Dr. Hal Green was excited to be offered a partnership track position with Midwestern Pathology Associates, the strong regional pathology group serving most of his home state. The pay was good, and, if all worked well, Hal would be offered partnership after 3 years. Hal was excited because Midwestern was slowly growing, and they owned their own histology and cytology labs, as well as controlling the extensive courier network and what he had been told was a first-rate billing operation. The partners had referred to the 80 support personnel as Midwestern Diagnostic Services (MDS), and one partner had bragged about the periodic dividends paid by MDS to the partner pathologists. Hal was told he would have the opportunity to buy in to MDS once he was a partner. The partners seemed excited by this, so Hal assumed it would be a good thing. What should Hal be asking?

Discussion: Unless he was planning to work at Midwestern Pathology for only a year or so, Dr. Green would want to know more about MDS prior to signing his employment agreement. He should ask about the relationship between the two entities and whether a buy-in to MDS was required of him as a partner or was optional. Dr. Green should also have a rough idea of the value and finances of MDS and how shares would be priced. For any buy-in, a pathologist should understand how it might be structured, whether financed out of salary or outside money (i.e., a loan) and whether as a onetime deal or structured over several years. Finally, Dr. Green should understand the rough business plans and prospects for MDS over the coming years as well as how he might sell the shares upon leaving the group or retirement.