True Democracy

Years ago, many emergency physicians were business owners. They owned their practice and this allowed them to have extensive control over their own staffing, practice patterns, work environment, work-life balance, and incomes. Hard work and smart decisions were rewarded financially. Over the last two decades, this practice model has become increasingly rare and valuable.

Many emergency doctors are now direct employees of their hospitals. Others are employed by another physician who “owns the contract” with the hospital. Increasingly, predatory publicly-traded contract management corporations have begun to contract directly with hospitals and force physicians who wish to work in that geographic area to work for them. Each of these models leads to a decrease in income, a decrease in control over their practice, and a less attractive lifestyle for physicians, despite an increase in workflow when compared to a well-run truly democratic group such as UES. In a true democratic group, the doctor is the owner of the business, and when the business does well, the doctor does well. This incentivizes doctors to work hard, to provide exceptional patient care and satisfaction, and to work cooperatively with consultants, hospital staff, and administrators.

Here at UES, we don’t hire long-term employee physicians or moonlighters to work the shifts. We are looking to hire partners that we can count on for decades to come who will care about our patients and our business. There are no “senior partners.” From day one of partnership, you get an equal vote and an equal share of profits with every other partner. It is very rare for a partner to leave our group because they know they are unlikely to find a job that provides similar autonomy and income, not to mention a better group of people. As partners, we police ourselves to make sure there are no toxic personalities, loafers, or dangerous physicians in the group.

The partnership track is two years long, assuming a full-time workload of 16 eight-hour shifts. Pre-partners are provided a standardized EPIC/Carepoint contract which includes both an hourly salary and benefits including malpractice insurance, health insurance, dental insurance, CME allowance, and moving allowance. Most pre-partners are recent residency graduates, and so receive mentoring during this critical period of professional development. The steep learning curve of residency continues for the next 1-2 years, and pre-partners generally rapidly increase their ability to practice safely, efficiently, and compassionately. The finances of the practice are completely open to the pre-partners and problem areas are rapidly identified and corrected. Every possible effort is made to help all pre-partners to meet the high professional and personal standards of UES. Pre-partners are expected to participate in most group decisions and to represent the group on hospital committees. There is no financial buy-in at the end of the two years. After five years as a partner, you qualify for a share of the accounts receivable as a buy-out. However, the main benefits of partnership are maximal control over your practice, and the ability to share in the profits of the business.

Sick of working for the man? Done with having a “suit” dictate your schedule while skimming the profits off of your labor? Come join UES and keep what you earn.

Next, how UES promotes Longevity in Emergency Medicine.