Physician Job Search: Cast a Wide Net

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In working with physicians who are embarking on their job search, and young physicians just out of training especially, I find it is very common to have an instinct of staying close to home, or close to their residency program, or simply settling on one geographic region in general.  I cannot emphasize how big of a mistake this can be.  In beginning a physician job search, it is crucial that physicians realize that casting a wide net can benefit them hugely in the long run.

The  medical field and physician employment contracts can vary greatly based on geographic region.  As I have discussed here before, geographic regions can impact physician salaries, medical malpractice coverage, and other important benefits.  So when a physician is looking for his or her first or next job position, they owe it to themselves to see what the market has to offer.  It may seem like a given that your hometown is the best place for you land, but you may think very differently once given concrete job offers that provide much more in the way of compensation and benefits, even if only a few states away from "home."

To learn more about how Lauth O'Neill can assist in the physician job search process, visit our website or contact Leigh Ann O'Neill at 317-989-4833 or loneill@lauthoneill.com.

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Physician Job Search Emphasis on Teamwork: What's It All About?

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As recently reported in an article from AMed News, a physician job candidate who showcases teamwork ability is likely to stand out from the crowd among other candidates.  This article was commenting on a recent poll taken by the Medicus Firm, which found that 78% of hospital CEOs who are already part of or plan to form an Accountable Care Organization ("ACO") want to hire doctors who are team-oriented.  Unfortunately for these CEOs, 58% of them indicated that between zero and half of their employed physicians were a good fit for an ACO.  So what does this all mean to physicians who are job searching now?

The new emphasis on team work is stemming from various payment overhauls called for in the Affordable Care Act ("ACA").  Such payment reform measures range from bundled payment programs to the formation of ACOs.  In both instances, the way in which physicians are paid will change drastically.  Medicare has historically paid physicians on a fee-for-service basis.  Under the ACA payment reform provisions, the future holds new Medicare payment models that will instead pay for better outcomes and efficiency.  For example, bundled payment pilot programs are underway that reimburse a group of providers for treating an entire illness or surgical encounter.  Not only does the single bundled payment cover a hospital stay, but also the surgeons' fees, the rehabilitation therapy needed afterward, the long term care hospital stay, if necessary, etc.  Under such programs, providers are incentivized to find ways to treat patients more efficiently and collaboratively.

Additionally, with the advent of ACOs also comes a new push for physicians and other providers to collaborate with hospitals and other facilities in order to provide the most efficient care possible.  An ACO is a group of coordinated healthcare providers that use a variety of quality metrics and cost reduction measures in order to lower the cost of the health care it provides to patients.  Under the ACA's main Medicare ACO program, when an ACO saves Medicare money by treating a patient at a lower cost, the ACO will be rewarded by splitting the savings with the Medicare program.

These two main payment reform measures from the ACA are resulting in much banter about the value placed on physicians who can work well in a team setting. So for all of the younger physicians out there who are beginning their physician job search, it makes a lot of sense to keep these changes in mind as you draft your cover letters, CVs, and attend interviews.  If you can emphasize your ability to work effectively as a team member, and to be open to new ways of providing efficient care to your patients, you are likely to stand out from the crowd.

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@KHNews Reports Physician-Owned Hospitals Among Big Winners Under ACA

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I saw this headline and had to laugh- to be clear, it's a joyful and satisfied sort of laugh.  The Affordable Care Act amended the Whole Hospital exception to the Stark Law, which had previously been the vehicle through which physicians were allowed to own a portion of a hospital.  When amending the whole hospital exception, Congress outlawed future physician ownership in hospitals, leaving previously-owned shares legally in tact.  The irony here comes with the fact that the Affordable Care Act also created the various incentive and quality payments that result in payment increases to hospitals if they meet certain quality measures.  The irony being, the very law that made physician hospital ownership now illegal is also the one rewarding physicians for their good work in running hospitals.

