Physician Compensation Concern: How Do You Know If Your Job Offer is Fair?

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A common fear we hear from our physician clients is: "I don't want to sound greedy, but do you think this employer has offered me a fair compensation structure? Are they offering me enough?" It's human nature- we want to be paid fairly for what we do, and we also don't want to be perceived as asking for too much. So how do you strike the right balance when it comes to negotiating the dollars and cents in your physician employment agreement?

It all starts with knowing what the market is paying someone like you. Are you in the Midwest? On one of the coasts? A metropolitan or rural area? There are a lot of factors that play into what an employer is willing to offer you, and what they legally can offer you. As physician agents and attorneys, we specialize in offering this type of insight to our clients. We review the Medical Group Management Association's physician compensation survey and tell you whether we think your job offer is fair.

While we offer this compensation analysis as part of our Analyze and Shape contract review service, some clients have already weeded through much of their agreement, and only want insight on the compensation piece. So we are happy to offer that as well. For a low flat fee, we can provide our analysis on just the compensation figures that have been offered to you, and how they relate to the market where you will be practicing. Call us today to find out more: 317-989-4833; or email Leigh Ann O'Neill at 317-989-4833.

Listen to our first Podcast, with @docofalltradez!

Not too long ago we were approached by @Docofalltradez, an anesthesiologist who not only cares for his patients, but in his spare time, educates physicians about avoiding burnout and protecting yourself financially. We were thrilled to join him to record our very first podcast, where we discussed a variety of topics, ranging from physician job searching, to physician contract review and negotiation, to what it means to have a physician agent working on your side. You can listen to the podcast, Surviving Surgery, by clicking here, and if you have ideas of additional topics you'd like to hear about, please leave a comment with your requests! We look forward to recording additional podcasts in the future!

As always, if you would like to learn more about our physician job search, physician contract review and negotiation services, please call Leigh Ann O'Neill at 317-989-4833 or email her at loneill@lauthoneill.com.

Me vs. My Employer – Why Do I Need an Attorney?

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            For physicians, no matter what your specialty, the road leading to employment is longer than that of any other profession. Beyond your formal education, there are multiple years of arduous and grueling training. It is no surprise that once it finally becomes time for physicians to accept an employment offer, they are incredibly eager to do so. This eagerness often translates into hastiness and a desire to simply “seal the deal” as quickly as possible. As a result, physicians regularly accept the first offer that they receive, and do not seek legal guidance concerning their employment contracts.

This sentiment is entirely understandable – not only are you eager to start working (i.e. start getting paid), relationships with potential employers are often very friendly, with both parties expressing a great deal of optimism. Therefore, many physicians have a mindset of believing that the employer has their best interests at heart and do not feel it necessary to seek counsel. While it wouldn’t be fair to say that potential employers don’t have your best interests at heart, it is more important and accurate to realize that an employer’s first priority is always the employer – no question about it. Unsurprisingly, the employment contract that is offered to you will have been drafted by an attorney who represents the employer, and therefore will most certainly be drafted in a way to be most favorable to the employer. Therefore, it is of paramount importance to ensure not only that you are adequately protected, but also that you are receiving a fair bargain. The importance of counsel is even more heightened by the fact that physician employment agreements are long, convoluted documents containing a great deal of sophisticated legal terms and phrases. This fact alone begs the question: how can physicians be expected to sign a contract that they may not even fully understand?

Seeking the legal guidance of an attorney experienced in physician employment issues can have lasting and significant effects for both your career and your personal life. As attorney-agents working exclusively for physicians and other health care providers, we have the experience and knowledge necessary to not only shape your agreement into its most favorable form, but also to advise you in terms of all of the aspects that will most certainly affect your personal life and that of your family.    To sum it up, this series of blog posts will highlight our Top 10 Reasons Why Physicians Should Seek Legal Review of Their Employment Agreements:

