[Nathans_Dad]

Round 1 of my interviews for a new job starting in summer 2007 is complete. I had 4 interviews this week, all 4 essentially offered me a job. I narrowed it down to two strong candidates but am having some trouble deciding between the two. Both job are for hospitalist positions, essentially I only take care of people in the hospital, no clinic or other responsibilities. Which one would you take and why? The candidates are:

1). Join a group of 3 doctors who are looking to grow to 5 or possibly 6. The group essentially is trying to rebuild itself after losing all of its experienced members about 4 years ago. They have lost market share in the hospital due to frequent turnover of docs in recent years. Currently they have about 15-20% of the hospital business. There is one other major competing group in the hospital, although with any sort of marketing by the group I am interested in, the other group could likely be pushed out fairly easily. The competing group is a sort of fly by night, high volume corporate group which has questionable quality of care. The three current docs are all very young, one is 2 years out of training, the other two are in their first year of practice. They are looking at me to be a "leader" in the group and help grow the practice. The practice is owned by the hospital, I do not think that they would be agreeable to a private takeover by the doctors so there really isn't much opportunity for ownership. Salary is $170 per year for the first 18 months and then about 80% of what I bill I keep. Currently the docs are only seeing about 10 patients a day but hope to grow that to 15-20. Hospital is about 300 beds, suburban community hospital. I could live in a nearby area, would be 10-15 minutes away from work. Overnight call would be from home.

2). Join a group of 6 doctors looking to grow to 9 and possibly more if the demand is there. Basically this one is a semi-teaching position, I would be staffing a ward service for residents about 50% of the time and being a private hospitalist the other 50%. The group has an exclusive contract with the hospital and will be the only hospitalist group able to admit, so it's a captive audience. Time on the teaching service is salaried plus you get a percentage of what you bill. Time on the private service is all production, no salary. The hospital is assuming all the overhead for the group so I would keep about 90% of what I bill (the 10% being the fee for the billing company). The guys already there are a little older than me (early 40s) and have been established at the hospital for about 5-6 years. Group would be owned by the doctors, but they would be unlikely to sell or be taken over because they are integrated with the teaching residency. Hospital is large, 750 beds, and is located in a not-so-nice part of town. Surprisingly, the hospital itself is actually nicer than choice 1 although it is located in a questionable part of town. I would live elsewhere, commute would be about 25-30 minutes. Call would be from home while on the teaching service and inside the hospital while on the private service. Salary is projected around $225-275 depending on how hard you want to work. Docs are projecting to see about 18-20 patients per day.

Both jobs have appeal to me. The smaller hospital is in a nice part of town, however I would never own that practice and would be looked to as the "go to" guy and the experienced one (despite the fact I have never been a true hospitalist). Salary is less, but might grow as the practice grows. The larger hospital has the appeal of keeping my hand in the teaching side of things, which I do like. Also salary is more, although the workload would be higher initially. The part of town doesn't really bother me that much, it is right off of a main highway so easy to get in and out. The commute is probably less than what I have now. RIght now I am kinda leaning towards option 2 but am still very torn. Thoughts?