Now this blog article is off-topic compared to what I usually write about, but I felt especially compelled to bring light to the fact that physician-owned hospitals are doing well under the Affordable Care Act quality incentive provisions.  You see, I have spent a fair amount of time in my career, and in life in general, as a proponent of physician-owned hospitals.  Time and time again they have come under attack for a multitude of reasons, and time and time again they have proven to provide more efficient and higher quality care.  So I am thrilled to see this result and merely had to share my delight in the irony here.  Cheers to the physician hospital owners our there!

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When to Not Use a Physician Recruiter: A View From the Other Side

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It's nice when someone else advocates for what I'm doing, and I didn't even have to ask them to do so. I just came across a great 2011 article on kevinmd.com written by a physician recruiter.  Now, he's not exactly advocating for what I do, but he's making an excellent point about how using a physician recruiter may not be in a physician's best interest. And that demonstrates how the services I provide are in physicians' best interests.  This article is an interesting read for any physician embarking on their job search and who is bombarded by physician recruiters' emails and phone calls.

The gist of this article goes to the fact that if a physician is searching for a job in a particular market that is already saturated with physicians, chances are the employers in that market aren't going to pay a recruiter's fee because they don't need to do so in order to recruit the physician employees.  In this type of scenario, having a recruiter job searching for you may actually hurt your chances because if you're put up against a guy who doesn't have a recruiter representing him, the employer may very well pass you up and hire the candidate who doesn't also cost him a $20,000+ recruiter's fee.

The real take-away point of this article, for me, is that physician recruiters work for the physician employers.  They're not really working for the physicians.  While they may help you in searching around for open spots, one thing is for sure, they're not going to hook you up with an employer who hasn't agreed to pay them for placing you there.  In other words, physician recruiters cannot actually be serving your best interests, and this is true for 2 reasons: 1) they are being paid by your potential employer, not by you, and that means they work for your potential employer, not you; 2) they will not explore employment options that may be the best fit for you, if the employer is unwilling to pay a recruiter's fee.

All in all, this article indirectly advocates for what I do: truly represent physicians in their job search.  Physician agents are hired by and paid by physicians.  As a physician agent, I don't get paid unless my client signs an employment contract- and if my client chooses, I don't get paid until my client literally starts getting paid him or herself.  My job is to do all that it takes to find the ideal employment arrangement for my physician clients, and to do so in a concierge manner.  Anyone in the medical field knows that doctors, particularly those who are still in training and taking Q4 call, don't have time to be Googling all over looking for potential employers, fine-tuning their CVs, and marketing themselves to all potential employers who might be right for them.  If they do have time for these tasks, they would much rather spend that free time doing something they enjoy, like eating or sleeping, or visiting with friends and family.  And that is the difference between physician recruiters and physician agents.  A physician recruiter is happy to place you with one of their clients who is going to pay them for bring you to the employer.  A physician agent is going to work tirelessly to uncover all potential employment matches, and shape your employment arrangement so that it meets your every expectation.

To learn more, visit our Premier Opportunity webpage to see how we provide concierge physician job search services.

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Physician Contract Review Tips: Beware of Billing Responsibilities

 

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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.

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Physician CV Tips: Fonts, Underline, and Bold

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The idea of having to play around with the underline, bold, and italics functions as you're drafting your CV may seem elementary and outside the realm of what you should be troubled with on a given day. However, you would be surprised how making a few adjustments to how your CV is styled can make all the difference in its attractiveness and readability. After all, when you're beginning your physician job search and you're about to send out a stack of cover letters to potential employers, the last thing you want is your CV to be stuck at the bottom of the "no" pile only because it looked boring or was too hard to read.

Now, you may be thinking to yourself, "I'm a doctor. My potential employers are sophisticated enough to not discount my CV just because it looked boring." Don't fool yourself. At the end of the day, all potential employers are only human. Just the same as anyone else, they are likely to respond to a CV that is more visually pleasing, and formatted in a way that makes it easier to read.

