Gender Pay Gap Among Physicians

ATTORNEY ADVERTISING

If you have not been blasted with reports about the gender pay gap in Hollywood, you may be living under a rock. Recent news articles and headlines have scoured the issue, and just about everyone is weighing in on the disparity between men and women’s incomes. Liam Neeson, for example, thinks the pay gap is “f---ing disgraceful.” While opinions and frustration levels vary, it is pretty much safe to say - nearly everyone is troubled by the pay gap.

Despite all the recent reports, it is important to note that the gender pay gap is not limited to those that grace the silver screen. Rather, the pay gap affects people across all professions and industries in the US. People, however, may be surprised to learn that the gender pay gap is alive and well among one of our country’s oldest and most revered professions: medicine. That’s right – although the year is 2018, reports indicate that female physicians – across all specialties - earn an average of 74 cents for every dollar that male physicians make. This figure translates to an approximate $90,000 per year. Even when the data is broken down based on medical specialty, there is no area where women earn as much as men. Of course, it is not news to anyone that the medical field is one that has historically been dominated by men. While male doctors still greatly outnumber females – approximately 66% of physicians in the US are men – women are entering the medical field at unprecedented rates. The number of women enrolled in medical school recently reached a 10-year high, and in 2015, female medical school graduates outnumbered males in several states.

One of the largest factors affecting compensation among men versus women is geography. The statistics prove that where you live does matter. In several cities, the pay gap is 30% or more (including Charlotte and Durham, North Carolina; Orlando, Florida; and Pittsburgh). Five other cities have pay gaps of at least 29%. It appears that the pay gap was the least significant (relatively speaking) in Sacramento, where female physicians earn 19% less than their male counterparts.

Perhaps the most disturbing aspect of this issue is an examination of when, if ever, the gap will close. Although the gender pay gap has certainly been inching closer and closer together (no one can deny the progress made in women’s education and workforce participation since the 19070s), the rate of change simply is not happening fast enough. Experts estimate that if the rate of change experienced between 1960 and 2016 continues, then women are expected to achieve pay equality in 2059. However, experts also advise that progress has slowed in recent years (since 2001, specifically), such that if the more recent and slower rate of change continues, women will not achieve pay equality until 2119. So, even if we take the more optimistic stance, women will continue to earn less money than their male counterparts for another staggering 41 years.

Having presumably achieved the same level of education and training upon entering the work force, why do female and male physicians get paid so differently? Unfortunately, there truly is not a good answer, but it appears that at least part of the problem is self-doubt and reluctance on behalf of women. Reports indicate that, in general, women feel less comfortable than men when it comes to negotiating their compensation, and therefore simply accept what is offered to them. Therefore, although the problems working professionals in our country face require a systemic response, it is clear that we also need women to stand up for their value and for female voices to be heard.

The physician-agents of Lauth O’Neill work solely on behalf of health care providers, and are experienced in the analysis and negotiation of physician employment contracts. If you have questions about your contract or compensation plan, contact the physician-agents of Lauth O’Neill.

ATTORNEY ADVERTISING

Physician Contract Review Tips: Intellectual Property

ATTORNEY ADVERTISING

In this next installment in our 2015 Physician Contract Review Tips series, we are discussing a subject closely related to our last article on Outside Income-Generating Activities. That article discussed physician employment agreement language that dictates whether the employed physician can participate in outside activities and retain the income therefrom.  In this article, we are focusing on intellectual property issues that surround certain work product that physician employees may create.  The range of focus on intellectual property rights in physician employment contracts spans from no mention at all, to sweeping, overly-broad language that leaves the physician employee with no rights or interest in his or her own intellectual property.  For many physicians, intellectual property issues may not be a hot button topic, but for those physicians who foresee participating in invention, innovation, consulting, and research work, any language in your agreement having to do with intellectual property can be hugely impactful.

