Physicians: Find the Right Job & Negotiate a Better Contract
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Physicians: Find the Right Job & Negotiate a Better Contract

Find out what the job is really like, optimize your compensation, and much more.
4.5 (10 ratings)
Instead of using a simple lifetime average, Udemy calculates a course's star rating by considering a number of different factors such as the number of ratings, the age of ratings, and the likelihood of fraudulent ratings.
239 students enrolled
Created by Jack Valancy
Last updated 2/2014
Current price: $10 Original price: $20 Discount: 50% off
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  • 2.5 hours on-demand video
  • Full lifetime access
  • Access on mobile and TV
  • Certificate of Completion
What Will I Learn?
  • After completing this course you will be ready to negotiate a favorable contract for a job that satisfies your key career issues.
View Curriculum

Whether you are a resident or fellow, or an early-, mid- or late career physician, this course will help you answer questions like:

- What are my key career issues?

- How can I find jobs that might satisfy my key career issues?

- How can I evaluate jobs during interviews and visits?

- What are my duties and schedule?

- Is the compensation fair?

- How can I leave the job?

Lectures include:

- How health care market consolidation affects your career

- The decline of the voluntary medical staff model

- Accountable Care Organizations

- Health system employment

- Physician-owned independent private practice

- Career costs of family

- Take charge of your job search

- Recruiters, networking, and other job sources

- Learning about the job and community

- Visiting the practice and community

- Physician-owned practice: Joining, buying (into), and starting

- Physician-owned practice: Hospital loan agreement

- Good and poor employment contracts

- Duties, schedule, location, and workload

- Compensation models

- Term and termination of employment

- Professional liability (malpractice) insurance

- Restrictive covenants

- Path to becoming a shareholder in a physician-owned practice

- Negotiating strategies and techniques

Who is the target audience?
  • Physicians considering new jobs and other career decisions.
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Curriculum For This Course
30 Lectures
2 Lectures 10:10

Whether you are evaluating your first employment contract, considering a mid-career change, or approaching retirement, this Introduction explains why this is the course for you.

Preview 06:59

Curriculum, Learning Features
1 question

Knowing yourself is the key to making yourself happy.

Sources of career satisfaction
- The Work Itself
- Culture, Colleagues, Career
- Location, Lifestyle
- Compensation

Take charge of your job search!

Identify Your Key Career Issues

Identify Your Key Career Issues
1 question
Health Care System Evolution
3 Lectures 20:04

In the 1980s, physicians who owned their practices served on hospitals’ voluntary medical staffs.

Since then, continuing changes in reimbursement have driven hospitals to employ physicians.

Employed physicians perform hospital functions formerly performed by the voluntary medical staff.

The Decline of the Voluntary Medical Staff Model

The Decline of the Voluntary Medical Staff Model
1 question

Before 1985, local health care markets were fragmented.

Changing reimbursement drives market consolidation.

In many markets today, a few health systems employ most physicians.

Accountable Care Organizations promote higher quality and lower costs; and may drive market consolidation.

Preview 09:59

Local Health Care Market Consolidation and Accountable Care Organizations
1 question

Management quality influences organizational culture and physician job satisfaction.

Hospital-employed physicians “lose money” due to system upgrades, staff compensation, and management overhead.

Physicians generate significant revenues for hospitals.

Management Quality Varies

Management Quality Varies
1 question
Find the Right Job
6 Lectures 36:25

Plan your job search 18 months in advance,
Start looking 12 months in advance,
Start negotiating 6 months in advance.

Practice your elevator pitch.

Make your curriculum vitae an easy-to-read chronology of your experience and qualifications.

Preview 05:37

Your Job Search Timetable and Curriculum Vitae
1 question

Recruiters work for employers.

Recruiters use pressure tactics.

Use word of mouth and networking to find jobs.

Find Jobs: Recruiters, Networking, and Other Sources

Find Jobs: Recruiters, Networking, and Other Sources
1 question

Learn about the local health care market

“Tell me about your practice”

Ask followup questions about key issues.

“Tell me about the compensation package.”

“I would like to be fairly paid for my work.”

“I will be happy to consider your offer.”

Hold Initial Discussions

Hold Initial Discussions
1 question

Plan your visit

Observe organizational culture: Positive? Negative?

Meet everyone

Shadow your prospective colleagues

Compensation, benefits, obligations

Employee vs. Independent Contractor

Preview 09:37

Visit the Practice
1 question

Look for
- Financial stability
- Highly functional systems
- Current technology
- Early- mid- and late-career physicians
- Low physician turnover
- New physician success

Evaluate Physician-Owned Practices

Evaluate Physician-Owned Practices
1 question

A hospital loan may be offered to start or join a physician-owned practice

Physician’s hospital loan subsidizes Employer’s expenses

- High loan balance
- Underperforming practice
- Reduced compensation

Reduce risks
- Due diligence
- Transparent financial relationship

Hospital Loan Agreements

Before signing a hospital loan agreement, you should insist on a __transparent__ financial relationship and perform __due__ diligence.

Hospital Loan Agreements
1 question
Negotiate a Better Contract
19 Lectures 01:24:20

Is this job a good fit?