Consider a few simple ways to increase the appeal of your CV:

1. Set the headings apart by using a font that is different from the rest of the content; also, try using all capital letters in your headings.
2. For each component of each item (such as your degrees), find a way to style each line of text differently so that they all stand out and are easily separated in the reader's mind. For example, use bold letters for the name of your school; italicize the degree that was earned; and use a similar, but slightly different font when listing achievements and awards under the particular degree- repeat with the next educational degree.
3. Use a thin line at the top of your CV to separate your contact information from the body of your CV.

Don't overlook these small details. The physician job market can be incredibly competitive, and it never hurts to set yourself apart from the crowd, even if in a seemingly small way.

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Physician Contract Negotiation Power: Be Willing to Walk Away

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In my experience with younger physicians who are finishing up residency or fellowship, the crowd is pretty much split down the middle in terms of folks being settled on practicing in one location, versus feeling as though they can take a good look around and find their perfect job.  Some younger doctors are starry-eyed and wish to peruse the country for that perfect fit, and others are more settled in a particular location due to family, friends, and sometimes mere comfort with their current surroundings.  This observation dove-tails into a common question I am asked: "Will I really be able to negotiate better terms under my physician employment agreement?"  Many physicians worry that they don't have any leverage in their employment contract, and that they may be negotiating with a large hospital system or academic center that is holding all of the cards.  The physician's bargaining power rests in two important factors:

1. How badly does the employer want you above other candidates?
2. Are you willing to walk away from an offer?

If you're a superstar with outstanding qualifications that put you at the top of any employer's recruitment list, you're likely to get much of what you ask for.  And if you're willing to shop around a bit, and walk away from an employment offer, you've set yourself up for negotiation success.  Nothing can replace impeccable training, solid references, and other outstanding CV features, but if you're not dead set on one practice or hospital (or if you at least don't let anyone know that you are), you're much more likely to find success in your physician job search and employment contract negotiation.  Thus, the importance of locating multiple job offers that may be right for you.

It is true that "you don't know what you don't know."  And it's impossible to know what the market may have to offer you if you only entertain one job prospect.  By doing so, you sell yourself short right from the get-go.  Imagine the possibilities that may exist when you are offered 2, 3, or even 4 jobs. Not only will you gain experience in what various employers will put on the table, you also position yourself favorably with the ability to walk away from any given employer who isn't willing to "play hard ball" in your negotiations.  By the time multiple employers have invested resources getting to the point where they will make you an offer, they are likely to go the next mile to make sure you accept their offer.

Of course, locating multiple potential jobs that may be right for you, and then negotiating them all to find the best fit takes months and months worth of focus, tedious work, and valuable free time away from your clinical duties.  A physician agent can take on this enormous task on your behalf, and deliver considerable expertise along the way. To find out how Lauth O'Neill Physician Agency can help, click here to learn about our Premier Opportunity Service, or contact Leigh Ann O'Neill at loneill@lauthoneill.com.

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Physician Employment Contracts: Medical Malpractice Provision Tips

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When a physician receives an employment contract, they are typically pretty savvy about knowing to look for the medical malpractice coverage provision to see if it provides them adequate coverage. In most employment agreements, the employer will cover the physician's medical malpractice coverage. Sometimes the cost of this coverage is taken out of the physician's practice income, and other times the coverage is provided at the expense of the employer, under a large umbrella policy like the ones hospitals and large practices have. While who ends up paying for the coverage is obviously important to the physician, there are issues of even greater import that should be more concerning to physicians. Most physicians have heard terms such as, "occurance-based," or "claims-made" and "tail coverage." But knowing which type of insurance is or is not included in your agreement, and what additional insurance you may need, is something best left to a physician contract lawyer to decipher. Without experience with medical malpractice coverage provisions, it is difficult to know with certainty whether the employment contract may leave you exposed. In addition to the type of insurance offered, and whether tail coverage may be needed, a separate issue that is often unknown to physicians are specific state law requirements that can have an enormous impact. For example, some states have patient compensation funds for which physicians may be eligible if their malpractice coverage is adequate. Such funds may provide additional coverage to physicians in instances where they are found liable in a malpractice lawsuit. Therefore, whether your employment contract complies with such state law provisions may have a significant impact on your potential exposure to medical malpractice liability. A thorough legal review of any physician employment agreement is crucial to ensure you are appropriately covered under the medical malpractice provision included in your contract. To learn more about physician contract legal review assistance, please click here to read about our Analyze & Shape service.

