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Part time partners in private practice
Anyone in private practice:
What kind of part-time situations do you have available to partners?
If you do have them, are they available to any partner?
What kind of compensation is offered (if you work 1/2 the number of weeks including 1/2 the number of evenings/call/weekends/travel etc, of a full time partner, is your compensation 1/2 that of a full partner, or some other proportion)?
If partners own assets, would they divest to own an equal proportion to their part-time status?
Have there been any issues or conflicts (besides short staffing) with having part-time partners? -
36 Replies
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Quote from toefluff
Anyone in private practice:
What kind of part-time situations do you have available to partners?
If you do have them, are they available to any partner?
What kind of compensation is offered (if you work 1/2 the number of weeks including 1/2 the number of evenings/call/weekends/travel etc, of a full time partner, is your compensation 1/2 that of a full partner, or some other proportion)?
If partners own assets, would they divest to own an equal proportion to their part-time status?
Have there been any issues or conflicts (besides short staffing) with having part-time partners?
You’re going to get a lot of anecdotal ‘evidence’ so here’s mine.
Over the course of my career, the issue of part-time work has always been tricky.
For the rad seeking part-time work, the thought process is usually along the lines of “If I work half-time, I should get half-pay.”
For the rads staying full time, the position of the part-timer usually gets rebutted with “Wait a minute. You’re still going to get full time benefits (mostly health care), but you’re only working part-time. Why should you be subsidized?”
My experience has been that the part-time pay is significantly reduced compared to full time, i.e. half-time work would be paid much less than half-time billing/RVU/production, etc.
Further experience has been that the part-time rad grudgingly accepts the above scenario, and ends up feeling more or less screwed by his former partners.
As for the remaining full-timers, all it takes is one malcontent to get his or her undies in a bundle about the “sweet deal” that the part-timer got while “the rest of us” have to take call, deal with admin, etc. The malcontent inflames those around him/her and instability results. Doesn’t even have to be a majority of discontented group members to result in a horrendous morale problem. I have been continually amazed throughout the course of my career how just one single irate blowhard can wreck an entire organization. Have personally seen two practices implode this way (not just b/c of the issue of part-time work).
As stated, this has been my experience. My opinion on part-time work is that in order for it to work, there has to be strong, stable, persistent leadership from the top down to keep it in place. Otherwise, the smoldering resentment on both sides builds up to make the situation unstable.
The above being said, I hope that someone with a history of better experience(s) regarding rads working part time will chime in as I’d be very interested.
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yep
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My experience has been that the part time pays a lot less not because of benefits but because of scheduling and commitment.
When you are a full partner, you commit yourself to 5 days a week of work plus let’s say Q4 weekend call. Most people who want to go part time, want to work 2-3 days a week and a lot of them want to choose the days that they are off. This causes a lot of difficulty in the group logistics unless they are two part timers who are willing to accommodate to each others schedules.
Also the full timers kind of commit themselves to go the extra-mile if it is necessary. That’s not the case for part timers most of the time.IMO, a partner should be at least 0.8 FTE to quality for profit sharing.
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What Dr. Joseph Mama notes above is absolutely true. Pay heed.
We allow part time partners however they sell out of the hard assets.
They are paid identical to partners proportionate to amount worked.
They pay their overhead costs proportionate to amount worked (a 50% partner will pay 50% of overhead expenses).
They retain voting rights but that may or may not change.
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So if it is the Thanksgiving week, the part timers feel that they are entitled to have the week off. The full timers feel that the major hassle of the practice is covering holidays and why it should not be shared with part timers who are getting paid equally per RVU.
The best deal in radiology is to be a full partner of a group and work 0.5-0.6 FTE and getting paid equally/RVU.
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We handle that by paying more for holidays. There is always someone that wants it.
We try to share holidays equitably among partners so everyone has X holidays per year, and part timers are taking their proportionate share of X holidays.
A significant amount of partner income is though the hard assets, so the big penalty in going part time is having to buy out.-
A big component of group harmony is in having like-minded people that are not focused on every $ and every RVU, but on the overall smooth functioning of the group, quality of patient care and radiologist contentedness.
As Dr. JM notes above, one malcontent that spends hours tormenting the other partners with tales of “I’m doing 2% more and getting paid the same!” or something similarly insignificant can destroy group harmony and radiologist satisfaction with impressive speed. Partners need to be flexible and willing to help one another, and if a true issue that requires leadership arises then they have to be prepared to handle that too.-
Quote from sandeep panga
spends hours tormenting the other partners with tales of “I’m doing 2% more and getting paid the same!”
It’s never only 2% or even 20%.-
Great idea Nathaniel! I hadnt thought of that.
