By Edward H. Hu, MD

1.  Very large practice with a single principal:  One has to wonder why such a large practice only has one ophthalmologist.  The individual may be unwilling to share or difficult to work with.  It is important to ask about previous associates and insist on speaking with all of them.


2.  Full financials are not revealed:  If the practice is not willing to have an open book policy at some point prior to partnership talks, one has to wonder whether the practice is hiding something.  This could lead to early mistrust, the ultimate deal breaker in a partnership.


3.  Poor communication:  Communication and trust are the keys to any successful relationship.  A business partnership is often equated to a marriage.  Regularly scheduled administrative meetings are critical to staying on the same page.  Even if the new associate does not have voting rights, he/she should be invited to attend these meeting if the future partners are serious about adding another partner and not just retaining an employee.


4.  Family involvement:  If there are members family working in the practice, what are the odds that the new associate will win a dispute against family?  Blood is always thicker than water.


5.  No control of scheduling:  Some practices may have the new associate see all the routine exam/vision plan/lower reimbursement patients.  One should ask how new patients are distributed and the solution should be fair for both parties. 

Coming out of residency training from a supportive academic environment, it is easy to be trusting.  Unfortunately, despite our intelligence and accomplishments, many of us do not have the business savvy required initially to see clearly.  The business side of Ophthalmology is just as important as the clinical side.  In the right environment, both sides can be equally gratifying in their respective ways. 

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