Physician Contract Language: Hospital Bylaws

In this hospital employment dominant environment it's more important than ever for physicians to have a good understanding of their employment contract prior to signing with the hospital.  Hospital bylaws are another factor to make sure you understand before signing the contract.

Bylaws of a hospital govern the terms of the hospital's medical staff, including staff membership and clinical privileges.  Physicians need to review both their employment contract as well as the hospital's bylaws to understand the full aspects of employment, including what would happen if the physician lost their job or their staff privileges.

American Medical News has an article addressing how to review both an employment contract and the hospital bylaws prior to signing.  Read the full article by clicking here:

http://www.amednews.com/article/20130513/business/130519968/5/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130513

Physicians: Other Alternatives to Hospital Employment

There has been significant attention lately to the increasing trend in hospital employment, however selling your practice to a hospital or becoming a hospital employee isn't the only option for successful hospital/ physician relationship.

There are several different options physicians have to integrate with hospitals while still maintaining their autonomy and more control over how they run their practice, while still allowing a successful relationship with the hospital.

Because of the physician shortage and demand for services, hospitals are often are willing to work out alternative arrangements to hospital employment.

There are many different options physicians have to integrate their practices with a hospital, however according to practice consultants there are 3 main categories- limited, moderate and full.

Limited: physicians provide specific clinical oversight duties 

Moderate: hospitals and physician groups work toward shared goals

Full: not full hospital employment, however the hospital maintains more control over the physician group

To determine the appropriate alignment for your specific group it is important to establish you or your group's core values.  Meet with the hospital to determine how the physician(s) and hospital hope to achieve from the alignment.  There will be many meetings involved, both with the hospital and the physicians as well as third parties, such as consultants and lawyers.

Both parties should determine the physician's group practice issues and common goals.

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

http://amednews.com/article/20130422/business/130429981/4/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130422 

Doctor-Owned Hospitals Prosper Under Health Law

Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth. The hospitals, many of which specialize in heart or orthopedic surgeries, have long drawn the ire of federal lawmakers and competitors. They say physicians often direct the best-insured and more lucrative cases to their own facilities, while leaving the most severely ill patients to others.


Some researchers say the doctors' financial interests encourage them to perform more tests and procedures, driving up the cost of care. The health law banned construction or expansion of these hospitals except in unusual circumstances.

But physician-owned hospitals have emerged as among the biggest winners under two programs in the health law. One rewards or penalizes hospitals based on how well they score on quality measures. The other penalizes hospitals where too many patients are readmitted after they leave. There are more than 260 hospitals owned by doctors scattered around 33 states. They are especially prevalent in Texas, Louisiana, Oklahoma, California and Kansas.

Of 161 physician-owned hospitals eligible to participate in the health law's quality programs, 122 are getting extra money and 39 are losing funds. Medicare is paying the average physician-owned hospital bonuses of 0.21 percent more for each patient during the fiscal year that runs through September. Meanwhile, the average hospital not run by doctors is losing 0.30 percent per Medicare patient.

Read the full article in Physician's News, or click here: http://www.physiciansnews.com/2013/04/16/doctor-owned-hospitals-prosper-under-health-law/?utm_source=4.16.13&utm_campaign=11713&utm_medium=email

Stronger Economy Stimulates Doctor Turnover

A recent Physician Retention Survey has determined many physicians are considering a new practice environment as a result of the strengthening economy.

There have been uncertainties in sustainability with the changing healthcare environment and how changes in healthcare reform and reimbursements may affect net compensation for physicians.  With positive media attention on a strengthening economy, many physicians are seeking out new, more stable employment opportunities.

According to the recent survey physician turnover has increased by the largest amount in 8 years.  If the economy continues to increase, the physician turnover is also expected to increase.  Many physicians will seek different employment opportunities or retire, as many were forced to delay retirement with a more tumultuous economy.

Turnover will come at a time when there is already a significant physician shortage.  

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

http://amednews.com/article/20130401/business/130409979/2/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130401

5 Steps for Employed Physicians to Resolve Contract Disputes

With the increase in hospital employment, more and more physicians are finding themselves signing employee contracts.  If issues were not properly understood during signing, or if physicians have misconceptions about their employment after they have already started, American Medical News has offered 5 tips to resolve contract disputes to have both parties come to a mutual agreement.