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I think rads dont really know what they want.
They think they want money. Keeping up with the Joness, an immigrant or low/middle class upbringing and mentality to save/hoard, assigning self worth based on income/portfolio size, or simply a desire to nonsensically make as much as possible drives radiologists to make irrational decisions within their group and for themselves.
This fuels many to have some negative feelings to those who are or want to be part time- they dont want to work hard, do weekends/holidays, admin, etc. Maybe its actually a subconscious feeling of they want to spend time with kids/family, exercise, pursue their hobby/passion, feel refreshed when they come to work and enjoy it more, live life more fully but I resent that because I prioritize income over everything else and dont get to live life that way that actually fuels negative sentiment to part timers and the resultant limited opportunities for part time in private practice.
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Quote from dr77767
I think rads dont really know what they want.
They think they want money. Keeping up with the Joness, an immigrant or low/middle class upbringing and mentality to save/hoard, assigning self worth based on income/portfolio size, or simply a desire to nonsensically make as much as possible drives radiologists to make irrational decisions within their group and for themselves.
This fuels many to have some negative feelings to those who are or want to be part time- they dont want to work hard, do weekends/holidays, admin, etc. Maybe its actually a subconscious feeling of they want to spend time with kids/family, exercise, pursue their hobby/passion, feel refreshed when they come to work and enjoy it more, live life more fully but I resent that because I prioritize income over everything else and dont get to live life that way that actually fuels negative sentiment to part timers and the resultant limited opportunities for part time in private practice.
Your hatred towards low/middle class people and immigrants is disappointing.
Nobody has any beef with someone who wants to spend time with kids/family. Unlike what you think, many low/middle class people and many immigrants are as family oriented as wealthy upper class people.
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They are MORE family oriented than wealthy people, at least looking at a global scale. The level of family and community focus only approaches that of lower/middle class past wealthy when we are in the uber-wealthy camp.
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Quote from dr77767
I think rads dont really know what they want.
They think they want money. Keeping up with the Joness, an immigrant or low/middle class upbringing and mentality to save/hoard, assigning self worth based on income/portfolio size, or simply a desire to nonsensically make as much as possible drives radiologists to make irrational decisions within their group and for themselves.
This fuels many to have some negative feelings to those who are or want to be part time- they dont want to work hard, do weekends/holidays, admin, etc. Maybe its actually a subconscious feeling of they want to spend time with kids/family, exercise, pursue their hobby/passion, feel refreshed when they come to work and enjoy it more, live life more fully but I resent that because I prioritize income over everything else and dont get to live life that way that actually fuels negative sentiment to part timers and the resultant limited opportunities for part time in private practice.
Insightful post. I find this dichotomy in myself (eg. I should be picking up extra shifts/moonlight etc to make more $ versus I should be spending this time/bandwidth with family/working out etc). It’s a struggle and tight-rope, very personal decision based on multiple factors…The mindset of more is so pervasive in our society/social media. Very hard to shake.-
Im assuming that no call = no partnership, but Ill ask anyway: Do partnership track, mammo only, M-F 8a-5p only jobs exist?
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Quote from Mammodonna
Im assuming that no call = no partnership, but Ill ask anyway: Do partnership track, mammo only, M-F 8a-5p only jobs exist?
I imagine somewhere.
I would guess nowhere desirable. Pretty sure the partners would hate a person that had that setup and made the same money.
Similar scenario to IR docs who are partners in a DR group but don’t read the DR, don’t do high level cases, stick a few needles a day and do para / thora. Just breeds resentment.
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This. They might call these people “lazy” but what they really feel is a deep envy for how someone can be so comfortable in their own skin making “just” $250k working part time, while having a much more impactful and healthy life outside of radiology, get to see more of the world, read more, climb more mountains, try out more stuff, have time to meditate and reflect, and be totally fine not having a $10M+ portfolio. Life is not lived behind a computer screen after all. Those insecure entitled grinders think they can take it with them.
Yes, helping out your work mates is an noble trait. Hoarding money and comparing yourself to others constantly is not.-
Quote from Re3iRtH
This. They might call these people “lazy” but what they really feel is a deep envy for how someone can be so comfortable in their own skin making “just” $250k working part time, while having a much more impactful and healthy life outside of radiology, get to see more of the world, read more, climb more mountains, try out more stuff, have time to meditate and reflect, and be totally fine not having a $10M+ portfolio. Life is not lived behind a computer screen after all. Those insecure entitled grinders think they can take it with them.
Yes, helping out your work mates is an noble trait. Hoarding money and comparing yourself to others constantly is not.
