Eyeworld

SEPTEMBER 2022 | EYEWORLD | 83 P communication: at staff meetings, in speaking with patients, and in marketing materials. The best quality associates want to get involved with decision making and with special projects they can call their own. Allow associ- ates to sit in on non-sensitive portions of your practice's partner meetings. Give them a voice, even if they don't have a vote. By allowing a young doctor to participate in the group's dis- cussions on strategy and spending philosophy today, you'll be helping a partner in training make better decisions with you in the future. Doctors who have not yet made partner along with younger partners are often sensitive about how new patients are assigned in the practice, especially if the compensation meth- odology leans toward topline production. There should be a written protocol for scheduling new patients, and the appointment clerks should be checked periodically so that the very human tendency to please the senior partner by feeding them the best patients is not biasing the system. Most associates (and partners, too) detest being clinically pigeon-holed and kept from areas of practice that they enjoy. As a general principle, unless an associate has been hired with the expressed agreement that they will stick to defined practice areas, it works best if every doctor is permitted to provide whatever care that they are trained for and reasonably competent at. That said, associate doctors also want clear boundaries. A common complaint we hear from associates we're about to terminate is, "I never knew I was expected to do that; why didn't someone tell me?" Every new associate should be given a written summary of your minimum performance expectations. This list may be quite different for partner-track associates, who should take on extra work in such areas as staff training, community outreach, and quality assurance review. Would it be better to hire an OD than an MD? There are roughly three ODs for every practic- ing ophthalmologist in America. Optometrists are vastly more available on the job market than Sweeten the partnership terms There are a lot of ways to do this. You can accel- erate partnership from the typical 2- or 3-year track to just 1 year, or even immediate partner- ship. Remember that partnership is a reversible event. If you err and make someone a partner who turns out to lack the required productivity or temperament, the transaction can always be reversed, if you plan ahead. You can revise the buy-in terms: • Increase the percent of ownership; even if you are diluted below 50% ownership, your rights as the senior or founding doctor can be preserved in your legal agreements. • Reduce the buy-in cost; this generally obliges a reduction in the goodwill component value. • Revise the partner compensation model to be more favorable to young doctors. Owners and associates are rarely on the same page regarding a fair percentage. Owners can be too parsimonious, offering just 15% of the practice, even if their associate is now doing nearly half of the work. We find even more often that it's the associates who are over-reach- ing. It's not unusual for us during a consulting assignment in this area to speak with an associ- ate who perhaps generates just 20% of the prac- tice's revenue but expects to be granted a full 50% equity position. The key is to memorialize all of the anticipated (but non-binding) terms of future partnership in the original employment agreement or in a side letter. Be a more attractive employer For most practices, there is a practical limit to how much they can pay new MDs. In today's competitive market, you may also need to reframe other aspects of employment beyond salary. It can feel lonely being the new doctor in a group practice. New hires should be matched to a partner-level physician mentor for the first year, with regular one-on-one meetings. All pro- viders in the practice should meet at least quar- terly, partly to discuss pearls and protocols, and partly to give everyone a feeling of belonging. As an owner, foster a group spirit. Even if you are the founder and highest producer, be an "us" practice, not a "me" practice in all Contact Pinto: pintoinc@aol.com; 619-223-2233 Wohl: czwohl@gmail.com; 609-410-2932 continued on page 84

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