Dr. Abraham did not become a partner in that practice, but he learned the value of having a clearly defined pathway to partnership.
“That [pathway] includes getting down and dirty with the details. I want fellows and other rheumatologists who are considering changing what their current practice profile is not to be nervous about learning how you’re valued and [defining] what your plan is,” Dr. Abraham said.
Moving On
Next, Dr. Abraham worked at a hospital for two-and-a-half years. The position included a signing bonus and a salary increase. Although Dr. Abraham initially enjoyed his time there, he experienced many of the challenges of the hospital setting, such as being told he wasn’t productive, despite seeing 20–22 patients a day.
“It’s disheartening,” he said, noting that he was only three years out of his fellowship and still finding his footing as an independent rheumatologist. He realized that the hospital setting was not the best work situation for him.
Dr. Abraham returned to work at the private practice he had been part of before, with talk of becoming a partner but, ultimately, no partnership agreement. He became chief business officer at the practice for about a year, leveraging his undergraduate minor in finance. But he still found himself seeing a full-time panel of patients.
Eventually, Dr. Abraham discovered the practice where he’s currently a partner in North Carolina. He has been there for seven years.
What It Means to Be a Partner
Dr. Abraham detailed how partnership works in his practice, likening it to eight individual businesses, one for each partner. Each partner has fixed costs toward the rent and equipment, such as radiographic and dual-energy X-ray absorptiometry equipment.
When he joined the practice in North Carolina, he said the other partners were transparent, showing him the financials and how the practice generally fares. The partners collaborate to make decisions about investing in real estate or adding administrative staff.
At the end of a designated financial period, as long as a partner has more of a net revenue in their service line, they can continue earning the same amount of money. A cut in salary may occur if this balance is not the case. But partners may contribute more financially if someone has to take time off for personal reasons, such as taking care of an ill parent or child.
“It’s really a work marriage, and you have to have common goals and get along,” Dr. Abraham said.