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Physician Recruiter vs. Physician Agent: What's the Difference?

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When I tell people the name of my company, and before I'm able to describe exactly what it is that I do, folks often say, "oh, sure, like a recruiter?" My response is, "no, exactly the opposite, actually." Physician recruiters are hired by hospitals and other large physician employers to find and vet out appropriate physicians to fill an open position. I, on the other hand, as a physician agent, work only for physicians. If I were to also be recruiting physicians on behalf of a hospital, that could be a direct conflict of interest. Even when it comes down to following different people on Twitter, I am very conscientious about how my followings might be perceived. I am dedicated to focusing only on what my physician clients are interested in. I do not work in any capacity to fill open positions that hospitals might have. While it is a happy ending when a hospital fills a position with a physician who was seeking what that position offers, my job is to first make sure I know exactly what my client is looking for, and then seek out employers who may be able to offer it. A physician agent is not supposed to stop at advertised positions that employers are trying to fill- a thorough and zealous physician agent will leave no stone unturned by talking with all potential employers, including those who may not be advertising any open positions at all.

So, in the simplest of terms, the main difference between a physician recruiter and a physician agent, is the physician recruiter is working for the physician employer, and is paid by the same. A physician agent is working exclusively for the physician, and if they work the way I do, is only paid when the physician accepts their employment contract. This distinction is extremely important, and cannot be overstated.

To learn more about the physician agent services we offer and our Premier Opportunity service, in particular, click here.

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Physician Employment Contracts: Termination Provision Tips

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One aspect of physician employment contracts that are often overlooked are the termination provisions. When physicians sign an employment agreement without having it reviewed by a health care lawyer, there is a good chance that the contact included unfavorable termination provisions. For instance, it is important for physicians to know how to protect themselves in instances where the employment arrangement terminates for some reason that is no fault of their own. Unfortunately, it is common for unfavorable contract terms, such as non-competition covenants, to continue to be enforceable despite the termination of the employment due to some fault of the employers. Many physicians find this possibility shocking, but this sort of language can be easily amended at the suggestion of a physician agent or physician health care attorney.

A second type of common and unfavorable termination provision is one that allows the employer to terminate the employment agreement without cause, even where no similar termination right is available to the physician. It is desirable for both parties to have a termination right that allows either party to terminate the agreement upon a breach by the other party of a material contract term and failure of the breaching party to cure the breach within a set number of days. A mutual term such as this is balanced and fair and is one example of the reasonable terms physicians want to negotiate into their employment agreements.

For more information on how we can assist physicians in negotiating their employment contract terms, please visit us at www.lauthoneill.com.

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Physician Employment Contract Review: Is That Really Necessary?

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This is a question I hear all the time.  As a physician agent and a lawyer, I often have physicians ask me: do I really need to have my employment contract reviewed by a lawyer? An interesting fact I have come to notice with regard to this question is that I never hear it from physicians who have been out practicing for several years.  I imagine part of the reason behind this phenomenon is they know by now that the answer it most certainly "yes."  It is always the younger physicians who are just finishing up their training who are inquiring about whether a legal review of their physician employment contract is necessary.

It's hard to blame young physicians for being somewhat skeptical about the need for a contract legal review- after all, as they are finishing up residency or fellowship, they have come to trust the attendings they work with, and see them as mentors who will look out for their best interests.  And that is certainly the case.  However, it is important to realize that actual employment as a practicing physician is an entirely different animal than the highly-regulated world of residency and fellowship.  Such training programs are government-funded, and are meant to provide young physicians with the training and experience they need to become practicing physicians.  Employment as a practicing physician, on the other hand, occurs in the "real world" where everyone is looking out for their own best interests.  In fact, the hospital or practice personnel young physicians deal with when seeking a new job are obligated to protect the best interests of the entities they work for when they make an employment offer.  And you wouldn't expect anything different.  Picture yourself joining a private group that will one day offer you partnership- would you want to be a partner in a group that hands out freebies and doesn't protect itself?  I doubt it.

