I wonder about those physicians who have become employees of hospital systems instead of joining the private sector. Would most have done so if they had become a junior partner like I did, working with colleagues who possess similar qualities and values?

Since becoming a junior partner eight years ago, I firmly maintain that a partnership offers benefits the typical employer-employee model cannot. I joined Vance Thompson Vision,* in Sioux Falls, S.D., in 2010. Now, I am helping to identify potential junior partners. Having been on both sides of the partnership equation, I’d like to share my insights on how to make the most of a relationship that can be uniquely gratifying to both parties.

A GIVE-GIVE DYNAMIC

What Vance Thompson, MD, gave me as a new associate was opportunity and confidence. He valued my opinion and gave me voice in the direction of our practice. What I brought him was appreciation for what he built, appreciation for what he continues to contribute, and a willingness to make his life easier. I think what junior partners bring their senior partners boils down to gratitude and freedom; what senior partners can provide for their junior partners are th opportunity and permission to provide input into their professional futures. At our practice, we have helped share the clinical and administrative loads and the overhead load. This allows Dr. Thompson to be away from the practice, free from worry about the team.

GENEROSITY IS ESSENTIAL

That giving spirit is crucial to making the partnership a success. Oftentimes I think senior partners are unwilling to share something else: the spotlight. Many say they want a star to join their practice, but they don’t really; they want a soldier who will do as asked. And that’s okay if the partners want a good, solid practice. If the goal is for an elite practice, however, recruiting thoroughbreds is necessary, but so is letting them run and make some mistakes.

SAME VALUES, DIFFERENT SKILLS

First, however, practices have to find that star, that thoroughbred. We look for people who have the same values we do — compassion, a sense of humor, commitment and egalitarianism — but with different skills.

When I say different skills, I’m asking, “Is the candidate naturally good at building culture? At being analytical? Is the candidate efficient? Does the candidate have a flair for marketing, or operations?” For instance, one of our associates, Alison Tendler, MD, loves dealing with dry eyes and also connects with people about self image in the aesthetics arena. I, on the other hand, am more analytical and feel most at home doing anterior segment intraocular surgery.

We want people who can help fill in our inadequacies — clinical and otherwise — while at the same time sharing our values.

DO YOUR HOMEWORK

To uncover this information, there’s no substitute for working alongside the candidate. We’ve accomplished this by hiring people who were fellows here. We got to know these people really well by working with them every day in the operating room, clinic and in meetings.

When that isn’t possible, behind-the-scenes interviewing helps. The person in front of you is naturally trying to put his best foot forward. To get beyond the good intentions, reach out to people you trust who also know the candidate. Probe for what the candidate’s strengths and weaknesses are. Everybody has weaknesses — that’s not the issue. What you need to know is what those weaknesses are, and if they constitute a fatal flaw.

HOW TO GIVE NEW ASSOCIATES OPPORTUNITIES

Once you’ve found that candidate with the strengths your practice needs, it’s time to help find the opportunities that will allow him or her to shine.

Here’s an opportunity Dr. Thompson helped me obtain: Vance is an investigator for Glaukos, and while he didn’t consider himself a glaucoma expert he thought I would be a great investigator and he advocated for me. Glaukos made me a primary investigator six months into my practice on a technology that would ultimately change the glaucoma landscape, and I will be forever grateful for that opportunity.

Lobbying for our associates to be included in research trials is not the only way to help them, of course. Oftentimes if a trade publication is looking for an interview, we give one of our younger partners the opportunity to talk, if he or she is an expert in the area.

We try to get them involved on advisory boards in positions of leadership within major societies, like ASCRS, where a young partner is on the membership committee, and AAO, where another one is on the seniors eyecare program committee. It’s about enabling them to get involved.

KEEP IT CIVIL

A final component to a successful partnership is — Surprise! — good communication. That sounds obvious, but it’s easy to lose sight of under the stresses of daily practice. The thing that doesn’t work is withholding your thoughts and not saying what you believe. You need to speak the truth and speak it graciously — and realize you don’t have a monopoly on the truth. The other partner’s perspective is valid, too.

We’ve found that as long as we observe those rules — say what you believe graciously, realize that you don’t have a monopoly on truth and maintain your core values — there’s never been a conversation we couldn’t get through. OM

*Full disclosure time. I’ve had a distinct advantage in learning medical practice partnership, because Dr. Thompson is someone to emulate. He demonstrated how a senior partner should model behavior. Another advantage: My fellowship was at Minnesota Eye Consultants, where Dick Lindstrom, MD, Tom Samuelson, MD, and David Hardten, MD, created a fair, equitable culture for all partners. I know that not everyone is so lucky!

About the Author

John P. Berdahl, MD, is a cataract, cornea and glaucoma surgery specialist at Vance Thompson Vision in Sioux Falls, S.D.