It is crucial that physicians understand each and every term of their employment agreement to the fullest extent, and it is also of utmost importance that physicians never assume they will not, at some point down the road, become involved in activities that might result in work product that is protectable. For instance, while you may not foresee working with a device manufacturer in the future, you also might not be comfortable signing over to your employer, for free, all of your future ideas, inventions, patents, copyrights, trademarks and other protectable work product. Some physician employment agreements do in fact go so far as to provide that the physician employee is agreeing to hand over to their new employer, at no cost, or at only a very minimal cost, their entire inventory, current and future, of intellectual property.  As one can imagine, agreeing to language of this sort could end up costing the physician employee an enormous amount of money in the instance where a piece of intellectual property becomes valuable in the future.  The moral of this article, as is true with physician contract reviews in general, is to not sell yourself short. Especially if you are just coming out of training, you may be hesitant to negotiate away certain contract terms that will limit your rights and interests down the road, but do not assume that they will always be irrelevant to you. They may in fact one day be more lucrative than your basic compensation you earn from providing medical services.

For more information on physician contract review tips, please contact Leigh Ann at 317-989-4833 or loneill@lauthoneill.com.

ATTORNEY ADVERTISING

Physician Contract Review & Negotiation: Make the Money Useful

ATTORNEY ADVERTISING

If you're rounding out your physician job search and have been offered a physician employment contract, congratulations! At this time of year, many physicians are signing their physician employment agreements and looking forward to beginning work. Maybe you've had your physician contract reviewed by a physician lawyer, and you're confident that it's just the way you want it. Maybe you haven't taken the step of having a physician lawyer review your contract, but you'd still like some helpful tips anyway. One particular dilemma that especially comes to light this time of year is the "payment gap". You're finishing up your residency or fellowship, and you'll start your new job maybe sometime in August or September- maybe you're taking a few well-deserved weeks off before you begin. Well-deserved, they may be, but we all know they come at a price. Where is your income going to come from during your time off before you start your job?

If you enlist the help of a physician contract lawyer, they will likely readily assist you with this dilemma. While each and every physician employment contract is different and all circumstances and possible outcomes are unique, it may be possible to maneuver the salary offered to you to help you out as you finish up training. Even if you were not offered a signing bonus or moving expenses reimbursement, it may be possible to adjust your salary in such a way to offer you some initial compensation up front.

ATTORNEY ADVERTISING

Value Added by a Physician Agent and Attorney

ATTORNEY ADVERTISING

In this series of articles, we are outlining examples of how Lauth O’Neill’s physician contract review and agent services have added value to our physician clients. While every physician job search is unique and has its own unique outcome, all of the examples in this series are based on actual client experiences.

Value-Added Example #4: Creating favorable and achievable bonus compensation terms. Often times when a physician receives an employment offer, the contract will include a guaranteed salary amount which will be paid to the physician each year of the contract term. In certain specialties and in certain regions of the country, physicians may be very likely to collect payments for their employer that far exceed the minimum salary offered to the physician employee. While many employers do not first offer any bonus or incentive compensation to young physicians who are straight out of residency, it certainly may be an option to you if the legal terms are crafted carefully and so that the employer feels comfortable agreeing to them. If you have access to the MGMA physician compensation survey, you will be able to determine what your potential collections will be, on average, in your first years of training. With this information, it is possible for a physician contract review attorney to create a bonus payment structure that will allow you to achieve compensation beyond what your salary guarantee will pay you.

For more information on ways to increase your physician salary and overall physician compensation, please contact Leigh Ann O'Neill at 317-989-4833 or loneill@lauthoneill.com.

ATTORNEY ADVERTISING

How do you Gain from Lauth O'Neill Physician Agency?

ATTORNEY ADVERTISING

The answer is simple: We make our clients money, and we save our clients money. The physician job search process is certainly not a short or simple one. It takes months, and more typically, years to complete, and involves innumerable moving parts. The job search process requires extensive outreach efforts and marketing of a physician's credentials and qualifications. And once job offers are received, the physician employment contracts must be legally reviewed for costly and detrimental legal terms, and also negotiated to ensure the best offer is accepted. After all, the point of a physician job search is not to just find a job. The point of your physician job search is to find the best job for you- and the one that is most advantageous to you legally and financially.