So if they're protecting the employer's best interests first, there is no room for them to be looking out for yours.  This isn't to say they are out to intentionally offer you a bad deal, or try to compromise you in some way.  But when they tell you not to worry about the terms of your contract because it's all "just standard language," you should not simply take their word for it and stop there.  What does that mean anyway?  "It's all just standard language"?  That isn't very descript or helpful when you're looking out for your own legal and financial well-being and trying to understand what your obligations are under the employment agreement.

I always encourage physicians to have their employment contracts reviewed by a lawyer, and specifically one experienced in physician contracts, because even though a potential employer may not be trying to do you any harm under your contract, they are not working to  protect your best interests- they're protecting their own.

Click here to learn how we help our physician clients, or contact Leigh Ann O'Neill at loneill@lauthoneill.com.

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Physician Compensation: What are the Various Models?

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When a physician employment contract is offered, often the first thing physicians look for is the compensation section to see how this offer stacks up against others.  What physicians sometimes find, is that rather than a simple 3-sentence paragraph outlining the annual compensation, and the payroll policy, there is a reference to an exhibit at the end of the agreement that sets out, over multiple pages, the compensation methodology according to which they will be paid.  While every individual agreement is different and should be reviewed by your individual lawyer, it is helpful to generally review some possible scenarios in order to gain some understanding of what payment methodologies are commonly used.

100% Straight Salary Guarantee

One of the most common physician compensation methodologies is the 100% straight salary guarantee.  In a time of hospital systems sweeping up private groups left and right, and physicians becoming employed in the majority of instances, the straight salary guarantee is a hugely common payment method.  This type of payment methodology is pretty much exactly how it sounds- the physician is guaranteed an annual salary of a certain amount, and such total salary is paid to the physician in accordance with the employer's regular payroll policy.  With this methodology, there is no incentive or bonus pay tacked on based on productivity.

Salary Guarantee + Incentive Compensation

In a payment methodology that includes a salary guarantee, plus incentive compensation, the physician is guaranteed a minimum annual base salary to be paid in accordance with the employer's payroll policies, and they are also eligible for additional compensation that can be based on a variety of factors.  Such incentive compensation can be paid on a quarterly or end of year basis, and may be based on factors such as wRVUs billed, wRVUs collected, quality incentive measures, or a variety of other factors.  When the incentive compensation is based on production, such as according to wRVUs billed or collected, the incentive compensation only kicks in once the physician has produced enough to cover his or her minimum base salary.  At that point, the methodology often calls for payment to the physician of a bonus in the amount of a certain percentage of his or her collections above the minimum guaranteed salary.  Take, as a basic example, a physician who has a minimum base annual salary of $100,000 per year, and an incentive payment of 30% of the collections the physician brings in over $100,000.  In this instance, if by the end of the fiscal year the physician has brought in collections of $200,000, he or she would have surpassed the base salary threshold, and would be paid a $30,000 bonus.

How the incentive compensation is structured exactly can vary widely depending on the specific agreement, and sometimes is dependent upon a base number of billed or collected RVUs or wRVUs, any excess of which can earn a bonus payment of $xx per RVU or wRVU billed or collected above the base amount.  Again, these are only a limited set of basic examples.

Pure Production Compensation

A third compensation methodology is one based purely on production, sometimes referred to as "eat what you kill."  This methodology is most commonly seen in private practice settings, and within those, it is mostly partners of the private practice who are compensated this way.  Under this methodology, a physician is paid a certain percentage of what he or she brings into the practice.  The remaining collections are typically paid to the practice in order to cover overhead expenses, such as real estate, malpractice insurance, support personnel, equipment, and supplies.