1. Due Diligence and Responsibility. Physicians are intelligent people – no one doubts that. The only problem is that your education and training has always been geared toward specific areas and skill-sets that do not include any business or legal acumen. It is safe to say that you have never taken a legal course or received any sort of education regarding contracts or employment law – and why would you?             One of the best markers of intelligence and sophistication is the skill of delegation, which requires the knowledge of when to utilize outside resources. Consider all of the aspects of life that require knowledge and skills outside of the average person’s wheelhouse. Buying a house - purchasing insurance - filing your taxes – investing money. These are all things you would not do on your own, but rather seek professionals to guide you. So why would you sign a contract without seeking the same sort of guidance? Especially when the contract is one that has the power to dictate the course of your career and also the operation of your day-to-day life. Therefore, the wisdom to seek the guidance of those with the appropriate knowledge and experience not only showcases a person’s good judgment, it also highlights a very respectable level of care and attention to detail. Remember that no man is an island and there is no prize for those who insist on “going it alone.”
2. Unbiased and Informed Insight. More often than not, individuals (and particularly physicians) are shy and hesitant to really dictate their worth and make demands on their own behalf. Part of this is related to natural humility and not wanting to brag or make haughty declarations. If you ask someone to make a list of her own best qualities, that list may not be extensive. Alternatively, if you ask that person’s friends and family to make the same list, it would likely showcase a lengthy, comprehensive, and wide-ranging documentation of everything that distinguishes her from others. Aside from this tendency toward an overly modest outlook, there is also the fact that physicians, especially those coming right out of training, do not have experience in employment matters and therefore simply are not informed as to what they are worth and what they should be asking for. When we work as attorney agents on behalf of our physician clients, we are in a position to highlight all of our client’s values, traits, and unique characteristics accurately and without bias or shame. Further, based on our considerable experience, we are able to make fair, reasonable, and justifiable requests in order to get our client the best possible deal.      

Stay tuned for the continuation of our Top 10 Reasons Why Physicians Should Seek Legal Review of Their Employment Agreements!

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Miller Review 2016

The Lauth O'Neill Physician Agency team is thrilled and honored to be invited back this year to The Miller Review Course.  On Thursday May 26th at 6:45 pm, we will offer an educational session on physician job searching and contract review and negotiations. The Miller Review Course prepares orthopaedic surgery residents and attendings for Part I of the ABOS exam. This year the course will be offered at the Sheraton in downtown Denver, CO. We had a fantastic time last year meeting with the attendees and answering the many questions that become so pressing at this stage in an orthopedic surgeon's career. We look forward to making great connections again this year and providing insight on the various steps in this important process.

For more information on the session we are offering, click here. To read more about the Miller Review Course, click here.

New this year at Miller Review! For physicians who are preparing for their Oral Boards, the Miller Review has added its MRC Part II course to prepare physicians for the ABOS Part II Oral Case Examination.

Physician Employment Benefits – What Will Be Offered, and What Questions Should You Ask?

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When physicians consider a job offer – whether it’s with a hospital or private practice – there are important considerations to keep in mind in terms of the various benefits being offered. Having reviewed and analyzed hundreds of physician employment agreements, the attorney agents of Lauth O’Neill are well-positioned to offer some guidance on this issue.

This series of blog posts will break this issue into two separate parts. First, we will outline the benefits that are typically offered to physicians pursuant to their employment contracts. Then, in next week’s post, we will address the questions that you should be asking about the benefits you have been offered, and offer some insight as to current market norms.

These issues are critical to ensuring that you and your family’s needs are adequately covered, so make sure you stay tuned to learn more about physician benefits! And of course, if you would like the assistance of an attorney agent to review and analyze your employment agreement, contact us today.

 What benefits are typically offered?

While no two physician employment agreements are the same, and you should have independent counsel advise you on your agreement, there are some generalities as to the benefits routinely offered to physicians. Below is a breakdown of those benefits categories, and the manner in which they might be offered:

