"The difference between the almost right word and the right word is really a large matter -- 'tis the difference
between the lightning bug and the lightning." -- Mark Twain
"One time, there was plenty for physicians to do without having to worry about money, but the stark reality is that physician
reimbursement has been locked in for almost a decade, and there is a workforce shortage. This means you have to be pretty
hardnosed about negotiating and not be shy about hiring a consultant or lawyer specializing in this work. 5-20k for this kind
of information is in the long run money wisely spent. This fee can also be negotiated into the contract."
When you
contract with a physician group, the contract should spell out your base pay and productivity expectations. A good contract
would compensate you for extra productivity. A great contract would take into consideration activities
that while not explicitly renumerative, bring in value like time for research and presentation at conferences, building clinics
in underserved areas, and management and leadership time spent in the hospital. The modern contract involves providing appropriate
compensation for all aspects of your work. If you contract with a hospital, you have to be specific about all the time spent
working including extra call -for example, if you are the one surgeon recruited by your hospital, you may choose to be on
call 24-7 while they recruit a partner for you -you have to be compensated for the second call that you take. EMTALA requires
only one in three call, so in fact, you can argue for compensation for taking 2 extra days of call out of three. This
is money the hospital would save by having you take a lot of extra call while they recruit another surgeon. Committee work
can be covered as can rounding in the hospital and consultation services in the hospital -especially because this kind of
work is not paid or is being eliminated. Covering more than one facility should add to the fees. A good contract puts a "vapor
lock" on malpractice including a tail in case you leave. It should have terms for how you leave, including fees for early
termination without cause. A good contract provides for all the fees involved for licensing and maintenance of it. A good
contract is explicit about noncompetes (where legal) and fees for buyout of a noncompete. Vacation days can be valued and
bought or sold back -mechanisms for this can be negotiated as well. Even time spent calling back patients or emailing them
can be negotiated. You can even negotiate fees for returning early from vacation to provide service -at a minimum compensation
for travel, lost hotel fees, and vacation day.
Its a matter of supply and demand. Know the MGMA
mean compensation for your specialty in private practice and academic practice in the region you are negotiating -they certainly
will.
Working in a hard to recruit area should add compensation for being hard to recruit. A simple rule told
to me by one very wise old man, add fifty thousand dollars for every hour's drive you are away from a certified Porsche dealer.
You can Google Map it.
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