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Understanding the Associate Years

When a practice hires you, they’re making a big financial investment in you. The biggest expense a practice has is related to physician compensation. This includes things like your salary, bonuses, licensing fees, malpractice, mileage, cell phone and benefits. These expenses take a big bite out of the practice’s bottom line and in many cases the partners are taking a cut in pay to bring you on board. Did you know that on average it takes between 16 and 20 months after you’ve started to cover your expense to the practice you join? Why does it take so long? Here are a couple of reasons:

  1. As a new physician coming into the practice, it’s expected that you will be slower to see the volume of patients some of the more tenured physicians are seeing. You have to build up your patient base as you’re learning the quirks and nuances of the group you joined. You will be billing fewer visits for several months, or even a full year, meaning you’re bringing in less money back into the practice than your colleagues.

  2. Billing payors for the patients you are seeing isn’t immediate. This process can take up to 90 days, meaning that the practice still has to pay your salary from the day you start, but they’re not seeing ANY return on their investment in you for at least the first 3 months of your employment and sometimes longer if there are any delays in your credentialing or hospital privileges. For more information on the billing process, read our blog here.


Ideally you will be able to match or exceed your colleagues’ productivity level and graduate to partnership level within 2-3 years when access to additional revenue streams like Medical Directorships, Joint Ventures, etc. become a possibility. For more on those topics visit these blogs regarding the business of nephrology. And of course, you can always contact us at fellowshipoutreach@davita.com if you have any further questions about your associate years.