1. Insurance; Health, Disability, Life and Malpractice.
   1. Health Insurance. The specifics of health insurance coverage are almost never provided in employment contracts. Rather, contracts often will include a blanket statement along these lines: “Physician shall be eligible for health insurance coverage provided to similarly employed physicians.” Also, information concerning health insurance is sometimes included in a policy completely separate from the employment contract.
   2. Disability Insurance. Disability insurance is extremely important for physicians because your livelihood is wholly dependent on being fully functional and practicing to your utmost capability. The most commonly offered coverage is group term disability insurance (either “long term” or “short term”). Again, details concerning the coverage are almost never included in employment contracts. Instead, the contract might merely state that the “Physician will be covered on the same basis and in the same amount of coverage as provided for other physician employees.”
   3. Life Insurance. Life insurance comes in a variety of types, shapes and sizes. Once again, employment contracts will usually merely mention something along the lines of: “Life insurance will be offered to physician on the same terms as provided to other physician employees.” Life insurance offered through employment almost certainly will be “Group Term Life Insurance,” which only covers a set number of years with fixed-rate premiums. The amount of coverage varies, but generally is in the range of $250,000 - $500,000.
   4. Malpractice Insurance. Perhaps the most important insurance coverage for physicians, malpractice insurance covers acts and omissions that lead to claims being brought against the physician. Malpractice coverage will either be “claims-made” or “occurrence-based.” Claims-made coverage only covers acts and omissions for which claims are brought during the term of a physician’s employment agreement. Because claims could be brought after the physician has left that employment, it is necessary to obtain “tail coverage” or “extended reporting coverage” following the employment term. Occurrence-based coverage covers acts and omissions, regardless of when the claim is brought, so long as the incident giving rise to the claim occurred during the term of employment. No tail coverage is required with occurrence-based coverage.

2. Vacation and PTO. The amount of vacation and/or sick days that a physician may take is usually set out in the employment agreement. More often than not, allowable vacation days may not “roll over” into subsequent years. Vacation days offered may or may not include additional time that is specifically designated for attending Continuing Medical Education events.

3. CME Expenses and Professional Dues. Attending CME events can be extremely costly for physicians. Travel and lodging is often required, as well as the purchase of relevant materials. Additionally, physicians are often expected (or required) to maintain memberships with professional organizations and subscribe to professional journals. Employment agreements often provide an annual reimbursement rate to compensate physicians for these expenses. If a physician is required to become board certified in his/her specialty, the agreement also might offer additional reimbursement for the costs associated with becoming board certified.

4. Retirement. Employers offer a variety of retirement plans, including but not limited to the following types: 401k, pension, tax deferred annuity, or profit sharing plan. Employment contracts will generally merely name the type of retirement plan in place, and provide that the physician will be eligible to participate in the plan currently offered to physician employees.

5. Relocation Expenses. More and more, physicians are accepting employment positions in areas outside of where they received their training. If a physician (and his/her family) needs to relocate for a job, the employment contract will usually offer reimbursement for the moving expenses. While some employers will outline a strict process and require that the physicians use preferred vendors, almost all employers will at least require the physician to retain all receipts and documentation in order to be reimbursed. Relocation expense reimbursement can range from $5,000 -$15,000.

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Private Practice or Hospital Employment?

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As many physicians are entering their final year in training, they're also beginning the job search process.  For some, the opportunity to be employed by a hospital seems immediately attractive due to the typically higher starting salaries and impressive benefits packages. After all, once training is over, your student loan payments are no longer deferrable, so the extra income is highly beneficial.  But then there is always the lingering possibility that going into the private practice setting may be more financially beneficial in the long run.  On this point, a survey taken by Webmd.com collected interesting statistics: "In this year's survey, most doctors (63%) are employed and make significantly less than the 32% of their colleagues who are in private practice. According to a major physician recruiter, 11% of doctors were employed by hospitals in 2004, and this rose to 64% in 2014."

With the rate of physician employment raising at an almost startling pace, it has become more and more common for physicians to be perfectly happy with hospital employment. The jobs seem to carry less risk than entering private practice, they typically are more straight-forward in terms of contracting, and they ensure an abundance of resources that will be available to the employed physician.  However, the benefits of private practice have not lost their appeal, as these opportunities often include the possibility of partnership within a few years of joining the private group, and with partnership comes additional money-making opportunities like earning ancillary income, and buying into lucrative facilities.  In other words, both paths have their benefits, and putting yourself in a position to fully understand the pros and cons of all options will lead to greater job satisfaction in the future.

For more information on how a physician agent can assist you through your job search, and ensure that all of your options have been explored, contact Leigh Ann O'Neill today at 317-989-4833 or loneill@lauthoneill.com.