In this scenario, as well as the Salary Guarantee + Incentive Compensation methodology, the details of your employment or partnershipagreement are critical. Differentiation in single words can make an enormous difference in the compensation you end up being paid.  Therefore, it is highly recommended that you obtain a detailed legal review of your physician employment agreement to ensure that you are receiving the terms most favorable to you.

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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.

Factors to Consider in Choosing Potential Employment Locations

As physicians begin their job search, or as they narrow in on accepting an employment contract, there are a variety of factors that should be considered in order to reach a decision that will help increase your chances of a long-lasting career.  While certain features such as the practice setting, compensation, and benefits are all important, it is also worth emphasizing the less-obvious aspects of various locales that could have a major impact. One geographic feature that is often ignored or disregarded in the face of more glamorous perks is the cost of living in a particular city or region.  It is easy to be impressed by the dazzling night life and art scene offered in a city like New York; but if you chose Denver, Colorado instead, you could maintain the same lifestyle for about 54% of your New York income. Specifically, it would only cost you about $46,000 per year to live your life in Denver; but for that same lifestyle in New York, it'll cost you $100,000.  The general cost of living, of course, takes into account the cost of housing, but when you look at the cost of housing specifically, the cost savings of living in smaller metro area can be even more dramatic than the general New York/Denver example.

A second important feature to consider in your physician job search is how progressive are the different states in their medical malpractice laws?  Being named in a lawsuit is not something any physician ever wants to think about, but the hard reality is that by the later stage of their careers, roughly 61% of physicians have been sued.  With those odds, it makes a lot of sense to consider how much a state's medical malpractice laws may help or hurt you in that scenario.  For instance, some states, have placed award caps on medical malpractice lawsuits to disincentivize patients from bringing the lawsuit to begin with.  Others have shorter statutes of limitations, shrinking the amount of years within which a patient can decide to bring a law suit.  On the other hand, some states have famously high malpractice premium rates, making those states considerably less attractive.

Other factors may be more important to certain physicians, while of little or no consequence to others.  For physicians who have a family, which cities are known for impeccable public schools? For the golfers out there, which areas have the highest number of quality courses close to work? What is the climate like in the regions you're considering? A higher average of sunny days could make work a lot more enjoyable (I'm assuming, perhaps incorrectly, of course, that you start work late enough, or end work earlier enough to see the sun at all).  If you'll be living away from your extended family, which cities have direct flights that can easily connect you for holidays?

While some of these factors may seem silly or elementary, when all considered together, they can make a significant impact on how much you enjoy the job and life you end up choosing.  When it comes to selecting from many different areas of the country, carefully consider all of the small things as much as the bigger ones.

Click here to read about the best and worst places for physicians to practice.

The Physician Job Search: Keys to a Successful Process

When physicians are in residency and fellowship training, and that final year starts to creep up on them, their minds start reeling about the task ahead: finding that perfect job.  It can be daunting knowing that this process is going to take up much of your free time (to the extent you have any to begin with), and knowing that the employers have done this thousands of times, and you’re just learning about the job search process.  It’s easy to feel like you will end up with the short end of the stick. In embarking on the job search process, keeping a few simple tips in mind can go a long way.  First, it is crucial that you have a firm grasp on what is important to you in your next job.  For many physicians, the market can be flexible and may include great perks.  But you can’t take advantage of those perks if you don’t have a thorough understanding of what aspects of an employment arrangement are most important to you.  Second, it is important to realize the power of obtaining more than one job offer.  By locking down at least 2 contracts, you can gain enormous leverage, and you will be able to clearly see what the market has to offer.  Third, you have to guard your legal interests.   The employers have attorneys hard at work making sure they operate within their budget and with an acceptable amount of legal risk, and so should you. Finally, you must delve into the specifics of a potential employer to gain a close understanding of any hidden concerns.  The last thing you want to do after completing your training is walk into a practice or hospital department that is suffering under failed leadership or struggling financials.