The article offers a more thorough explanation of each tip, here are their 5 steps to resolve contract disputes:

1. Stay Calm
2. Review the Contract
3. Talk it Out
4. Write Letters
5. Consider a Lawsuit

Read the full article in American Medical News, or click here:
http://amednews.com/article/20130311/business/130319970/4/?utm_source=nwltr&utm_medium=heds-htm&utm_campaign=20130311

Will Hospital Employment Lead to Physician Strikes?

Hospital-employment means higher reimbursements and more stable schedules for doctors, but it also could lead to the creation of physician labor unions, according to The Wall Street Journal.

With an employed status comes the right to collective bargaining, wrote David J. Leffell, a practicing physician and former CEO of the Yale Medical Group.

Physicians provide a service that can't be outsourced, according to Leffell, and as service workers they can exercise the right to strike to help negotiate staffing, benefits and patient care issues.

The rise of unionized physicians would put more pressure on hospitals already facing strike threats from nursing unions-which, if carried out, lead to extra costs for temporary nurses and added security, as well as patient care disruptions. 

Moreover, it's already gotten easier for healthcare workers to unionize, after a decision in the "Specialty Healthcare" case was overturned in August 2011 and determined that a group of nursing assistants at an Alabama facility could form their own bargaining unit without other types of nursing home staff.

And while the move from private to hospital-owned practices makes it easier to regulate and monitor physicians, Leffell pointed out it may jeopardize access to care: "Office closed, doctors on strike."


Read the full article in The Wall Street Journal, or click here:
http://online.wsj.com/article/SB10001424127887323375204578270401138739978.html

Physician Job Search: How to Interview to get Your Dream Job

When physician's submit their CV for a prospective job opportunity, the CV speaks for itself and is crucial in getting to the next stage of the interview process.  However, once the interview process starts and physician's visit the facility and meet with the other physicians, interview skills, practical (not just clinical) knowledge, and personality really come in to play to get the job offer and move to contract negotiation.

Coming across as a team player, particularly for the current hospital-employed trending marketplace, is a very important factor in the interview process.  The site visit is an exploratory process for the physician to help determine if this may be a good fit, but it is also an interview and it's important not to forget it is an opportunity to showcase not only the physician's training and experience, but also his or her personality and compatibility.

A CV is a good way to get the process started, but the physician still needs to interview and prove they are not only a good clinical fit for the opportunity, but also have the right dynamic to fit in to the current group.

American Medical News has a recent article on the importance of the interview and also the incoming physician coming across as a team player.  Read the full article by clicking here:

http://www.ama-assn.org/amednews/2013/01/28/bisa0128.htm?utm_source=nwltr&utm_medium=heds-txt&utm_campaign=20130128

Tips for Physicians When Joining a New Practice

Physician's Practice has published an article on the do's and don'ts for physicians joining new practices from medical practice consultants and etiquette experts.

They have compiled a list of 10 do's and 10 don'ts for physicians joining a new medical practice.  They have asked medical practice consultants and etiquette experts to share their top recommendations for starting off on the right foot.

Read the full article by clicking here:

http://www.physicianspractice.com/blog/tips-doctors-when-joining-new-practice?GUID=98C7CA21-2AF6-465B-A27F-FC956DFC383F&rememberme=1&ts=25012013
 

Hospital Employment Contracts: Renegotiate After Term Expiration

With the increasing trend of hospital employment many physicians are now on a salary with their associated hospital.  However once the term ends they still have negotiating power when considering re-signing.

American Medical News has just published an article with 5-steps to re-negotiate a contract before it expires to continue to make a long-term sustainable employment contract.  The article suggests these 5 tips to negotiate your new physician employment contract:

1. Know your renewal date

2. Use data to support your request

3. Consider how pay is structured

4. Ask about pay for nonclinical duties

5. Bring up retirement and other personal matters

Just because many physicians are now hospital employed doesn't mean they no longer have any negotiation power.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2013/01/14/bisa0114.htm?utm_source=nwltr&utm_medium=heds-txt&utm_campaign=20130114

Physician Compensation Increase in 2013

With the increase in physicians being hospital employed, most working physicians are receiving a salary.  According to recent reports the average physician's salary should increase by 2.6% in 2013.

The business consulting firm, Hay Group, projects this physician salary increase based on surveys of 1,212 hospitals across the nation.

HealtheCareers, a leading physician job and market assessment site, has published an article on both the expected increase in physician's salaries as well as expectations for Allied Health in 2013.

Read the full article in HealtheCareers, or click here:

http://www.healthecareers.com/article/salary-trend-for-physicians-in-2013/171724?type=email&source=physician-010813