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5 Tips for Your Physician Job Search

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The light at the end of the training tunnel is now in clear view for many residents about to finish their post-graduate training. And while many of you have a fellowship ahead, now is the perfect time to begin your job search. Even if your fellowship will last longer than one year, it is never too early to begin organizing your job search. Here are a few helpful tips:

1. Understand clearly what you're looking for in terms of the type of practice you want to have, and the type of city in which you want to live. Make sure you consider all angles of your next move, and what aspects of your new life will hold the greatest importance. This means understanding not only the lifestyle points that are critical to you and your family, but also the day-to-day operational characteristics of your ideal job.
2. Know what you're worth in different geographic regions, and how pay differences might be offset by cost of living differences. If you're able to access the Medical Group Management Association's Physician Compensation Data, you can easily see how different areas of the country compensate all different types of physicians. Using this information together with cost of living data in different cities can give you a good understanding of what each dollar you earn will get you when you go to buy a house, spend money on groceries, etc.
3. Also keep in mind the fact that it's simply cheaper to practice medicine in certain states than in others. This isn't necessarily due to the fact that some cities have lower costs of living, but because the state has laws that favor physicians, especially in times when things have gone wrong. Some states have medical malpractice damage caps or patient compensation funds that assist physicians in paying damages that have been awarded to a patient in a medical malpractice lawsuit. Also, some states have more favorable non-compete laws, which allow physicians who are displeased with their current job to practice more freely in the same or nearby market without having to bear the pain and expense of a move to a new city or state.
4. Organize your outreach efforts! If you're going to embark on a thorough and comprehensive job search, you will need to do your homework - a lot of it. Not only do you have to research all potential employers that meet your ideal opportunity criteria, but you also need to have your marketing efforts in order. This means perfecting your CV, drafting strategic and effective cover letters, and knowing all targets in potential employers.
5. Don't be afraid to ask for help! This might be the most important tip we offer (if even a bit self-serving, we admit), but it is true. The physician job search process is a long and time-consuming one. So if you have the opportunity to work with an expert in physician job searching, that might be the right way for you and your family to approach this process. Physician agents are able to complete many burdensome job search tasks on your behalf, not to mention putting their expertise to work to make sure no stone goes left unturned.

For more information on the physician job search process, and how the physician agents of Lauth O'Neill Physician Agency can help, call Leigh Ann O'Neill at 317-989-4833 or email at loneill@lauthoneill.com.

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MGMA Offers Helpful Interview Tips from the Employer Side

Today the Medical Group Management Association ("MGMA") published an article targeting practice administrators and offering helpful tips on interviewing physician employee candidates and creating structured job descriptions.  While this article was meant for the benefit of practice administrators, it is a helpful tool for physicians who are embarking on their job search as well. What could be more helpful before an interview than taking a peek inside the mind of the interviewer? The MGMA article discusses how it is most beneficial for the employer to allow the interviewee to do most of the talking, thereby giving the interviewer plenty of insight on the physician candidate's background, mentality, attitude, and personality. Keeping this in mind, physician candidates should take advantage of the opportunity while they're interviewing to show the employer why they would be the best fit for the job. Do not be afraid to showcase your strengths, which will help the interviewer see the ways in which your unique abilities can serve their organization.

Additionally, it may be helpful to review the list of sample interview questions that the MGMA article sets forth as recommended questions to be asked by the interviewing employer. Given the reach of the MGMA to their practice administrator audience, and the common sense nature of the sample questions, it is very likely that physician candidates will come across these very questions as they interview for their next job.

Miller Review, Here We Come!

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We are thrilled to offer an educational session on physician job searching and physician employment contract review at the upcoming Miller Review Course in Westminster, CO on Wednesday May 20th at 6:30pm.  All Miller Review attendees are welcome! We will be discussing young physicians' most pressing questions:

• What is the greatest misconception about physician contracts?
• How do you keep from missing that perfect job?
• What's the best way to market yourself and stand out from the competition?
• How do you negotiate a competitive compensation package?
• What are the invisible benefits you can ask for?
• Is there a way to calculate the long term financial impact of your contract?

If you will be attending the Miller Review Course this year and would like to attend our session, please RSVP here. And if you will not be attending Miller Review, but are involved in a different Boards review course or residency program, and would like a similar educational session offered to your participants, contact Leigh Ann O'Neill to set up a dynamic course offering that will leave your participants well-versed in the physician job search and contract review processes. Contact Leigh Ann today at 317-989-4833 or loneill@lauthoneill.com.

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Welcome, New Lauth O'Neill Team Member Laura Lauth!

