Picking a partnership
By Angus McBryde, Jr, MD
One of the issues that each of us encounter with difficulty is “joining” a practice. Questions arise such as: Which practice has the continuum of interest that not only recruits a new (and usually but not always a younger) man or woman but offers them positive and tangible reasons for retention? Generically this must be because of an increasingly happy, productive and collegial association with the general or subspecialty orthopedists. The earnest and direct efforts of most groups feature one person in a leadership position who initiates the bond or Velcro that attracts and holds a new associate of any age. Far too often a group administrator or lawyer handles the bulk of this communication. That is fine if you also have a lawyer; however, lack of an ongoing interested contact infers or can simulate a lack of interest.
Specifics of the contract are important also and seemingly innocuous clauses – not just non-compete clauses which are pretty well understood – can alienate. Contracts that are clearly not at all individually oriented and just “fill in the blanks” do speak volumes. Do they really want me? I have seen contracts sent to residents and fellows in the past that still have a “her” from a prior recruit in the body of the document instead of a “him”. Again the collegial aspect of the partner’s interest must be there. “Wine and dine” is only a piece of the puzzle and is often used to cover lukewarm efforts.
There is many other issues key to retention that may be the clue to the effort of prolonging “apprentice time”. Salary guarantee of course needs to be competitive and any “buy in” must be absolutely defined and not a protracted obligation. Escalation of the salary by realistic production goals; call days and nights becoming equitable after a prescribed time; full and written disclosure of any limited partnerships or front desk intrinsic or in-group patient assignment methods; “seniority dollars” in absentia; in -kind payments; individual provider contracts that, if present, need to be ethical. Many fine orthopaedists have real problems with total $ productivity. Number of patients seen; related, poorly compensated work but with real group benefit; large consult and trauma coverage numbers; being a “doctor’s doctor” -- all can be prerecognized and discussed.
These are all issues that may or may not be recognized by your counsel. There are many more. I can promise our younger (and mid career) members that COS has the ability to give or find good sage advice in this one area and many others. I look forward to working with you.
Angus McBryde, Jr., MD
Copyright 2006 Clinical Orthopaedic Society
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