Are Radiology Practice Partnerships Still Happening?

June 7, 2019

Why it’s worth earning what you own.

One of my pet peeves used to be the common practice of considering Memorial Day and Labor Day weekends to be the start and end of summer, respectively. As I opined in a recent column, words have meanings. The seasons weren’t just made up based on when folks were likely to be free from school, work, etc. to head to the beach.

But then I found out about the distinction between meteorological and astronomical seasons, and thought, y’know what, if even the scientific types can’t agree on their terms, why not let people decide to use floating holidays to compartmentalize their year? If you live in a temperate zone, it’s nice enough to go for a swim, and you’re not a member of the Polar Bear Club, go ahead and call it summer for all I care.

By that definition, it was summer in my neck of the woods this weekend. That meant it was high time for my relatively-new annual ritual of cleaning up the grill and otherwise sprucing the backyard so I can have company over without being mortally embarrassed by the look of the place.

It’s not a lickety-split task. The grill alone has a bunch of parts that can be taken out and individually scrubbed, and while I’m there it only makes sense to clean out the mini-fridge that lives near it. One might forgive me for doing a slipshod job, or being truly lazy and paying someone else to do it.

Still, I’ve found that I rather enjoy the task, and doing it well. Aside from the happy anticipation it generates for cookouts and other guest-hosting activities in the ensuing weeks, something about performing this chore gives me the feeling that, even though I officially owned the stuff the day I bought the property, I’m actively earning that ownership and all of the enjoyment that it brings.

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The same sensation hit me when, having freshly moved in, I discovered a rather large box of quality chinaware that had been sitting in my old basement probably since the time of the flood. Some serious elbow-grease was going to be necessary to restore it to a serviceable state, and I wasn’t about to just stash it in my new basement for another few decades. So, for a period of weeks, I would intermittently devote chunks of spare time to furiously scrubbing at the stuff-and, in the process, found myself feeling like I was earning my ownership of it. Otherwise, it was just a box of stuff that might as well have been someone else’s.

Professions like medicine, once upon a time, had a routine “earn your ownership” thing going on: You joined a group, proved yourself for a certain duration while working as an “associate” or whatever else they wanted to call you, and if all went well you’d become a partner, meaning that you had a share in the ownership of the place.

Even if your circumstances were that you could bypass this and start your own operation (or had the scratch to buy an existing one from somebody else), you were still in for some blood, sweat, and tears if you truly wanted to own a viable enterprise. It didn’t matter how fat your checkbook might be, if you just threw money at the situation but put in no personal effort, it wouldn’t stand a great chance of doing well.

Either mechanism (earning partnership or starting your own) served pragmatic as well as philosophical purposes. By putting in such blood/sweat/tears, you learned minute details of the place. Even if you technically owned it already, you were making it more yours. Or making yourself more a part of it, put another way. That remains as valuable and adaptive during your thirtieth year of practice as it does during your third.

Times change, and onetime expectations that working hard equals making partner have also changed. With fluctuations in the job market, there have been times and locations where one simply couldn’t expect to achieve ownership (at least, not real equity-see my old column about duplicitous “Fake partnerships”).

Perhaps in response to the diminished availability of true ownership, a lot of younger radiologists stopped expecting-or even wanting-any. Many considered it a plus to live as employees or locums: They could show up for their contracted hours, do whatever work they were going to for the day, and leave. No need to form emotional ties to a given workplace. What’s that, the practice is struggling and needs more help to survive? Hey, good luck getting your partners to cover more hours this weekend, but that’s not in my contract. Seeya on Monday. One might argue that a sufficient number of rads willing to spend their entire careers as employees gave rise to some of the huge radiology corporations that now exist.

(Amusingly, it was not uncommon to see some of the same owners/partners who begrudged their associates a reasonable bit of ownership turn around and complain that their employees weren’t willing to do what it took to build a practice.)

Again, times change, and here we are in another robust job-market. From my own search about a year ago, I saw that there’s at least some lip-service being given to offering candidates a shot at partnership. Hopefully the offers are sincere-I think our field could benefit from a greater sense of actively-earned ownership.