Second edition of Neurosurgery Market Watch now available online!

Our feature article is a comprehensive neurosurgery-specific RVU explanation and breakdown. Perry Hoeltzell, MD PhD shares his views in our candidate profile on his new position, while health lawyer Roderick Holloman addresses contract challenges in our Legal Corner column. And don’t forget to check out our standing sections, Physician Incentive Payments and the Featured Opportunity.

Click here to read the full issue: http://harlequinna.com/neurosurgery-market-watch/. To subscribe to the hard copy of our newsletter please email your address to info@harlequinna.com.

Key Factors in Hospital Employment Contracts

Hospital Employment continues to be an increasing trend in physician employment models. However American Medical News recommends physicians keep in mind the following 7 items before signing a hospital employed contract:

1. Job Description
2. Restrictive Covenants
3. Outside Activities
4. Payment Recoupment
5. Tail Coverage
6. Call Coverage
7. Contract Termination

Before physicians sign any employment contract it is important they understand not only the terms of their compensation but key factors in the entire employment picture. If both parties have a comprehensive understanding of exactly what the incoming physician will be doing including all responsibilities, precisely how they will be compensated including any production or RVU based bonuses, and all other requirements of the position it will avoid confusion and possible unpleasantness after the contract has been signed.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/12/19/bisa1219.htm

Physician Shortage: Not So Grim in Certain Locations

There has been a lot of press on the threat of the current and impending physician shortage; however not all states are experiencing the same concerns of physician shortages. On a national level, Scripps Howard News Service has reported that new research determines not all areas are under as much pressure for current physician demands as well as any new demands health care reform may require.

This is still a good market for most any specialty physician, surgeon, or family practice physician to find a job based on their personal motivators, but some areas are not as tight on physicians of all kinds as other locations. Rural areas and areas with a high percentage of retired patients are typically experiencing an increased demand for physicians compared to larger, metropolitan cities.

Another encouraging figure comes from the Association of American Medical Colleges (AAMC) which reports the number of medical school applicants is at an all-time high. First-time applicants increased 2.6% from last year to 32,654 students, and total applicants rose 2.8% to 43,919 applicants, AAMC said in an October report. Actual enrollment rose 3%, according to Scripps Howard.

Colorado is one of the states that isn't feeling too much pressure regarding the physician shortage, even considering health care reform, if it continues to move forward. However Oklahoma is concerned about the current and impending shortage; The University of Oklahoma and Oklahoma State University are even encouraging the state to recruit and train more physicians. South Carolina is another state that is concerned about the current and future demands for physicians.

Read the full article by clicking here:
http://www.fiercehealthcare.com/story/physician-shortage-isnt-bad/2011-12-15

100% Increase in Physician Practice Employment Expected in 2011

2011 has proven to be a strong year for employing positions in physician practices. With the year almost over, the Bureau of Labor and Statistics has reported that employment in physician practices will nearly double from figures last year.

The Bureau of Labor and Statistics does not track position titles, however based on classified and job board listings most of these positions are in clinician roles.

The physician shortage is still apparent, 2012 is looking to continue to be a strong year demanding physicians of all specialties in both hospital based and private physician groups.


Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/12/05/bisf1208.htm

End-of-year Tax Tips for Physicians

Some of these tips relate solely to your personal tax return, some pertain to physicians who own their practice and thus file a corporate return, and some could apply to either personal or corporate returns.

Here are some tips, "P" refers to personal returns and "B" refers to business:

1. Donate More to Your Hospital, Medical Research Charities, or Other Qualified Organizations (P, B)

2. Defer, Defer, Defer (P, B)

3. Set Aside More for Retirement (P, B)

4. Sell Stocks That Are Losers! (P)

5. Take a Business Trip for Continuing Education or to Broaden Your Clinical Horizons (P, B)

6. Add Up Any Job-Hunting Costs (P, B)

7. Buy More Business or Medical Equipment (B)

Some of these advantages may go away for 2012, now is the time to start taking advantage of any breaks for 2011 returns.

Read the full article in MedScape, or click here:

http://www.medscape.com/viewarticle/752793

Physician Compensation Update

In most specialties physicians are seeing an increase in compensation from last year. According to MGMA data the specialties experiencing the most dramatic increases were dermatology, emergency medicine, neurology, orthopedic surgery, and pulmonary medicine. The few specialties experiencing a decline were invasive cardiology, urology, and ophthalmology.

