How do I find a group practice to join?

[psychlatte]

Hello! I'm a PGY-4 resident at a program across the country from where I plan to move after graduation (NYC). I am leaning towards going into private practice, but I have no business experience and would prefer to be among colleagues as I'm just starting out.. problem is, I have no psychiatry connections in the area. I've looked on indeed.com, practicelink, etc but it seems like there really aren't any job listings in line with what I'm looking for. So... how exactly do I go about this? Is cold calling/emailing the best way? I can find practices on google of course, but there are hundreds of established practices and I'm not sure how to narrow it down.

Secondary question- when to start reaching out? I won't be able to start working until roughly a year from today (I'm a couple months off-cycle), is it too soon to be interviewing?

Apologies for the newbie questions, and I appreciate your input!

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[Sushirolls]

It's fine to start now. Established docs know you won't finish until end of June. Gives time to interview, shore up a contract and even start in on paperwork and licensing. So now sounds about right.

1) Where do you want to live?
2) Google and internet sleuth the heck out of the area you want to live, for the practices that you might want to call and reach out to.
3) Call them. Express your interest. Have your CV ready. Go from there.

 

[Merovinge]

Cold calling feels weird only until you do it a few times and get some level of positive feedback. It's human nature. I know my partner struggled with this when we had a nationwide job hunt, she just felt really weird calling a random practice and asking "are you hiring?". Other than just direct exposure (which is the best answer to your question), get some support from classmates or anyone who has been through the process.

 

[lol.psych]

If there’s an alumni network (or you could even try Doximity searching), or if your PDs or other long term faculty/attendings know of any alumni who landed in NYC, that could be a starting point.
If you’re interested in anything related to psychoanalysis/psychodynamic therapy, you could also try getting in touch with the psychoanalytic institute where you’re moving — they might have some leads or inklings about which group practices are casually/unofficially keeping an eye out for new folks.

 

[clozareal]

Perhaps the district branch of the NYC APA can help you?

Home

nycpsych.memberclicks.net

 

[dl2dp2]

Perhaps the district branch of the NYC APA can help you?

Home

nycpsych.memberclicks.net

This is a good suggestion.

Honestly, I think if you find someone's phone on psychology today and just call/Email them and explain what's going on, I *bet* you 50/50 they'd respond. Try snooping around and see if you can find a senior private psychiatrist who seems to vibe the right way for the type of practice they've set up for themselves.

Also, joining a practice is not a great way to go. What I would do is just offer someone a fee per hour... for simplicity let's call it $500. It's really not worth sharing your revenue. The amount of business consultation you need is at most 10 hours a year.

 

[clozareal]

This is a good suggestion.

Honestly, I think if you find someone's phone on psychology today and just call/Email them and explain what's going on, I *bet* you 50/50 they'd respond. Try snooping around and see if you can find a senior private psychiatrist who seems to vibe the right way for the type of practice they've set up for themselves.

Also, joining a practice is not a great way to go. What I would do is just offer someone a fee per hour... for simplicity let's call it $500. It's really not worth sharing your revenue. The amount of business consultation you need is at most 10 hours a year.

A senior private psychiatrist may also be looking to retire and hand off their patient panel to you too which is a bonus.

I disagree with joining a practice not being a great way to go. If they have a system set up for you to learn patient intakes, documentation guidelines, CPT coding, revenue cycle management, discharge policies, how to handle acuities, then it can be much more of a streamlined educational experience than a piecemeal one where you go straight into PP. So many problems that come up in PP are not taught in residency/fellowship and it can be helpful to have accessible colleagues that have dealt with this problem before to ask. You can do it in a consultation group or with friends in PP too but not everyone has access to those.

Mark Wilson, MD from Center for Wise Mind Living in NYC is looking for psychiatrists if you want to reach out to him.

