vanishes. The child certainly isn’t self sufficient at that point so who is going to take care of them? My point is that whoever or whatever entity will be taking care of them at 12 weeks could do so at 10, or 8, or 6, etc. Between 1-2 weeks and 12 is all choice IMO.
                              Last edited by ENT Doc; 05-18-2021, 02:24 PM.

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