Assessing a Job Offer

Question: I am new to private practice. I have been approached by another physician to join his group. He proposes that I see all pediatric patients and provide follow-up and on-call coverage, and, in return, he will provide for staff and the building. We will divide the generated income 50/50. Is this a fair and balanced proposal? What arrangements do I need to consider in this or similar circumstances?

Answer: I think this sounds almost too good to be true. He’ll carry all the overhead, but you get half the revenue anyway? Or is he just sharing the revenue from your pediatric cases?

Here are some questions to ask:

What has, historically, been the annual net revenue of the practice (2005, 2006, and Q1 2007)? What has the physician taken home in each of these years? Fifty percent of zero is zero.

How many pediatric patients does the practice have now, and how does it plan to market your services to get more? Is there adequate demand?

If the practice is adding another provider, it presumably needs to add staff. What are its plans for that? Are there adequate facilities in the existing building for more staff and for you? Think about the literal space.

Either your position is salaried or you are a partner. Getting 50 percent of revenue makes you sound like a partner, but you don’t mention anything about how all the other overhead will be shared or getting any share of the value of the practice now or in the future.

What does call really look like for this practice? How many calls per day? What if you want to take a vacation? What are the other physician’s long-range plans? Do you have any say in management? What if you see problems in billing? Can you fix them? Do you have full access to collection and billing data so that, one, you can make sure you really are getting 50 percent and, two, you can make sure staff are collecting for all your hard work so there is more revenue to share?

You get the idea: Ask, ask, ask. And then insist on a full contract that is reviewed or drawn up by a consultant familiar with physician employment or partnership contracts.