In this series of articles, I will outline examples of ways Lauth O'Neill's professional services have added value to our physician clients. While every physician job search is unique and has its own unique outcome, all of the following are based on actual client experiences.

Lauth O'Neill Value-Added Example #1: A $75,000 increase in annual salary, in addition to a $50,000 signing bonus. How did we pull this off? We know how to gain leverage for our clients, and we know how to use it appropriately to negotiate better benefits.

Lauth O'Neill Value-Added Example #2: Amending insufficient medical malpractice coverage terms to avoid unquantifiable expense to our client. When a physician employment contract includes insufficient medical malpractice coverage, the consequence can be detrimental to the physician- not only expensive, but potentially career-ending. We understand the ins and outs of physician employment agreements, and know exactly what to look for to ensure that our clients are not stuck with unfavorable and harmful legal terms.

Check back here often or contact Leigh Ann directly for additional ways Lauth O'Neill Physician Agency provides value to its clients. Contact Leigh Ann at loneill@lauthoneill.com or 317-989-4833.

ATTORNEY ADVERTISING

Physician Contract Review Tips: Not-so-Obvious Points to Keep in Mind

ATTORNEY ADVERTISING

When I am hired to do a physician employment contract review, I regularly uncover a multitude of different contract provisions that can be made more favorable to my clients. In some instances the employment contract is relatively balanced with regard to many contract terms, but in other ways the contract is completely lacking in crucial provisions that will make the employment arrangement a good one for the physician to enter. For example, a few not-so-obvious aspects to keep in mind are:

1. Your ability to earn income outside of the employment arrangement- Many times employers attempt to keep for themselves any income earned by the physician for activities performed as a physician. For example, some physician employment contracts stipulate that if a physician consults with device manufacturers or other medical industry companies, any income realized from the physician's work for the company will be the property of the physician's employer.  Other times contracts will require that a certain percentage of this income must be paid over to the employer. It is also not uncommon for physician employment contracts to require that any income earned by the physician for serving as an expert witness in a trial, or in other physician-based capacities will be the property of the employer. Provisions such as these are obviously unfavorable to physicians, as in many cases, especially those in private practice, physicians rely on outside compensation to supplement their annual income.

2. Having assigned OR and procedure room times- This point is often overlooked by younger physicians who are accustomed to being forced to work at all hours of the day and night, whether they want to or not. Of course, starting your own practice is an entirely new ballgame, and one factor that is often overlooked is the assurance that you will in fact have a physical space to practice medicine and surgery. Many times physician employment agreements will simply state that the employer will provide the physician employee with the space and equipment he or she needs to perform the job at hand. However, it is a maddening experience to show up to work on day 1 and find that the optimal OR and procedure room times are filled by senior physicians, or those who made sure to ask for specific time assignments in their physician employment contract. One can only imagine the frustration felt by a physician starting a new job who comes to find out that yes, in fact, they do have two days worth of assigned OR or procedure room time, but it's broken up between afternoons on Tuesdays and Fridays and all day on Saturday. Paying close attention to the terms of a physician employment contract relating to these accommodations can make an enormous difference in the long-term success and satisfaction in an employment arrangement.

3. Ensuring balanced billing responsibilities and liabilities- It is not uncommon, especially in private practice, for physician employment contracts to include a provision placing responsibility on the physician employee for certain billing duties. In some cases, employment agreements state that billing personnel will be responsible for coding the services provided by the physician and submitting the bills for payment, but also that the physician will be liable for any recoupments or other recoveries that occur due to incorrect bills. While it is desirable for physicians to have someone experienced in billing be responsible for submitting their claims, there can be very detrimental consequences to the physician if a mistake is made and care has not been taken to protect the physician from liability. Additionally, this type of arrangement can lead to unforeseen consequences to a physician's incentive or bonus income if billing responsibility is not properly tailored.