Lauth O'Neill Physician Agency is thrilled to announce that attorney and physician agent Laura Lauth has joined our team! Laura provides thoughtful and careful guidance to her physician clients, as she strives to ensure their best interests are protected, and they find the job of their dreams.  Laura graduated from the University of Miami School of Law in 2013, and is licensed in Indiana and Illinois. Contact Laura today with your physician job search and contract review needs: 317-979-0081, lklauth@lauthoneill.com.

New Blog Series: Breaking Down Physician Compensation

 

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Today we begin a new blog series focusing on physician employment compensation.  In this 4-part series, we will examine the different types of compensation typically offered to physicians, and what each method really means to you as the practicing physician.  In this first installment, we are looking at different compensation models, and how they typically work.

When a physician employment contract is offered, physicians often first look for 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

What was once one of the most common physician compensation methodologies, but is becoming less common today, 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 still a fairly 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 additional incentive or "bonus" pay 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 monthly, quarterly, or end-of-year basis, and may be based on factors such as wRVUs billed, wRVUs collected, quality incentive measures, total collections, 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 per-wRVU amount, or in an amount of a certain percentage of his or her collections above the minimum guaranteed salary.

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 an incentive payment of $xx per RVU or wRVU billed or collected above the base amount.

PURE PRODUCTION COMPENSATION

A third compensation methodology is one based purely on production.  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 partnership agreement 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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Physician Contract Review Tips: Outside Activities Income

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In this installment in our Physician Contract Review Tips Series, we are addressing a type of provision that is included in nearly all physician employment contracts: the ability of the physician employee to participate in income-generating activities outside of the employment arrangement. This type of provision is important to those physicians who may wish to engage in activities such as, but not limited to, consulting, research, teaching, speaking, and even expert testimony outside of their employment agreement (hereinafter, "Outside Activities").  In the minority of physician employment agreements, this issue will go unmentioned, which may leave the physician employee open to participating in such Outside Activities.  However, in the majority of physician employment contracts, there will be a provision that limits the physician employee in one way or another.  In some cases, the agreement will stipulate that the physician cannot participate in any Outside Activities without the prior written consent of the employer.  Additionally, the provision may state that any income earned from Outside Activities, unless otherwise prior agreed to, will become the property of the employer.  In other instances, physician employment agreements will flatly prohibit the physician employee from participating in any Outside Activities whatsoever. Finally, in a third of various other possible scenarios, the physician employment contract might state that the physician employee may participate in certain Outside Activities, but all income earned by the Physician must be turned over to the employer.

As with nearly all physician employment contract provisions, the language addressing participation in and income earned from Outside Activities is typically negotiable. In some cases, we are able to narrow the restrictions initially set out in the agreement, or can carve out certain activities our client is interested in pursuing. Of course we always aim to amend agreements such that our clients can keep for themselves any income they earn.

For more information on how we can assist you with your physician job search or contract review, please call Leigh Ann at 317-989-4833 or email at loneill@lauthoneill.com.

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Physician Employment: Timing Your Job Search

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The fall is an exciting time for physicians in training- for many in their last year of residency or fellowship, this is the time to begin the all-important job search! While some physicians may already have their first job locked down, for many, the job search process is just getting started. With the end of the calendar year right around the corner, potential employers have their budget for next year and their unmet clinical needs at the top of their minds. This makes it the perfect time for physicians to network and send out their cover letter and CV.

In an age of recruiters contacting physicians day and night, it is easy to loose sight of the need to take control of your own physician job search. Many physicians in training rely on word of mouth regarding what positions are opening up, and on getting offers for interviews from recruiters. It is important to remember that a comprehensive job search includes not only considering the job openings that come to you by way of recruiters and your colleagues, but also includes diving out into the large expanse of potential employers and finding what else might be available. Many times physicians end up taking a job that was brought to them, rather than going and seeking out what may end up being a much better match. While time consuming, a comprehensive job search will help lessen the dreaded outcome of unhappiness in your first job, and needing to do it all over again within just a few short years.

For information on how a physician agent can make your job search efficient and comprehensive, while also adding tremendous value from all angles, please visit our Premier Opportunity page to learn about our services, or contact Leigh Ann O'Neill at loneill@lauthoneill.com or 317-989-4833.

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Physician Contract Negotiation: It Can't Hurt to Ask. Or Can It?

