The Job Hunt V

I ended up considering six different job opportunities as well as one that was primarily non-clinical (multidisciplinary translational research). The groups varied from small (ten anesthesiologists) to moderate (forty anesthesiologists). They were all-physician practices that did not employ nurse anesthetists. Some operated in only one location while others had contracts with many different small surgicenters and surgeons. There was considerable variation financially, with differences in expected salary up to $100,000. Some groups did everything from neuroanesthesia to obstetric anesthesia to pediatric cases to trauma. Others had a very narrow scope. Call schedules weren't that different between groups, and depended mostly on whether obstetrics and trauma needed to be covered. Most groups were subsidized by the hospital they contracted with. Most groups appeared to have great relationships with their surgical colleagues and administration; some even had prominent leadership presence. As I am additionally trained in critical care medicine, I was also interested in opportunities to work in the ICU, and among private practice groups, this was very rare.

One aspect of private practice physician groups I had to learn about was the concept of "buy-in." For many groups, when a physician initially joins, they are an employee rather than a partner or shareholder. They may have to work for several years at a lower salary and without a vote before they can become a partner of the group. This is known as the "buy-in." There was significant variation in how this was set up, but for all groups, voting on business matters was limited to only a subset of physicians, and for most groups, salary and bonuses depended on how long someone had been part of the group. I don't particularly like the concept of the buy-in, but it seems to be a non-negotiable constant in many practices.