Why Being a PA Partner is Not Always the Best
I work for a multi-specialty private practice with over a hundred physician partners. We have multiple “provider” meetings a year, and a part of what I like about working with this group is that they do a fairly good job of including PAs and NPs in the meetings and not just the “partners”. These meetings are typically state of the union type meetings: the executives discuss the plan for the next year; including goals, changes, finances, marketing, etc. We recently had a provider meeting and the main topic of conversation was finances.
Due to a perfect storm of circumstances the group made less money last year than needed for this year; there were clinic closures due to weather that caused a loss of income for those days, also next year we are planning on changing our EMR, which is going to be a huge expense. The CFO, speaking for the board, proposed creating a “rainy day fund” to help offset these expenses in the future.
Financial Risks of Owning Your Own Business
In order to create these extra funds they were proposing that the partners take a 4% pay cut to put that money toward savings. Running a business, just as in personal finance, you want to have a portion of money saved up for unexpected expenses. When you’re a partner in a business you’re invested in that business and when it doesn’t do well financially, you carry that burden too.
The way medicine is going the small private practices of the world seem to be going to the way side and more and more physicians are opting to be an employee of a hospital system or larger group. For PAs, there may be some opportunity to be a business partner in a practice, but for the most part PAs are employees; and this makes me wonder if it to seek opportunities to be a partner in a medical business?
A few years back I was talking to an old-timer urologist who was getting close to retirement. With the way payments and reimbursements have changed over the years, he was saying that his income has basically been the same for several years. Not that he had a low income currently, but his income twenty years ago was worth a lot more than it is now. Essentially, he has not had “cost of living income raise”. We like to complain when we only get a 3% raise, that we’re only keeping up with inflation; but keeping up with inflation is much better than not keeping up with inflation.
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PA as Partner in a Medical Practice
The PA and NP providers in our organization also have a meeting semi-annually and at these meetings we discuss issues that are more specifically relate to our needs. One topic that we had discussed at our last meeting was partnership opportunities for non-physician providers.
The way the current partnership works is that after a physician works here for a certain number of hours, it basically comes down to a year of full time employment, they are eligible to become partners. They are required to pay a small amount, which they would get back if they ever left the company.
We have a profit sharing plan already in place that everyone is a part of and is paid through our 401k. What came out of the discussion is that there are limited benefits and more risks associated with being a partner; this includes when the company takes a financial hit, and that falls onto the partners.
I personally did not go into medicine because I thought it was good business to be in. Part of why I was drawn to being a PA, was that I could work in a “helping” field and I didn’t have to worry about opening or running a practice.
In reality both of those are somewhat false: even if you don’t want to run a business you still have to understand the business side of things (insurance, billing, coding, etc.) to some extent; and it doesn’t always feel like I’m here to make the world a better place – some days are hard, and it does feel like it’s just a job. There is a lot of paperwork and charting that needs to be done and you’re not always healing all your patients.
Overall, I believe that Physician Assistant is a good career, and I’d much rather have a 3% raise, than a 4% reduction. If you’re the entrepreneurial type there are draws to seeking out opportunities to own your own practice or become partners with a physician, however I personally think there are better business opportunities out there.
What do you think? Is it worth it to be a partner in a medical practice? Did you become a PA for the business opportunities? Don’t forget to sign up to receive future posts by email, please comment below the original post and share with your friends!