 

[ElanaMD]

It's not a bad idea to work in a private practice as a learning experience if your ultimate goal is to start your own private practice, but you may run into a few obstacles:

• If it's an insurance practice, the practice owner may want to credential you with insurance with your NPI 1, which would preclude you starting your own out-of-network/cash private practice (you want to make sure they are billing insurance under their organizational NPI)
• Generally the profit model with group practices is a revenue split (like 60/40 -- you take 60% of the revenue you generate and the practice takes 40%). What this means is you only get paid if you see patients. Typically it takes time to build up the case load when you hire a psychiatrist within a group practice. So it's not always the best way to get guaranteed income while you are building your own practice (an hourly moonlighting job/shift work is actually better for this).
• The practice owner that you're learning from may or may not be great at business. I've seen wide variations in terms of the business skill people have in running a private practice. You just want to be extra sure that the person you are working under is someone you look up to and has the kind of practice that you would like to model.

Instead of networking with private practice owners to see if you would work under them... why not reach out and network to see if you could be mentored/supervised by them? Inevitably any experienced private practice psychiatrist in a place like New York will be full and will have overflow of referrals. If you just reached out for the purpose of networking and asking advice (maybe paying them for their time, bringing lunch of coffee to their office, etc), and you tell them you are starting your own practice, it's very likely they will start sending you patient referrals. Instead of paying 40% of your revenue to a practice owner, you are paying a smaller amount of money to be taught. Then, you get an hourly moonlighting/side gig to pay the bills while you are building up your practice.

Just a thought. FYI here's someone with a PP in New York that might be a good person to connect with (I actually trained her in building her practice) - Lisa Wang MD:

 

[clozareal]

It's not a bad idea to work in a private practice as a learning experience if your ultimate goal is to start your own private practice, but you may run into a few obstacles:

• If it's an insurance practice, the practice owner may want to credential you with insurance with your NPI 1, which would preclude you starting your own out-of-network/cash private practice (you want to make sure they are billing insurance under their organizational NPI)

The way to get around this is to put your Tax ID number on your superbill and put a note saying for the insurance company to use that rather than the NPI number. This can be a bit of a headache even if you start at a group practice then quit and start a PP. The insurances think you're still with the previous employer. It would not preclude you from starting your OON/cash private practice though.

• Generally the profit model with group practices is a revenue split (like 60/40 -- you take 60% of the revenue you generate and the practice takes 40%). What this means is you only get paid if you see patients. Typically it takes time to build up the case load when you hire a psychiatrist within a group practice. So it's not always the best way to get guaranteed income while you are building your own practice (an hourly moonlighting job/shift work is actually better for this).

Yes, that's usually the case. I have seen some group practices are getting savvy around this though. When I was interviewing, three group practices told me that they would give me a base for the first 6-9 months and then start doing productivity. If at any point during those 6-9 months my productivity > base rate, then it would automatically go to productivity for that month, but wouldn't override the remaining months of guaranteed base.

• The practice owner that you're learning from may or may not be great at business. I've seen wide variations in terms of the business skill people have in running a private practice. You just want to be extra sure that the person you are working under is someone you look up to and has the kind of practice that you would like to model.

I agree with this.

Instead of networking with private practice owners to see if you would work under them... why not reach out and network to see if you could be mentored/supervised by them? Inevitably any experienced private practice psychiatrist in a place like New York will be full and will have overflow of referrals. If you just reached out for the purpose of networking and asking advice (maybe paying them for their time, bringing lunch of coffee to their office, etc), and you tell them you are starting your own practice, it's very likely they will start sending you patient referrals. Instead of paying 40% of your revenue to a practice owner, you are paying a smaller amount of money to be taught. Then, you get an hourly moonlighting/side gig to pay the bills while you are building up your practice.

This is a great alternative model and basically what I'm doing. You can pay for case and private practice supervision/consultation. You can even be mentored by Elana herself! (I'm in your Dream Practice School which has been interesting).

 

[ElanaMD]

This is a great alternative model and basically what I'm doing. You can pay for case and private practice supervision/consultation. You can even be mentored by Elana herself! (I'm in your Dream Practice School which has been interesting).

That's cool, small world!