Tips to Evaluate a Practice Employment Opportunity

Most new physicians join a practice without first giving it a thorough history and physical exam. By asking pertinent questions up-front, before you join the practice, you can save yourself a lot of aggravation. First, it will help you to avoid joining the wrong practice. Secondly, knowing your rights in the practice ahead of time will help you or your employer avoid dragging each other to court in the future. 

1 - Compatibility

First and foremost is compatibility between you and the practice itself-the physicians, the staff, the systems. Does it feel like a comfortable environment for you? I strongly encourage all new physicians to visit a practice for at least a full day so you can give people a chance to show their true selves, rather than their "interview personalities".

2 - Check References

Call the medical director or chief of staff of the hospital where the physician has privileges and say that you're considering joining the practice. If the feedback is positive, you'll know it. If it is lukewarm or guarded, you'll be able to read between the lines. Does the practice have a rude nickname in the community, and for any apparent reason?

Carefully assess the business health of the practice. The best approach is to have an independent medical practice management consultant perform a Practice Survey and tell you if it is a good opportunity. There are many hidden problems that a consultant can find that an inexperienced person might miss.

3 - Income and Financial Issues

Are you going to be an employee for a time, or a true partner? How much risk is there? Is there an income guarantee? Guaranteed by whom? Most practices pay a base salary plus a percentage for productivity: for example, $90,000 base plus 30% of all gross receipts over $200,000. By offering these incentives the practice is asking you to demonstrate an ability to manage volume and build a practice. Are the incentives reasonable, or so unrealistic that no newcomer could expect to reach them? Check out the turnover history of other associates in the practice to see if there's a revolving door situation.

A very important consideration that many overlook is the transferability of any HMO or managed care contracts. What if a practice gets the majority of its patients from one or two health plans, but the plans are closed to accepting any new physicians? Don't just accept the word of the partners that you will be accepted into the managed care plan, get it in writing from the plan itself.

Are you expected to eventually buy into this practice? How much and when? Is one partner planning to retire and expects to be bought out by the other partners? If so what kind of payout would be expected?

Are you expected to buy into the office real estate? (A real estate agent's joke: Q:What's the difference between venereal disease and a medical office condo? A: You can get rid of a venereal disease).

4 - Security and Risk

What kind of plan is there for you if things don't work out? If you decide after a few months that the practice is not for you, can you walk away without major obligations?

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