Physician Employment Contracts

Once our candidates have decided they would like to move forward with one of our opportunities, the contract negotiation process begins. While many candidates believe the decision has been made and they have confirmed where they will be practicing, the contract can be the most difficult, and the most essential, part of the entire job search process.

Physician employment contracts have become increasingly complex. While candidates may initially focus on contract provisions that define income, benefits, and working conditions, they must also recognize the importance of other business-related stipulations. These include partnership requirements, termination clauses, and non-compete agreements.

The New England Journal of Medicine has provided some good suggestions and information to consdier before officially penning your name on an employment contract. While the publication offers very good advice, it is crucial you also run any contract by your own lawyer and even your accountant. As always, your recruiter can also help you with this process.

Here are some tips the article suggests:

-Ask, and answer, key questions before moving to contract negotiations.
-Strike a fair non-compete clause by obtaining pertinent information first.
-Avoid discussing compensation or other key terms before seeing a contract, even a “sample” one.
-Request practice financial documents early on in contract discussions, and beware of practices that won’t produce them.


Read the full article in the New England Journal of Medicine, or click here:

http://www.nejmjobs.org/career-resources/physician-job-contracts-update.aspx

2009 Health Spending Increase

National health spending may nearly double by 2019; 2009 saw the largest recorded one-year increase in health spending as a percentage of the economy, and it's only going up according to CMS actuaries.

A shrinking economy combined with greater public health spending in 2009 produced a 1.1% point increase in national health spending as a share of gross domestic product, the largest single-year jump since records began in 1960. This was largely because of a spike in Medicaid spending and relatively low growth in private spending. Spending on doctors is expected to reach 6.6% by 2017 as the economy recovers.

A Medicare physician payment cut scheduled to take effect March 1 would significantly impact spending on doctors, according to the report. Under the cuts, total spending on physicians and clinics would increase by 1.5% in 2010. If prevented, such spending would increase by 4.1%.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/02/15/gvsf0218.htm

Physician Practices: Competing in the Marketplace

Our firm works with many private practices, and even several solo practices looking to add one other physician. The American Medical Association provides strong tools and resources to add the most value and profit to any practice, particularly smaller practice models.

"Competing in the Marketplace" provides a practical and pragmatic overview of the integration options- ranging from mergers to a wide variety of other contractual arrangements. Running a small or solo practice can prove extremely financially rewarding if operated correctly, however many changes in the marketplace have placed sever financial strains on physicians that can only be addressed by some form of integration.

To help physicians choose for themselves a level of integration that makes sense given their specific goals, the AMA identifies many of the benefits and drawbacks of several integration arrangements in the attached resource.

Please read the full article in AMA, or click here:
http://www.ama-assn.org/ama1/pub/upload/mm/368/competing-in-market.pdf

Physician Survey: How Recession has Affected Practices, Shortage in Primary Care Physicians

About 9,000 primary care physicians nationwide are being surveyed to examine work force matters, medical homes, and other practice issues. One goal is to help determine whether there are enough primary care physicians to tend to the nation's needs, especially if insurance coverage is extended to more people in a reformed health system.

Questions on the four-page survey include asking whether physicians plan to work longer hours or hire more staff if they experience an influx of new patients. The survey also is assessing physicians' readiness to establish patient-centered medical homes, asking if electronic medical records or disease registries are part of their practice.

Primary care physicians and subspecialists in pediatrics and internal medicine received the surveys, Salsberg said. Collaborating on the effort with the AAMC are the American Medical Association, American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, and American Assn. of Colleges of Osteopathic Medicine.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/02/08/prsd0210.htm

New U.S. Medical Schools to Open

Medical school applications are hitting an all-time high. The proliferation of new schools is also a market response to a rare convergence of forces: a growing population; the aging of the health-conscious baby-boom generation; the impending retirement of, by some counts, as many as a third of current doctors; and the expectation that, the present political climate notwithstanding, changes in health care policy will eventually bring a tide of newly insured patients into the American health care system. For several years many potential students have been attending offshore medical schools, or giving up hope entirely, when they could not get into domestic schools.

The United States has recently opened, or has impending openings, of nearly two dozen medical schools, the most at any time since the 1960's and 1970's. These new schools are seeking to address an imbalance in American medicine that has been growing for a quarter century. Meanwhile, American hospitals were using foreign-trained and foreign-born physicians to fill medical residencies. During the 1980s and '90s only one new medical school was established. If all the schools being proposed actually opened, they would amount to an 18 percent increase in the 131 medical schools across the country. (By comparison, there are 200 law schools approved by the American Bar Association.)

Read the full article in the New York Times, or click here:
http://www.nytimes.com/2010/02/15/education/15medschools.html?ref=health

Hospital employment climbs 11% in January 2010

Employment at the nation's hospitals rose 0.11% in January to a seasonally adjusted 4,698,700 people, the Bureau of Labor Statistics reported today. That's 5,000 more people than in December and 28,300 more than a year ago.

Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 4,691,400 people in January, 9,200 fewer than in December but 28,800 more than a year ago. The nation's overall unemployment rate fell by 0.3 percentage point in January to 9.7%.

Read the full article in American Hospital Association News, or click here:

http://www.ahanews.com/ahanews_app/searchNewsNow.jsp?date=02/05/2010

Physician Relocating: Resources to Make your Move Easier

Most of the physicians we place in new positions require relocation. Making a career move that involves relocation often engenders two competing feelings: excitement about the new challenge and destination, and apprehension about the logistical and time-consuming tasks that moving entails.

The New England Journal of Medicine has published an article on how to make relocation for you and your family as easy as possible so you are able to focus on the exciting prospect of starting in your new position.

There are many resources available to make your move as easy as possible. The first place to look for assistance in relocating (other than from the recruiter you are working with!) is the employing organization or practice. Many groups and health care organizations can either provide direct assistance to relocating physicians and their families, or access to trusted community resources. These can help to simplify the process of choosing a neighborhood, real estate agent, school, or any of the dozens of services recent arrivals are likely to need.

Physicians should also indicate any special needs of family members. It is not unusual for a hiring practice or organization to provide assistance with a spouse’s job search (given that 80% of households are two-income families now), a child’s educational needs, or an aging parent’s care.

Read the full article, including links to resources that help provide relocation assistance, at The New England Journal of Medicine, or click here:

http://www.nejmjobs.org/career-resources/physician-relocation.aspx

Interviewing Skills for Job-Seeking Physicians

The New England Journal of Medicine has published an article written by Dr. Robert Kuramoto on interviewing skills for physicians, how to prepare yourself before the interview, ace the interview, and on follow-up after the interview.

Dr. Kuramoto elaborates on each point, but here is a summary of how to prepare yourself for an interview:

-Research the Practice or Hospital
-Be Ready to Discuss Your Professional Goals and Personal Interests
-Be Ready to Sell Yourself
-Act Like This Is the Only Interview That Matters
-Prepare a Comprehensive List of Questions
-Speak Positively about Your Experiences and Don’t Disparage Former Employers
-Review Your Travel Itinerary to Ensure Punctuality
-Dress Professionally
-Bring Your Spouse, if Invited
-Don’t Avoid the Subject of Money, But Don’t Dwell on it Either
-Schedule Strategically
-Send a Thank You Note after the Interview

Your recruiter can help with a lot of these points to make you excited and prepared for your interview and to impress the facility or group you are meeting with.


Read the full article in The New England Journal of Medicine, or click here:

http://www.nejmjobs.org/career-resources/physician-interview-skills.aspx

MGMA Guidline Survey Results: Physician Compensation

MGA, the Medical Group Management Association, has published their latest physician compensation survey data. Many of the hospitals and facilities we work with base their physician salaries or income guarantees based on MGMA guidelines, which are an objective comparison of physician income based on area, experience, and training.

The key findings this year from MGMA have stated that physician compensation rose slightly in 2008, however physicians did not really see a gain as most increases were outpaced by inflation.

The survey also found that physicians in non-hospital owned practices typically earned more, although they also worked longer hours. The survey found specialty care physicians see the biggest difference with 27.72 percent more income than hospital based practices, whereas primary care physicians in non hospital-owned practices make 2.31 percent more than their counterparts in hospital-owned practice. However the compensation was remarkably similar when comparing workloads; when compensation is evaluated per physician work RVU (relative value unit, the standard work measurement unit), the data show there is little difference between group ownership.

Read the full article in MGMA or click here:
http://blog.mgma.com/blog/bid/24509/Key-findings-from-MGMA-s-physician-compensation-survey

Physician Offices Generating Jobs

Medicine continued to be the bright spot in the economic downturn, adding 21,500 jobs in December 2009, with 8,900 in physician offices, according to preliminary data released Jan. 8 by the Bureau of Labor Statistics.
Experts suggested that these numbers not only indicated that the health system is getting stronger economically, but also that delivery of care is shifting to the outpatient setting. Most health care sectors added positions, but physician offices did so more quickly than in prior months. Hospitals did so more slowly.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/01/25/bisd0128.htm

Physicians: Sharing your Space

American Medical News has published an article on things to consider when looking for an office mate.

Physicians sharing space with physicians or other health care professionals is not a new concept. But those in the medical office real estate business say interest in subleasing is growing. The transition to electronic medical records is leaving empty rooms where paper charts were once stored. Also, declining reimbursements and recessionary pressures are leading physicians to seek ways to reduce fixed costs.

Economic pressures are prompting many physicians to sublease underutilized office space. A good match can help reduce overhead and help grow a practice.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/02/01/bisa0201.htm