It is important that physicians have their employment agreements thoroughly reviewed to ensure that all provisions are carefully considered, and that they negotiate for adjustments to be made in critical terms so that their employment arrangement ends up being as favorable as possible.

ATTORNEY ADVERTISING

Physician Employment Contract Negotiation Tip: Look Out for Practice Location Terms

ATTORNEY ADVERTISING

In a time of decreasing reimbursement rates, it is becoming more and more popular for hospital systems and some larger private physician groups to open rural clinics and other types of practice sites. This trend is on the rise because reimbursement rates tend to be better in rural areas, and other regulatory rules are often relaxed for rural health care providers. Due to the influx in rural clinics and practice sites, physician employers are obviously faced with who will staff these additional locations. Of course, many employers simply hire physicians to work only in these rural locations, but other employers are staffing the locations with their physician employees who work the majority of their time in more urban practice locations.

Because it is often more difficult to find physicians who are willing to work only in the rural locations, the employers are faced with ways of staffing the rural practice sites with their urban physicians, and many times it ends up being the more junior physician employees who are called upon to commute to the rural locations on occasion. With this increasing trend, it's not surprising that many physician employment contracts these days are coming with provisions that require the physician to provide services at "any practice location the Employer owns or provides services." This is becoming one of the classic contract provisions that seems harmless and just like any other "standard" contract language, but it can bring significant discontent on the part of the physician once the job actually begins. While the physician employment contracts should always stipulate an actual address of the office location where the physician will be providing services, physicians should be weary of this additional "catch-all" sort of language that may require them to provide services at other office locations that may not have been specifically set out in the contract.  Keeping an eye out for this type of vague language and amending it to provide only specific requirements on the part of the physician is always a good idea so that the physician can begin his or her job and be confident there are not any unwelcome surprises down the road.

For more information on how Lauth O'Neill can assist in your physician job search or physician employment contract review, please contact Leigh Ann at 317-989-4833 or loneill@lauthoneill.com.

ATTORNEY ADVERTISING

Physician Contract Review Tips: Beware of Billing Responsibilities

 

ATTORNEY ADVERTISING

When a physician is offered an employment contract, particularly with a private practice, some of the medical service billing responsibilities sometimes rest on the physician.  As if it's not enough to worry about caring for your patients and taking care of other administrative duties, physicians are often faced with various billing tasks that require enormous attention to detail and experience in an area that has become its own industry.  It is, of course, part of the job- knowing what CPT codes fit which service, and which modifiers go where; but one can't help but wonder if there might be someone better suited than a physician to handle the nitty-gritty billing concerns.  After all, there is an entire industry of professionals whose exact job it is to ensure that medical services are billed properly.  So beware of vague or overly-broad billing responsibilities in your physician employment agreement.

Of even more significant concern in some instances is where the physician employment contract expressly assigns the billing responsibilities to someone on the billing staff, but also holds the physician responsible for any payment recoupments or audit recoveries that occur due to incorrect billing. While it very well may be the fault of the physician in some instances of billing errors, the last thing you want is to be held accountable for someone else's mistake. For instance, in some physician employment contracts, the billing staff is responsible for coding the services and sending out the bills, but then the physician is held responsible if something is billed incorrectly and a payor recovers their payment. In this type of arrangement, it is helpful for the physician to have some amount of oversight or appeal rights when it comes to the practice's internal billing practices and policies.

For more information on how the details of your physician employment agreement may significantly impact your practice of medicine and your income, please contact Leigh Ann O'Neill at lone ill@lauthoneill.com or 317-989-4833.

ATTORNEY ADVERTISING

The Physician Job Search: Why the Mixed Numbers?