Consider your contract in the context of
- Direct observation
- Experiences of prospective colleagues

Good contracts
- Precise, clear, equitable, concise
- Positive tone

Employment Contracts in Context

Employment Contracts in Context
1 question

Specialty and scope of practice

Typical office, hospital, and call schedules

Specific office(s), hospital(s), other locations

Anticipated practice development

Shadow your prospective colleagues

Duties, Schedule, Location, and Practice Development

Duties, Schedule, Location, and Practice Development
1 question

Local market conditions strongly influence compensation

Base salary may be reduced/eliminated after 1 - 3 years

Incentive compensation = Work Units above Threshold x Rate

Correlation between work and pay
- strong: wRVUs
- moderate: Collections
- weak: Profits

Preview 05:34

Compensation: Hourly Rate, Base Salary, and Productivity Incentives
1 question

Each CPT code has 3 Relative Value Units (RVUs)
- Physician’s work effort (wRVU)
- Practice expenses
- Malpractice insurance expenses

wRVU Threshold ~= same percentile as guaranteed compensation

wRVU Rate = Guaranteed compensation/wRVU Threshold 
~= median wRVU rate for specialty

Compensation: Measuring Productivity, wRVUs

Compensation: Measuring Productivity wRVUs
1 question

Collections Threshold <= 2.5 x Base Salary

Collections Rate >= 25% amount above Collections Threshold

- Fair allocation of fixed, variable, and direct expenses

Profits only
- Shareholder agreement protects your rights

Compensation: Measuring Productivity, Collections and Profits

Compensation: Measuring Productivity Collections and Profits
1 question

Obtain realistic projections of your practice’s
- Starting size
- Growth rate
- Goal size

Develop a plausible practice business plan

Consider other physicians’ experiences

Compensation: Measuring Productivity, Realistic Projections

Compensation: Measuring Productivity Realistic Projections
1 question

More employers offer modest incentives 
for quality and patient satisfaction.

Some employers offer other bonuses.

Compensation: Other Performance Incentives

Compensation: Other Performance Incentives
1 question

Typical recruiting incentives
- Signing/starting bonus
- Relocation expenses
- Student loan repayment
- Immigration expenses

Compensation: Recruiting Incentives

Compensation: Recruiting Incentives
1 question

Learn about your employer’s health insurance, retirement plan, and other benefits.

Most employers also offer CME and other professional expense reimbursement.

Compensation: Benefits

Compensation: Benefits
1 question

Compensation + benefits

Ask for more money.

Preview 02:47

Compensation: Consider the Entire Package
1 question

Physicians can often work a flexible schedule 
or part-time to help maintain a healthy work-life balance.

The Career Costs of Family

The Career Costs of Family
1 question

Initial term
- 1-3 years

Termination without cause
- 90-day notice

Malpractice tail insurance premium

Restrictive covenants

Term and Termination of Employment

Term and Termination of Employment
1 question

Malpractice tail insurance extends the protection of a claims-made policy after employment ends.

The Employer should pay the tail insurance premium because employment creates Physician’s liability 
which continues after employment ends.

Professional Liability (Malpractice) Insurance

Professional Liability (Malpractice) Insurance
1 question

-May not practice in restricted area during restricted period

Non-solicitation, non-interference
- Patients, employees, business relationships

Can I live with the restrictions?

Obligations during and after employment

Restrictive Covenants and Other Obligations

Restrictive Covenants and Other Obligations
1 question

The legal framework describes how and where the Employer and Physician will interpret and enforce their contract.

Legal framework “boilerplate” language typically benign.

Notices to your home address

Entire agreement

Get it in writing!

Legal Framework

Legal Framework
1 question

Path to partnership outlines mutual expectations

Goal: Full and equal shareholder

Estimate buy-in price, return on investment

Fair compensation as an associate

Consider group practice compatibility

Consider practice financial stability

Avoid hospital loans

Buying (Into) a Physician-Owned Practice

Buying (Into) a Physician-Owned Practice
1 question

Consider your key career issues

Let sleeping dogs lie

Negotiate with decision maker

Avoid litigation

Walk away from a bad deal

Productive Negotiations

Productive Negotiations
1 question

It’s probably a good idea to have someone advise you on your employment contract before signing.

Here’s what to look for when choosing professional advisors -

Professional Advisors

Professional advisors
1 question

Before signing your contract, 
consider how well the job might satisfy 
your key career issues.

Will I Be Happy Here? Wrap-up.

Will I Be Happy Here?
1 question
About the Instructor
Jack Valancy
4.5 Average rating
10 Reviews
239 Students
1 Course
Jack Valancy helps physicians build rewarding careers.

Since 1979, when he started Jack Valancy Consulting (, thousands of physicians have participated in Jack's classroom course, The Complete Practice Management Seminar™. His Classroom Farewell Tour continues through 2017. 

Jack Valancy's Udemy course, Physicians: Find The Right  Job and Negotiate a Better Contract, is adapted from his classroom course.

Jack Valancy has taught at graduate medical education programs around the country, and served on the clinical faculty of Case Western Reserve School of Medicine for more than two decades. He holds an MBA from Case Western Reserve University and a Bachelor of Science in Applied Science (Systems Analysis) from Miami University.