Thursday, November 5, 2009

Maybe it's not so good to be the king

I love Mel Brooks but maybe it's time to rethink his famous line from the movie "History of the World Part I." Maybe it's not that great to be the king -- at least not for physicians who are the kings and queens of their practices.

This month's cover story reveals the results of our annual Physician Compensation Survey. Looking at the numbers, an interesting subplot that emerges is the question of whether it is worth it anymore to shoot for practice partnership or ownership.

There's no question that owners make more money than employed physicians, on average, and there are obvious psyhcological advantages to being the boss, if you're the take-charge type (as many physicians tend to be). Yet the financial benefits, it seems, are narrowing. And the headaches are worsening.

Of course, we've known that for some time. But our data this year offers some new insight into life as an owner, versus that as an employee.

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Consider that owners were more than twice as likely last year to see income declines as employed physicians: 43 percent of owners said their income was down over the last year, compared with 20 percent of employed docs. And here's another startler: More than one in five of owners/partners (of all types of private practices) said they made less than $100,000 last year, a percentage only slightly below that of employed docs. It's hard to fathom a physician accepting all the risk of ownership and the hassles of management only to bring home, say, $80,000 a year.

No wonder most practice owners described their income as "disappointing." And no wonder we keep hearing about more and more practices selling out to hospitals.

Which brings me to my questions for commenters. Owners, would you recommend partnership to younger physicians, or tell them to just "get jobs." Are you considering selling out/retiring/closing shop at some point soon? I'm very interested to know your current thinking on the idea of selling to a hospital. Does it feel like a "way out" or a sell out? How do you think you'll feel having a boss, vs. having (potentially) fewer money worries?

And employed docs, are you reconsidering your long term career plans? Do you want to be a partner or owner someday? Did you ever?

Comment below and e-mail me your thoughts at, if you have any interest in being interviewed for a possible upcoming column.

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