Eyefixer has some kind of weird infatuation with me since he always twists my words and makes me look like the "bad guy"
He also thinks I live in Fargo, ND
(It's South Dakota -- get it right!
)
Anyways, my comments are just meant to give the perspective of someone who owns a practice. Of course, any practice owner would love to bring on an equity partner if some conditions are met:
(1) The existing patient volume is overwhelming the current partners such that the practice cannot expand or thrive without someone new coming onboard.
(2) The proposed practice buy-in amount gives some type of incentive for the existing partners. Why would someone just give away equity (and thus future revenue) without gaining some type of incentive him/herself?
(3) The proposed new partner is easy to get along with for the next 20 years.
(4) The proposed new partner is a good surgeon/clinician and is ethical.
(5) The proposed new partner has some business acumen or at least has the aptitude and desire to run a business and do some administrative work outside of office hours. (aka I don't want to do all of the admin work if I now have less equity).
My point in my post above is that many new associates come in thinking that they "deserve" everything under-the-sun just because they finished training...even if they suck as a surgeon, are abrasive to patients and staff, cannot make business decisions to save their lives, and don't want to deal with any admin work after clinic. I just feel like people are being told to "...ask to have a piece of everything! Get clinic revenue, ASC buy-in, optical buy-in, dry eye product revenue, real estate buy-in...and make sure you only pay 50k for that 50% stake too!" Things don't always have to be "all-or-none" and there are many good jobs out there they don't include everything.
Due to the vagueness of most associates' job situations, I frequently advise people to
save as much money as possible during their associate years if things really don't go their way. Instead, most newbies go on a spending spree and buy a new car (or worse a house) with their newfound 200-250k salary. Again, starting a new practice is a viable option for anyone who worries that partnership may not happen.
Lastly, I find it interesting that people who work for Kaiser (and get paid roughly the same amount as a busy associate does) do not describe Kaiser as "predatory" and "abusive" like a private practice. I guess the bigger an organization gets, the less "personal" and thus accepted some of their decisions are (e.g. the decision of non-partnership) even if they lead to the same net effect (e.g. salary of 200-400k).