With the help of a physician agent who you can rely on throughout the process, your job search doesn't have to be daunting or burdensome.  An agent can take care of all the tedious legwork for you.  To learn more, visit www.lauthoneill.com.

Physician Employment Contract Tip #3: Get It In Writing

Remember that scene from Jerry McGuire when the star football recruit's dad shook Jerry's hand, promising that his son was Jerry's newest client, and refused to sign a written contract because his word was "stronger than oak"?  While that sentiment was charming, we all know Jerry suffered a major lapse in judgment in letting that one go. It's common for dealmakers to talk a good game, and even though they may not be doing so maliciously, or with any harmful intent, it's just that it's easier to make verbal promises, than to go through the hassle of putting it on paper.  In the world of physician employment contract negotiations, this is also a common occurrence.  Many physicians will find themselves assured by the word of a potential employer that certain benefits will, in fact, be given in an employment arrangement.  However, when you go to read the contract, there's no trace of those 5 extra vacation days that you were promised. The employer may have sworn up and down that those 5 extra days were a shoe-in, but unless it's spelled out in your physician employment contract, you can't count on it.

Another alarming example is when a term may even be in writing, but it's inconsistent.  For instance, what if your salary is written in the contract to be "Two Hundred Thousand Dollars ($150,000)."  What if the employer told you in an interview that the salary is $200,000, but now there is an inconsistency in the actual agreement? Which version of this number is controlling?

Examples such as these make it easy to see the importance of physician employment contract legal reviews.  You must be certain that every feature you have come to expect from your physician employment arrangement is set out in writing, so that if push ever comes to shove, you have a signed, written agreement, with the terms you want clearly spelled out.

Physician Recruitment Agreements: Free Money?

When a private practice wants to hire a new physician, but they don't have the capital to pay the new physician's salary on their own, they often partner with a hospital to fund the deal.  The physicians, who are many times straight out of residency or fellowship, are often told of the recruitment agreement, "it's like free money."  Well, not exactly. While physician recruitment agreements often work out for all parties involved, there are some instances where the ending is not so happy.  Along with the various legal concerns that come with physician recruitment agreements - key among them being meeting the applicable Stark law exception requirements - there are also very serious considerations that physicians must take into account that have the potential to spiral into disaster.  First, the recruitment agreement will provide that the hospital will offer "support" in the form of a monthly salary guarantee to the new physician, and in exchange, the physician agrees to remain practicing in the community for a specified length of time- the "forgiveness period."  As the specified length of time passes, the amount of money the hospital has loaned in the form of the salary guarantee will be incrementally forgiven. The ratio of the "support period" to the "forgiveness period" typically ranges anywhere between 1 support year in exchange for 1 forgiveness year, and 1 support year in exchange for 3 forgiveness years.  Point being, when physicians accept a recruitment agreement, they must be prepared to stick around and practice in the community if they are not otherwise able to pay off the amounts they have borrowed from the hospital.  This can be a gamble, as physicians may be recruited to a community that does not have the volume of patients needed to support the addition of the new physician.  In these cases, physicians can end up "upside down" in their recruitment agreements, where they cannot afford to stay in the community following their support period, and are forced to move elsewhere to find business, and therefore are stuck with a hefty loan to pay back.

For this reason, among others, it is also important for recruited physicians to carefully consider what amount of salary is reasonable for them to accept from the hospital each month; in other words, physicians must be reasonable in calculating what you are able to live on each month, and don't overdo it.  The more you accept from the hospital, the more you will potentially be liable for following the support period if for any reason you are not able to continue practicing in the community.

Above all, it is essential that you have a physician contract lawyer review your physician recruitment agreement and your accompanying physician employment contract, as various regulatory requirements must be met.  Beyond that, because physician recruitment agreements carry some amount of risk, recruited physicians should carefully select a physician contract attorney who practices in this area regularly and who can adequately protect your interests.