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One of the questions I often hear from physician clients as they are navigating the negotiation process is, "should I really ask for any changes to my contract? Couldn't that backfire?"  The answer, of course, depends on who you are dealing with, and the report you share with your potential employer.  Most often we find that in candid and pleasant contract negotiations, where the physician is being reasonable in his or her requests, the response to those requests is very positive. Most sophisticated employers understand that when a physician hires an attorney to review their employment agreement, they are doing so in order to protect their best interests, which is exactly what the employer did when they drafted the employment agreement.  The same employer typically understands the physician's point of view, and appreciates the ways in which physicians try to protect themselves.

As an attorney for physicians who are negotiating their employment agreement, I see this scenario play out all the time.  I routinely make various recommendations to my clients as to how their employment offer(s) can be strengthened in their favor, and my clients often wonder what the consequences might be of asking for some or all of the suggested changes.  I always advise clients that when you go back to an employer with requests for changes, you are technically making a counter offer, which the employer is free to reject; however, with the right tone and candor, such requests can be successfully requested without jeopardizing the employment offer.  And in most cases, the employer is anxious to work together with the physician to find a reasonable contract term with which both parties are happy. So in answer to this post's question: No, it typically does not hurt to ask for certain changes to be made to your physician employment agreement.  When done properly, pleasantly, and with reasonable expectations, physician contract negotiations can often result in a contract that is more favorable to the physician than what was originally offered.

For more information on physician employment contract negotiations, please contact Leigh Ann O'Neill at loneill@lauthoneill.com or 317-989-4833.

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Physician Contract Review Time!

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With much of the medical community operating on a fiscal year that begins in less than two weeks, many physicians are about to begin a brand new job. Many times when an employer offers a physician a job, the employer will actually suggest that the physician have their contract reviewed by an attorney. Even so, many physicians wonder if paying an attorney to review their agreement is really worth the cost.  I am often asked whether employers really make changes to their employment agreements? Do the employers ever increase the physician's compensation? Does the verbiage in the contract really make a difference? The answers to these questions depends, of course, on the particular circumstances at hand. I always tell clients that one of the most valuable aspects of having their contract reviewed by a lawyer is that the client learns exactly what is expected of them, and what the consequences will be if the physician ever leaves the employment relationship. And with regard to having changes made to the contract terms, compensation, and benefits, some employers will make significant changes on all fronts, while others will limit the changes they are willing to make to only certain areas of the agreement. The moral of this story is that physician employment contracts always include legal terms that can have significant consequences to the physician employee, and many times, employers are ready and willing to make changes to agreements that favor the physician employee. For these reasons, it is always a good idea to have your physician employment agreement reviewed by a lawyer before you sign on the dotted line.

For more information on how a physician contract review may benefit you, please contact Leigh Ann O'Neill at 317-989-4833 or laloneill@me.com.

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Physician Job Searching: Feeling Overwhelmed?

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With the end of the medical fiscal year drawing to a close in about 2-3 months (depending on your specialty), the enormous task of finding and locking in the right job can seem overwhelming, especially when you consider all of the steps involved in doing a thorough job search (oh, and what about that little thing called "Boards" coming up?). Having a job search partner, who is paid to look out for your best interests, can make this process not only much more manageable, but maybe even enjoyable? At least that is my goal! As a physician agent, I do all that I can on my clients' behalf, so they can enjoy whatever free time they might have left after the long days and nights at work. Everything from fine-tuning your CV, to writing your cover letters, to looking up contact names and addresses for prospective employers- it's all covered in our Premier Opportunity service.  Also included in this concierge-style service, is a full legal review of all offers your receive, including compensation analysis, negotiation coaching and assistance, and a full practice evaluation profile.

The physician job search process is tedious, complicated, and when done thoroughly, can be enormously time-consuming. Not only do you likely not have enough free time to engage in this process in a way you owe it to yourself to do so, you gain enormous benefit and value in having a job search partner there along this road with you, taking the burden off your shoulders at every possible turn.

For more information on the services we offer, please contact Leigh Ann O'Neill at 317-989-4833 or laloneill@me.com.

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So Many Agreements- What Do They All Mean?