Very good point. We sometimes overlook that ‘just’ 250k is still a lot of money and very easily liveable income. I was making 70k just a few years ago as a fellow with a 1 year old…I still made it work. It’s all relative.
To respond again to that prior question from other poster –
You can def make 500k in most parts of the country doing only mammo , 40 hours a week, no call, with some negotiations. I know as I have friends on both coasts that were able to do that. The midwest this would be easy i think.
The ‘partnership’ thing with someone not taking call, or a part timer, that’s a complex issue, and many PP groups aren’t fans of that.
All that being said – we’ll all be employed in the next decade so it’s a wash. Find a good job with good pay and be happy.-
Quote from ar123
You can def make 500k in most parts of the country doing only mammo , 40 hours a week, no call, with some negotiations. I know as I have friends on both coasts that were able to do that. The midwest this would be easy i think.
The ‘partnership’ thing with someone not taking call, or a part timer, that’s a complex issue, and many PP groups aren’t fans of that.
There are wRVU based mammo jobs that can make WAY more than 500k with no call and 40 hours (or less) per week.
Anyone reading a high % of mammo and just getting a partnership salary (not getting paid on individual wRVU production) is leaving a huge amount of $ on the table due to current nonsensical reimbursement.-
Quote from Radsoxfan
Quote from ar123
You can def make 500k in most parts of the country doing only mammo , 40 hours a week, no call, with some negotiations. I know as I have friends on both coasts that were able to do that. The midwest this would be easy i think.
The ‘partnership’ thing with someone not taking call, or a part timer, that’s a complex issue, and many PP groups aren’t fans of that.There are wRVU based mammo jobs that can make WAY more than 500k with no call and 40 hours (or less) per week.
Anyone reading a high % of mammo and just getting a partnership salary (not getting paid on individual wRVU production) is leaving a huge amount of $ on the table due to current nonsensical reimbursement.
Another great point. But I would say, ride that gravy train while it lasts – bc it will not.-
Mammo gravy train for years now and no changes.acr leadership and Medicare. Follow the money.
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Comparison is the root of unhappiness, it seems like.
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If the group is stable, has been around for decades, and expects to continue to be, granting part time partners the deal the OP posted seems fair. Maybe put it in the bylaws that the person has to have been a partner for X number of years as the payout for such.
If this type of thing continues to exist, every partner will benefit from it when it is their turn.
Everyone is always complaining about how others are stealing from the remainder, but if everyone ultimately gets it, then it is a “benefit” of years of practice building and hard work. I just don’t see the big deal. Give that part timer less non health care benefits (like 0.5X of CME, and other such stuff). Negotiate it so that they don’t get the same day off each week, etc.-
We have it such that you can start backing down after so many years of partnership. You cant just come in as a part time partner, that would never fly. You still take proportionate evenings/weekends. If you go below half time you cant vote. We have the problem of nobody wanting to back down.
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Market conditions affect how people feel about part timers. When rads are in short supply, groups easily accept part timers. Then when the job market is tight for applicants, no one needs part timers.
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From a business perspective, part time employees are a good deal.
The partnership should profit from employees; ow why would anyone be a partner?
There is a sweet spot, where the trade off is fair to both sides.
Being part time without meetings, nights or weekends is worth a lot; or a combination there of.
Pre retired, employed part time is great. A lot of preretirement partners are entitled, so keeping them in the partnership is a bad idea on many levels, esp if they can vote.
If younger partners want part time, eg young parent, I still think employment model is the way. Young mothers sometimes expect too much, if they want the time to parent, it will cost them something. Ive seen young mothers do it all as full time partners, but its an exhausting existence, and looks miserable to me.
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Quote from Midwest Eastern Rad
Negotiate it so that they don’t get the same day off each week, etc.
Why would you make your schedule more complicated ? ‘JimBob covers mammo and fluoro every Mo/Tu/We’
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Quote from fw
Quote from Midwest Eastern Rad
Negotiate it so that they don’t get the same day off each week, etc.
Why would you make your schedule more complicated ? ‘JimBob covers mammo and fluoro every Mo/Tu/We’
In response to the original poster that there is no flexibility…
I do believe that certain people always having the same days off per week actually complicates the schedule because it allows no flexibility for anyone else. With automated computer programs these days like Qgenda, the scheduling shouldn’t take a hit by varying the number of days. Or do it as a one week on, one week off type of thing. There are so many ways to be flexible and fair to all. Again, my point is that all the younger partners who complain about such a set up have the short view altogether, unless they plan to leave before retirement. It’s much whining about nothing IMO -
The amount of whining I have witnessed is hard to believe sometimes.
I think a lot of the people whining have never had a job besides being a doctor. Try laying shingles on a roof for a living.