In a survey completed by WebMD in 2012, physicians fessed up to their dissatisfaction in their current jobs.  In fact, only 23% of surveyed physicians said, if they had to do it all over again, they would return to their current practice setting.  What's more, almost half of surveyed physicians said they feel their compensation is unfair.  I personally found these results to be somewhat surprising.  I was surprised by these numbers because, in my mind, physicians, of all professionals, seem to be in the best position to choose the job they want, and to receive the compensation they feel is fair.  After all, we often hear that there are gaping physician shortages, especially in certain regions of the country.  So why then are more physicians not able to say they are happy in their current jobs and with their current pay? One possible explanation is that physicians are often hasty in accepting their first job offer.  Not only are physicians typically under immense pressure to pay off incredible student loan debt, but they are also often hesitant about delving into the contract negotiation process.  These reasons sometimes lead to premature acceptance of a job that will certainly pay the bills, but may not offer exactly what the physician truly wants out of his or her job.

A second explanation is that when young physicians enter the world of practicing, they have not yet been exposed to various practice settings or certain employment arrangement possibilities.  After all, they've been slaving away as residents and fellows for the past few years, and pretty much any employment arrangement is going to look better than what they're used to. So it's easy to see why young physicians are quick to accept any job offer that includes a salary with 6 numbers.

While it might be comfortable for young physicians to accept a job in the same practice setting they're used to after their training, or it might seem to make the most sense to accept a job in the completely opposite practice setting (i.e., going from academic to private), I would encourage residents and fellows to take a broad look at the various different practice settings available before choosing one.  It may end up that the same academic setting they're used to is a great match for them, or shifting to a smaller setting may be the right move, but it's impossible to know until you get a feel for the variety.  It is also hugely important to have a detailed legal review completed of your contract.  Given that most physicians are entering an employment setting with an employer they have not yet worked for, it is important to be sure that you have the maximum legal protection in case the job doesn't turn out as hoped.

For more information on how a physician agent can assist in the physician job search process, please visit us at www.lauthoneill.com.

Physicians, Pro Athletes, & Musicians Alike- All Benefit From an Agent

I founded Lauth O'Neill Physician Agency because my professional and personal experiences taught me there is a need for physician agents.  Not only do physicians benefit from having someone in their corner, looking out for their interests, but they also need a "go to" person who can take on many of the tedious tasks that come in searching for a new job.

In my experience as a health care attorney, and combined with being married to a physician, I have naturally crossed paths with many physicians.  Many of them are at the beginning of their careers, and once they receive a job offer, they often ask me if it is necessary to have a lawyer look at the employment agreement.  My answer is always a resounding "YES!" And often times, I perform the legal analysis myself.  I have worked on both sides of physician employment.  And after serving hospitals and other group practices as my clients, I am acutely aware of what employers do to make a physician employment contract extremely favorable to themselves.  This, of course, often means the contract is unfavorable to the physician in certain ways.  Not to mention, they almost never offer compensation and benefits at the levels trained physicians can expect based on national benchmark data. So yes, the need for physicians to have their employment offers reviewed by a lawyer has always been very clear to me.

What I had not experienced until recently was the immense amount of time and effort that goes into finding and securing a physician's ideal employment arrangement.  In assisting my husband in his recent job search, I gained an intimate understanding of numerous steps that go into a successful physician job search.  First, locating the opportunities that fit your professional desires, then communicating with the potential employers to let them know you're interested and qualified, and interviewing multiple times with the same folks- this is only the beginning of the process.  Once an offer is made, then the hours spent on this task really start to climb.  Physicians not only need a legal review of each offer completed, but they must also endure what seems to be endless back-and-forth with the potential employers to ensure they receive the compensation, benefits, and terms they have earned.

In talking with my husband's colleagues about the trials and tribulations of their job search processes, the rhetorical question has often been posed: "Can't I just pay someone to do this for me?"  I only had to hear that question once before I recognized the need for physician agents.

As a physician agent, it is my goal to do all that is necessary to make my clients' job search not only successful, but as little of a burden to them as possible.  Therefore, I provide our Premier Opportunity service so that physicians can simply tell me what sort of job they are looking for, and in what region, and I will go to work finding their options.  Seeing the physician's job search process through to the end, the Premier Opportunity service includes every crucial step that allows physicians to find and shape their ideal employment arrangement.  I am excited to make each next clients' success my priority.