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It's that time of year for physicians coming out of training- contract signing time. And it is definitely an exciting time! However, it can also be very stressful, as the process of reviewing and signing your next employment agreement can be complicated, time-consuming, and tenuous. One issue that often comes as a surprise to many young physicians, is that the contracting process can be very far from straightforward. In some instances, there isn't just one contract to worry about, but instead there may be two. And they can come in all different forms, and under all different names. For example, you may be offered a traditional "Employment Agreement," or perhaps an employer sends you a "Letter of Agreement;" there may be a "Recruitment Agreement" or "Relocation Agreement" involved- and what do each of these do exactly, what do they mean? Of course the true answer is completely dependent on the actual agreements you are offered, and I highly encourage you to seek your own legal counsel, as only your own attorney can provide you a professional opinion on the agreements you are offered. But here are some general guidelines to keep in mind.

First, as suggested, the name or heading at the top of a given agreement is merely that- a name or heading- it does not necessarily tell you the true nature of the agreement, or the content of the terms. Second, you may be offered one agreement that references another, and the two seem to be intertwined in some ways. This is the case when an employer offers you a job via an Employment Agreement, and then there may also be a "Recruitment Agreement" that involves a separate hospital. This is a common arrangement where a private group may want to hire you to fill a need in the community, and the group needs financial assistance from a hospital to be able to afford to pay you a guaranteed salary. Be sure to read each document offered to you very carefully, and ensure you fully understand the nature of the relationship that will be established. Make sure that if any external documents are referenced in the agreement(s) offered to you, you obtain copies of and carefully review, all of the referenced external documents. It cannot be overstated, especially in instances where multiple parties are involved, such as in recruitment arrangements, seeking independent counsel is crucial, as they stakes can be very high, and the only person truly looking out for your best interests is you.

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

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Physician Licensing Resource: Check it Out

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In follow-up to my recent post, Licensing Time is Here!, I wanted to pass along a great resource published by the team at Adventures in Medicine: their Directory of State Licensing Boards for MDs and DOs.  This publication is a great one-stop shop for physicians who will be moving to a different state to begin a new job and need to apply for their new state license. The licensing process can be lengthy, tedious, and confusing. So having a good starting place, allowing you to easily access the required documentation, is a huge help. Thanks Adventures in Medicine for sharing this great tool!

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Pay-for-Performance: Physicians, Hold on to What Brought You to Medicine

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When physicians are fresh out of medical school, they are often full of the ideals we would all love them to hold onto throughout their practicing years. Young physicians are working to reach the point where they are in a position to take care of their patients, and to improve the quality of care their patients receive. Typically, young physicians have not been faced with the annoyance of bureaucracies many employers impose, and they have not yet had to deal with the implications of costs, compensation, and overhead. Therefore, their focus remains on the patient, and the provision of the best quality care possible.

Holding onto these ideals will serve physicians well as they enter their practicing years, whether they become employed by a hospital system or join a private group practice. As we all know, health care reimbursement is rapidly changing on many fronts. Not only are physician reimbursement rates going down in many instances, new incentive programs are also springing up that allow for physician payment to be directly tied to quality of care. For instance, physicians can participate in Accountable Care Organizations ("ACOs") which are paid a percentage of the amount of money they save the Medicare program. Additionally, bundled payment programs are becoming more prevalent. Bundled payment programs set a flat rate fee for a particular procedure a patient may undergo. In both types of arrangements, physicians are obviously financially incentivized to save money and provide care more efficiently. In other words, going back to the ideals taught and widely held in medical school, focusing on the quality of care provided to patients is becoming more and more tied to the compensation physicians can expect to see in the future. As I type this sentence it even seems silly in how obvious that statement may seem; however, there is a very strong history in American health care of physicians being paid on the basis of the services they provide, rather than being paid based on how well they provide those services.

Due to the inevitable evolution into pay-for-performance health care reimbursement, it seems to me that young physicians are well-served in holding onto the ideals that drew them into medicine in the first place. Keeping this frame of mind will serve physicians particularly well as they go into their job search process and negotiate their employment contracts. Employers love to work with physicians who acknowledge that this is where health care reimbursement is heading, and that the physician is amenable to participating in the structures that are becoming more prevalent.

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NPs and PAs: Check out our Guest Post at Midlevel U!

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Thanks to Erin Tolbert for inviting us to guest post on her website, Midlevel U! We provided an article we hope will be helpful to mid-level practitioners, such as nurse practitioners and physician assistants.

Midlevel U is packed full of great content and resources for health care providers- check out their archive of blog articles, job bank, and other helpful tools for nurse practitioners and physician assistants. And enjoy!

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