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Agree with most of the above.
Great post by Mama.
I think if one wants to go part time, they should be willing to be an employee. This should be no problem for preretirement rads.
As far as leadership, the more complex the employment/partnership arrangements, the stronger the leadership needed to hold it together. Otherwise, keep your partnership arrangements as simple as possible, allowing for less hijinks. Eg., full time partner or part time employee. Being an employee has its benefits; picking days to work, no call, no meetings etc. Ideal for preretirement rad. There is no free lunch.
As stated, it only takes a little poison to contaminate a well. So if you start giving out part time partnerships without careful forethought, it can unravel pretty fast. What if a critical mass wants to go part time? Who gets it?
Partners have to hold things together during tough times; days off are at the pleasure of the practice. Someone has to take up the slack. Just simpler for all partners to be accountable in the same way.
Most my colleagues have been great, but I’ve had a few sleazes trying to continually get their way at the expense of everyone else, including part time partner. Keeping it simple and holding all partners to a similar level of accountability tends to work. If they don’t like the responsibility, an employment contract can be arranged with concessions.
No way would I try part time partnership from what I have seen, for all the stated reasons. I think even if your current leadership can manage it; down the road there will be potential mine fields which others may not be able to control.
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Quote from sandeep panga
What Dr. Joseph Mama notes above is absolutely true. Pay heed.
We allow part time partners however they sell out of the hard assets.
They are paid identical to partners proportionate to amount worked.
They pay their overhead costs proportionate to amount worked (a 50% partner will pay 50% of overhead expenses).
They retain voting rights but that may or may not change.Fair set up.
In my experience, people who go part time don’t want to work weekends and holidays.
Things happen this way:
Senior partner esp after their kids finish college, first starts to sell his weekends and holidays to younger rads but still come to work everyday. After a year or so he starts to sell his weekdays to junior rads when they are on vacation. Eventually, in a business meeting he asks to go part time at 0.5 FTE with no weekds and no holidays and preferable no evenings but insists to get all the benefits esp the profit sharing at the rate of 0.5. When the group disagree, he gets upset and disgruntled and after 2 years he retires.-
We have a part time partner provision in the operating agreement. If you have 1/2 share, you also have 1/2 the vote. You have to have been a partner for x years. Iirc there is a provision that no more than x% of voting shares can be held by part-timers. It’s geared towards someone on a retirement path. I dont think anyone has ever done it.
Did the health system employment thing in the past. We had people at all kinds of different percentages. At various times I was 100,66 and 86% FTE. If you dropped below 75, your cost for benefits like family health insurance went up. We also had people who didn’t take weekend and evening shifts. There was a steep price attached to doing that, but some later in their career just didn’t want to deal with it anymore. It wasn’t a function ‘selling’ and you didn’t have to ask anyone to ‘do your work’. That person simply was on a non-call track and got a smaller paycheck in return. Worked well in the large group environment. Nobody cared what FTE others were at. It was just built into the schedule with the number of shifts worked. There was also internal moonlighting, so if one of the part timers had some days off he didn’t need, he could basically have the company ‘buy them back’ from him.-
My group has employment contract. partners who retire or go part time are bought out of their share of AR at separation. They are then paid per shift worked (at a fair rate determined by average workload per shift), paying their own benefits (ins, pension, etc) out of their shift pay. The remaining group partners still assume practice overhead (billing, acct, telerad). Has worked well for near retirement scenarios.
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we have a few 50% PT rads. Essentially get 50% of their base salary and 50% of bonuses. No voting rights that I know of but not a big deal given group size. Unsure of benefits which is a more significant issue. I know one of the rads is a high volume reader/IR guy so he more than covers his pay
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It can work, needs to be win-win. We figured the part time arrangement must be cost neutral to the group.
Our part-timers, regardless if 0.5FTE or 0.8, take full call and work equal share of holidays to everybody else. The part timers do full tumor board. Everybody, but more so the part timers, get random days off to make the schedule work. Call and holidays are paid separately, so the income at 0.5 FTE is a bit more than 50%.
There needs to be some flexibility, i.e. when short staffed, the part timers work an extra day or two per week for a period of time.
Scheduling is doable but challenging. Not using scheduling software.
Hospital employees. Prorated benefits coming from the institution. Now about half of the group is part time. Historically a lifestyle group, relatively small (12 rads).-
All the partners I know work about 70% anywaybut they cherry pick, take the better shifts, leave early and get easier holidays = by numbers they appear more productive. Employees work hours allotted, crappy holidays, and leave on time.
So what does a 50% partner even mean? Work 35%, cherry pick and only do 1 week of nights a year?
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