Physician Contract Negotiation Tip #2: Know What You Want Out of Your Job

Many physicians, especially those fresh out of training, are hasty about accepting the first job offer that comes their way because they have enormous student loans to pay off, and they haven't yet endured a horrific employment experience that has taught them to tread carefully into any given employment arrangement.  After all, when you're out there looking for your first job, the potential employers are great salespeople- reassuring you that your wants and needs will be met. It's hard to make sure your wants and needs are going to be met when you're unsure about what they are exactly.  It is not uncommon for young physicians to feel that they don't have much wiggle room in terms of defining their employment arrangement.  To most, it seems as though you should just take what is offered, and don't rock the boat.  It is hard to know what you truly want from your employment when you've never been asked to define your ideal job.

But as a newly practicing physician, you have many more options than you think, and so it's important that you carefully consider what aspects of your employment are most important to you.  Maybe you have hundreds of thousands of dollars of student loans to pay off, so the highest salary possible, or even employer-funded repayment of the loans, is most important to you.  Or maybe you're into research, and so funding for your research work, and maybe even having one research day per week are important to you.  Or maybe you have a family, or want to have one soon, so a more flexible schedule is paramount to whatever salary is offered.  With employers growing more and more progressive in terms of flexible employment arrangements, it is important for physicians in their job search to carefully craft what their ideal employment opportunity will look like.  Knowing this crucial information up front will save you and your potential employer time and money down the road by ensuring that you will be happy in your employment arrangement, thereby limiting the possibility of needing to change jobs later.

Working with a physician agent in your job search process helps ensure that you have vetted all potential opportunities, and especially ensures that the employment arrangement you accept has been carefully shaped and molded to meet your needs and secure your financial and legal interests.  Contact Lauth O'Neill Physician Agency today to see how we can provide you valuable services, without you paying a dime until you start getting paid.  317-989-4833 or loneill@lauthoneill.com.

Physician Job Search: How to Make Sure You're Not Missing A Better Offer

Many physicians who are nearing the end of their job search and are ready to sign a contract, often worry that they may be missing a better offer.  Maybe they have an offer in hand, but they only looked for jobs in one market, or they only paid attention to the job offer that came to them without having to go out and look.  After all, it is nice to be wanted, and who wants to rock the boat by continuing to look around when a perfectly good offer is sitting right here?

This is a classic mistake that is often made- undervaluing your worth, and then stopping at one offer when there are countless other offers that may be better suited for you.  The real mistake comes, however, in failing to orchestrate your job search such that this type of doubt remains.  Hiring a physician agent to complete your job search for you will ensure that your specific needs and desires in a job search are accounted for and are used in shaping your ideal employment arrangement.  Physicians have plenty to worry about with their patients and other professional responsibilities- it doesn't make sense to add the additional worry that comes with tackling your job search on your own.  Lauth O'Neill Physician Agency specializes in determining the employment arrangements that suit your needs, and marketing your interest and qualifications to potential employers.  Your physician agent can ensure that all viable employment options are explored, and that your employment offers are structured to meet your needs and protect your interests.  A physician job search that is tailored to your every expectation will allow you to rest easy, knowing that you have found the physician employment agreement that is right for you to sign.

Physician Employment Contract Negotiation Tip #1: Know What You're Worth

If you're finishing up residency or fellowship, you've spent the last 4, 5, 6, 7, maybe even 8 years being paid about 18 cents per hour. Now you're out there looking for your first "real" job. So when someone comes along and offers you a 6-figure salary, it's tempting to accept it, no matter how unfair the offer actually is. Unfortunately, some employers are anxious to take advantage of young physicians who are desperate to take any job that will help them begin to pay off their enormous student loans. So many times young physicians wind up accepting compensation under their physician employment agreement that is not up to par with market standards. After all, it's hard to know what the market standard is when you don't have access to national physician compensation benchmark data. That is where a physician agent can help you. In providing our Premier Opportunity service to our clients, Lauth O'Neill utilizes our access to the MGMA and other important surveys to ensure that our clients receive the compensation and benefits they deserve. Before you accept a physician employment contract offer, be sure someone is looking out for your financial and legal interests.