Fake Partnerships

January 5, 2018
Eric Postal, MD

Radiologists will catch on.

Once upon a time, in the world of private -practice diagnostic radiology, I’m told there was a pretty standard career path. First you did residency, and maybe fellowship. Next, you got yourself a job with one rad group or another. After a few years of proving yourself to the group (and them to you), you were offered partnership: A lasting status in which you got a real “piece of the pie.” Not just financially, but also in terms of insider intel and decision making.

Times changed, as they tend to. Depending on when you completed your training and where you subsequently decided to reside, you might not have found so many paths to partnership. If, like me, you chose to live in a “geographically desirable” region in which the radiology job market was pretty well saturated, your options for partnership were few to none.

Or, I should say, your realistic options were vanishingly few. Local rad groups still intermittently needed to hire fresh meat, after all, and had to compete against one another for the better recruits. There are a few ways to do that-like offering better salaries, vacation time, benefits, etc. Such measures have price tags, however, for the group. Alternatively, you can use nice, cheap words-like telling prospective recruits that you are offering them a “partnership track.” Emphasis on the “telling” part.

There’s more than one way to offer a fake partnership. The simplest way is to flat-out lie, whether to yourself or the rad who’s been unfortunate enough to find his way to your door. It’s easy to lie to them: Just make all sorts of promises about how they’ll be a ranking partner, use words like “equity,” and if they actually stick around long enough that you’re due to promote them-you don’t. Maybe you make some noise about how costs are up and revenues are down, if you feel the need to act like this wasn’t your intention all along.

That requires a certain depth of villainy and soullessness that many of us don’t have. For those who might feel bad about doing so, there’s the lying-to-yourself path: Start out with the notion that, yes, chances are the new rad won’t have what it takes to complete the partnership track, but in the meantime you’ll have the employee you need. And, if they do indeed work out well, you’ll want to keep them around, and it’ll be worth your while to promote them when the time comes.

Except that never actually happens. The closer they get to the finish-line, the more inventive you get at finding fault with them. Or making ever increasing demands on them, so that sooner or later they fall short (or get fed up and leaves). Maybe you even lie to yourself about how costs are up, revenues are down, etc., and gosh! Isn’t it a shame, you can’t make them a partner at this time?

If you don’t have the gumption to outright lie, you can opt for bending the truth: You actually proceed to offer a “partnership,” but it turns out not to be worth the paper it’s printed on (and maybe you don’t even use paper, it’s so flimsy and insubstantial). The new rad will get partnership in Corporation A, a fully-owned subsidiary of Corp B, which is in turn nested in Corp C…and of course all of the assets, revenue, and decision making are at the levels of B or C, in which the newbie is to receive zero interest. And/or the newbie’s shares are non-voting ones, cannot be sold, and can be taken back by the current (i.e., real) partners at any time without reason.

Offering fake partnerships might be a way to string along some associates for a few years, keeping your operation at somewhat functional in the process. It’s unlikely to be a strategy to hire and retain the sort of rads you’d presumably want in your operation…that is, if you intend on keeping your group viable and competitive for the long haul. Part of the problem is that rads talk to one another, and if you’ve been playing the fake partnership game, sooner or later they’ll all know about you.

Meanwhile, the other group(s) in town, who at least had the decency to be up-front while recruiting-not pretending to offer anything they knew they wouldn’t deliver-will look a lot more honest and aboveboard by comparison. Guess where the best new hires will gravitate.