Physicians: Find the Right Job & Negotiate a Better Contract

Find out what the job is really like, optimize your compensation, and much more.
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  • Lectures 30
  • Length 2.5 hours
  • Skill Level All Levels
  • Languages English
  • Includes Lifetime access
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    Available on iOS and Android
    Certificate of Completion
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About This Course

Published 7/2013 English

Course Description

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

What am I going to get from this course?

  • After completing this course you will be ready to negotiate a favorable contract for a job that satisfies your key career issues.

What is the target audience?

  • Physicians considering new jobs and other career decisions.

What you get with this course?

Not for you? No problem.
30 day money back guarantee.

Forever yours.
Lifetime access.

Learn on the go.
Desktop, iOS and Android.

Get rewarded.
Certificate of completion.

Curriculum

Section 1: Introduction
06:59

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.

Curriculum, Learning Features
1 question
03:11

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
1 question
Section 2: Health Care System Evolution
06:49

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
1 question
09:59

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.

Local Health Care Market Consolidation and Accountable Care Organizations
1 question
03:16

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
1 question
Section 3: Find the Right Job
05:37

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.

Your Job Search Timetable and Curriculum Vitae
1 question
07:49

Recruiters work for employers.

Recruiters use pressure tactics.

Use word of mouth and networking to find jobs.

Find Jobs: Recruiters, Networking, and Other Sources
1 question
04:42

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
1 question
09:37

Plan your visit

Observe organizational culture: Positive? Negative?

Meet everyone

Shadow your prospective colleagues

Compensation, benefits, obligations

Employee vs. Independent Contractor

Visit the Practice
1 question
04:25

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
1 question
04:15

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

Physician’s hospital loan subsidizes Employer’s expenses

Risks
- High loan balance
- Underperforming practice
- Reduced compensation

Reduce risks
- Due diligence
- Transparent financial relationship

1 question

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

Section 4: Negotiate a Better Contract
06:54

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
1 question
06:00

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
1 question
05:34

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

Compensation: Hourly Rate, Base Salary, and Productivity Incentives
1 question
05:53

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
1 question
06:40

Collections Threshold <= 2.5 x Base Salary

Collections Rate >= 25% amount above Collections Threshold

Profits
- Fair allocation of fixed, variable, and direct expenses

Profits only
- Shareholder agreement protects your rights

Compensation: Measuring Productivity Collections and Profits
1 question
02:14

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
1 question
02:31

More employers offer modest incentives 
for quality and patient satisfaction.

Some employers offer other bonuses.

Compensation: Other Performance Incentives
1 question
03:28

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

Compensation: Recruiting Incentives
1 question
04:32

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

Most employers also offer CME and other professional expense reimbursement.

Compensation: Benefits
1 question
02:47

Compensation + benefits

Ask for more money.

Compensation: Consider the Entire Package
1 question
01:31

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

The Career Costs of Family
1 question
04:32

Initial term
- 1-3 years

Termination without cause
- 90-day notice

Malpractice tail insurance premium

Restrictive covenants

Term and Termination of Employment
1 question
04:48

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
1 question
07:18

Non-compete
-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
1 question
04:54

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
1 question
05:46

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
1 question
04:22

Consider your key career issues

Let sleeping dogs lie

Negotiate with decision maker

Avoid litigation

Walk away from a bad deal

Productive Negotiations
1 question
02:33

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
1 question
02:03

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

Will I Be Happy Here?
1 question

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Instructor Biography

Jack Valancy, Jack Valancy helps physicians build rewarding careers.

Since 1979, when he started Jack Valancy Consulting (www.valancy.com), 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.

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