Promoting only those physicians with the needed ownership and entrepreneurial skills solves the problem of having unsatisfactory co-owners. Yet it creates another problem: If clinically qualified young doctors are denied this traditionally important status, how do you retain them as employees?
The answer lies in what I might call “golden handcuffs.” If you meet a capable physician-employee’s financial expectations, there may be less incentive to go elsewhere. Make a permanent associate’s salary generous, though obviously less than that earned by the partners.
Consider a special incentive program to help instill a sense of partnership without the economic risks or management burdens assumed by partners. Provide such long-term associates, or members, with incentives in their own profit centers. This allows still more potential profit for the actual partners.