Equity buy-in structures of emergency medical group practice

The authors polled emergency medicine groups in an attempt to identify whether equity was offered and the time, costs, and methods of achieving equity. Several characteristics of equity and nonequity groups were compared. A survey was distributed to 514 groups from a list identified by the American College of Emergency Physicians. Nonresponders received a second mailing. Valid responses were received from 127 groups representing 3,405 physicians. Of the respondent groups, 69 allowed full equity participation. The mean time to full partnership was 2.2 years for new physicians. Single hospital groups tended to have shorter (1.6 years) buy-in periods compared with multihospital groups (3-4 years). The most common method of buy-in was a differential in the "bonus" structure between new physicians and partners. The actual cost to attain full equity varied greatly with a range of from $0 to $500,000. Groups not owning their accounts receivable had a total mean buy-in cost of approximately $40,000 as compared with those that did own their accounts receivable, where the average buy-in cost was approximately $106,000. The proportion of equity groups that had two thirds or more physicians board-certified in emergency medicine was significantly greater than those groups without equity. The detailed structure for attaining equity varied greatly between groups. The authors conclude that many emergency physician groups allow full equity participation. The average time to full partnership is generally less than 3 years. There are many diverse schemes of entering into partnership. The cost of acquiring full equity varies greatly.