Experts say the big picture will most likely cause physician compensation to flatten, but the ever-rising demand for services should have an upside offsetting effect.

Hospitals and medical groups are also becoming more open-minded in their employment offers, trying to stay competitive not only from a salary stand-point but also offering enticing benefit packages, relocation, paid vacation and CMEs, and other incentives to create a big-picture compensation package.


Read the full article in the New England Journal of Medicine, or click here:
http://www.nejmcareercenter.org/article/89/physician-compensation-update-it-s-a-mixed-picture/

Changing Career Path: From Clinical to non-Clinical

For a variety of reasons some physicians seek to switch their clinical career to a non-clinical position. However once they make that change it is very difficult to shift back to even a limited clinical practice, so it is important if you are considering making this change to take all factors in to account. After more than 2 years of a non-clinical position, it is very difficult to switch back to a clinical career.

While making the transition the focus doesn't have to have a dramatic stop to clinical work, it can be a slow decrease over time of a less clinically focused practice. Many physicians continue to maintain their state licenses and also up to date CME requirements to keep a possibility of more clinical work in the future.

The switch to a non-clinical position is very desireable to many phsyicians both as a retirement alternative as well as a research outlet for younger physicians. However the consequences are severe if the decision is based on short-term objectives, it is crucial to be certain you are ready to make the switch prior to completely transitioning out of a clinical position.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/11/07/bisa1107.htm

The Art of Negotiating Physician Employment Agreements

Negotiating an employment contract prior to starting a new physician practice opportunity is paramount in ensuring a mutually beneficial long-term relationship with both the physician and the hospital. This is the only opportunity both parties have to ensure their respective needs are being met.

Whether you're the head of a medical practice inviting an experienced physician to join the group, or a resident contemplating a Letter of Intent, fair and effective negotiations are crucial to establishing a long-term working relationship.

Forethought, preparation, and the ability to listen are essential to success. Often times by the time most physicians realize that the terms of their Agreement are less than propitious it is usually too late. Most disputes between physicians and employers resulting in termination aren't related to medical competence. More often than not, physicians claim that their employers failed to inform them of, or misrepresented, working conditions, patient workload, call responsibilities, partnership potential, or the prospects for increased compensation.

During the negotiation process sometimes physicians become blindsided for lack of preparation and the failure to rank priorities effectively. It is important to consider a personal balance of long-term priorities over the course of your career including location, family, community amenities, and compensation.

Read the full article in Physicians News, or click here:
http://www.physiciansnews.com/2011/11/07/the-art-of-negotiating-physician-employment-agreements/

Quality Incentives Become Bigger Factor in Physician Compensation

With the increase of employed physicians and hospital employed positions, hospitals are increasing their flexibility to offer multiple types of incentives in addition to salaries.

According to a recent study from the Hay Group, "2011 Physician Compensation Survey," 64% of health care organizations offer an annual incentive plan to physicians. Incentives in addition to salary vary in their scope and are sometimes specialty specific but are generally based on either volume based incentives or quality based bonuses.

Quality and patient satisfaction, which public and private insurers are pushing as an incentive over productivity, were key factors in determining incentive pay.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/10/24/bisf1027.htm

Physicians to Receive Smaller Raises in 2012

Physicians in all specialties (including primary care) can expect to see smaller compensation increases in 2012 compared to 2011, but those in group practices won't be hit quite as hard, according to Hay Group's 2011 Physician Compensation Survey released this week.

In particular, the survey predicts physicians across all organizations to get pay increases of 2.5% next year, down from actual increases of 2.7% average in 2011. Physicians working in group practices, while also getting less than last year, are expected to earn slightly higher pay increases of 3.2% in 2012 versus 2.5% for those working in hospital-based settings.

According to the survey, physicians' pay increases, from best to worst, are predicted for 2012 as follows:

Group-based specialist--4.5 percent
Group-based primary care--3.3 percent
Group-based overall--3.2 percent
Hospital-based primary care--2.9 percent
Hospital-based overall--2.5 percent
Hospital-based specialist--2.4 percent

In addition, researchers found that annual incentive plans for physicians were less common in 2011 (64%) than they were in 2010 (69%). Amongst organizations that did pay incentives, amounts continued to be determined based on quality and patient satisfaction.

Read the press release from the Hay Group at Fierce Practice Management by clicking here: http://www.fiercepracticemanagement.com/press_releases/physician-pay-increases-decline-2012-hay-group-study-finds-0?utm_medium=nl&utm_source=internal