MW partnerships

[rnchrista]

Anyone here in a partnership under a joint practice or given thought to it?
I realize that is a huge decision and I'd love to hear what's worked, the drawbacks, and they keys to making it a success.

[JunipersMom]

I apprenticed under a joint practice and would love to find that in my midwifery future. Now I just have to find someone on my side of the state to work with.

[Earthy Birthy]

JunipersMom, you're in MI, right? I might just be moving to Grand Rapids soon if a job offer for dh works out...

[Maggi315]

Hi,
I'm subbing because I am trying to do the same thing. I put out an ad on Midwifery today about finding help, it's under apprenticeships, but actually I really need someone who can work independently. Are you on any yahoo groups? I am and searched their archives and found some examples and such that were helpful.

[JunipersMom]

I cant even find an apprentice right now. I've been offered another midwives apprentice ~ but haven't been able to hook up with her.
And yes I'm right outside of Grand Rapids here in Michigan

[fruitful womb]

I'm a client. I would like to give you my perspective on MW partnership. I've seen it work and I have also seen it fail. Its like a marriage. When finding a partner, chemistry is very important otherwise your clients will sense trouble among the two of you. I prefer to see a MW who has a partner because I'm rest assured the burden isn't so heavy upon her shoulders. Hope you all don't mind me lurking around here since this is a "Birth Professionals" thread. There are so many fascinating threads here. I couldn't resist.

[jengacnm]

Originally Posted by rnchrista

Anyone here in a partnership under a joint practice or given thought to it?
I realize that is a huge decision and I'd love to hear what's worked, the drawbacks, and they keys to making it a success.

I'm not sure what you mean about "under a joint practice", but I'm in a fabulous partnership. My partner started the business about three years ago and I jumped on during month three. She began the business as a sole proprietorship, then changed it to a corporation. We're in the process of changing the business over to my name because she plans to move on in a few years.

ITA with a PP about it being like a marraige and chemistry being important. We'd already worked together in a hospital based practice and knew we shared the same philosophies. I don't know how well I can answer your questions because our partnership and business just unfolded naturally.

I truly can't think of any drawbacks. I can't imagine how solo midwives do it, esp when we deal with the inevitable long labors or back to back labors.

I suppose a drawback is that you need to have enough volume to support the both of you.

The keys to success are definitely communication, flexibility, and tolerance. We sometimes talk three or four times a day. Sometimes up to four days will go by with nothing going on. We've had some spirited debates about things like prolonged rupture, GBS management, and inductions. But we've never truly had a disagreement over the way a particular labor was managed. We allow each other equal time but ultimately find a decision we can agree upon.
She's quite tolerant of my occasional scatterbrained antics-like coming out to a birth at two in the morning just to drop off some instruments. I'd left mine in my oven.

More on chemistry-we complement each other well. She's the brains of the business and I'm the mouth. She has an eye for detail that I don't; I have an affinity for public speaking that she doesn't. I'm more outgoing than she is; she is the very picture of zen calmness in the midst of hemorrhages and shoulder dystocias.

Wow, this was a ramble. My summary? Find the right partner, and I can't imagine working any other way. Our line of work is just too demanding to do alone.

Good luck!

Jennifer

[Maggi315]

My biggest concern has been to how receptive my clientele will be to having more than one midwife. Most of them hire "me" and want to see me, they seem anxious about having another midwife, "what if I don't like her"?

Also, for those working in partnerships, how do you handle taxes, are you an official partnership? I hestitate to do that because of the liability issues involved, I would rather hire the 2nd midwife as an employee with a probation period.

And what about call? The whole purpose of me getting help is to be able to relax a little bit, to have some time off. And not try to see all my prenatals each week and be on call 24/7. Do you alternate call and prenatals? Do you see people in homes or office? I do both, although I am quickly outgrowing my home office space, now that i have a secretary, an assistant/apprentice and soon to be another midwife, it is very hard to have people coming and going out of my house all day long. It makes it very hard to separate my work time from my kids time. With another office space, they could be working and I wouldn't have to be involved every second.

Yes, I worry about volume. Right now, I have about 4/month coming up and ran income projections for 2,3,4 births so we would have a good idea of how our income can vary. That has been hard because I am giving up so much income monthly, but I never intended to work this much. And my clients have been passing my name around in their communities, I would predict by next fall, to have 6/month easily.

I read about how others split income, how do you all do it? I like the idea of taking all the monthly income and splitting it 3 ways: 1/3 each midwife and 1/3 to business for secretary, rent, supplies, conferences, taxes, etc. That cuts down on the competition and nickpicking over who is doing what.

This is a great discussion and very timely, if anyone has contracts or anything they would be willing to share, I would be very interested, I need to make one up before July 20. Thanks!

[jengacnm]

[QUOTE=Maggi315;8555087]My biggest concern has been to how receptive my clientele will be to having more than one midwife. Most of them hire "me" and want to see me, they seem anxious about having another midwife, "what if I don't like her"?

It helps to present yourselves as a partnership. We don't really have a call schedule; there are times when she's not available, others when I'm not. Occasionally people have told me that they feel more comfortable with me, but not often. And of course I don't know how often people have said that to my partner. :-)

Also, for those working in partnerships, how do you handle taxes, are you an official partnership? I hestitate to do that because of the liability issues involved, I would rather hire the 2nd midwife as an employee with a probation period.

We are a corporation, and our accountant does our taxes. We are both employees of the business. She is the president. The business doesn't pay taxes because we are a break even business-our accountant told us that if we end the year witha $237 surplus, we'll figure out a way to spend it.

And what about call? The whole purpose of me getting help is to be able to relax a little bit, to have some time off. And not try to see all my prenatals each week and be on call 24/7. Do you alternate call and prenatals? Do you see people in homes or office? I do both, although I am quickly outgrowing my home office space, now that i have a secretary, an assistant/apprentice and soon to be another midwife, it is very hard to have people coming and going out of my house all day long. It makes it very hard to separate my work time from my kids time. With another office space, they could be working and I wouldn't have to be involved every second.

We have a set office schedule of her 8 hours on Monday, and me 6 hours on Wednesday and Thursday. If I am at a birth, she will sometimes do my office hours for me. We have an office.

I read about how others split income, how do you all do it? I like the idea of taking all the monthly income and splitting it 3 ways: 1/3 each midwife and 1/3 to business for secretary, rent, supplies, conferences, taxes, etc. That cuts down on the competition and nickpicking over who is doing what.

All of our income goes into the business account, and the way we pay ourselves has evolved. We now get a flat rate for office hours and on call, and payment per birth, per birth assistant, per home visit, and other misc. (I get paid for first assisting at c sections, and public speaking gets payment.) That being said, I'm planning to change myself over to a salary soon.

This is a great discussion and very timely, if anyone has contracts or anything they would be willing to share, I would be very interested, I need to make one up before July 20. Thanks!

I never had a contract, and I never felt a need for one. Some well intentioned friends cautioned me that I SHOULD have one, but my intuition said otherwise. I trust my partner completely. I've had a contract before, in a different job, and it didn't stop me from getting screwed.

HTH!

Jennifer