CambieMD

cambiemd
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15+ Year Member
Oct 4, 2003
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Attending Physician
I know that a lot of you boys and girls are looking for jobs now. The whole proscess can be a little intimidating. I have a few thoughts as I look back on the process.

1. Find an attorney who concentrates his/her practice in health care law. Many lawyers will review your contract and miss clauses that will hurt you. They may miss things because they are not familiar with the practice and culture of medicine.

2. Restrictive convenants are usually enforceable. If you do not want to held to a noncompete clause try to get it removed. Fighting a restrictive covenant can be costly. A friend of mine spent 30k. His former employers eventually dropped the suit. A good attorney may attempt to make a restrictive covenant reasonable.

3. Speak to former employees/physicians from the practice.

4. Stay away from hospital guarentees if you are signing with a practice. Many salary guarentees merely place cash in the pockets of the practices' partners. Many docs end up stuck in an undesireable ares after the first year is up.

5. If you are in a hospital based specialty, stay away from hospitals in financial problems. Avoid hospitals on the verge of being sold. All contracts will be renegociated by the new buyer.

6. Stay away from dinky hospitals. Being on staff at a hospital with a bad rep can hurt yours.

7. Seek the advice of someone who will hold your confidence.

8. If it sounds too good to be true you may be dealing with a lier.

9. The highest paying offer may not always best the best one.

10. Try to get them to pay your tail coverage. Chances are, you will not spend your entire career at one practice.

11. Please do your homework.Physicians as a group tend to prey on each other. Checking things out may save you some pain down the road.

12. Do not believe them when they tell you that they will not try to enforce something in the contract, they will. " Oh I just put that in because my lawyer insisted on it." The purpose of the contract is to protect the practice. Your job is to lessen the negative consequences on you if/when things sour.

13. Do not buy a house right off the bat.

14. Your your God given common sense. No one will give you anything for free.

15. Partnership is not always worth it. It can vary depending on the specialty.
Beware of expensive buy-ins schemes.


I am by no means an expert but I have been through a few things and I have seen friends go through crap.

Good luck

CambieMD
 

EvilNewbie

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Oct 5, 2004
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Hey, thanks for the informative posts... most of the things I already knew but somethings I didn't know such as the hospital guarantees? What is it and how can you tell you have a bad one. I plan on becoming partner wherever I enter my practice but as to how do you know its a bad deal to become partner especially since most partnerships in my field requires expensive payments and time. Thanks!
 
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CambieMD

CambieMD

cambiemd
10+ Year Member
15+ Year Member
Oct 4, 2003
715
4
Southeast
Visit site
Status
Attending Physician
EvilNewbie said:
Hey, thanks for the informative posts... most of the things I already knew but somethings I didn't know such as the hospital guarantees? What is it and how can you tell you have a bad one. I plan on becoming partner wherever I enter my practice but as to how do you know its a bad deal to become partner especially since most partnerships in my field requires expensive payments and time. Thanks!
Hospital guarantees are structured to assist physicians new to an area in building a practice. The problem with hospital guarantees is that existing practices can hire a new doc with a hospitla guarantee. The existing practice receives money to cover the new docs overhead. The practice will receive over 100k to cover your overhead. That sounds nice but the prcatice doesn't sign for the money, you do. The payments that you receive are structured as a loan. You pay back the loan by staying in the area for a certain number of years. It is usually three years. Your salary may be 130k and the practice receives 150k to cover your overhead. You have no say in how the money is spent. Usually you turn into a pumpkin at the end of the first year when the hospital payments end. This practice is seen most often in primary care. The area is usually undesireable because it is rural or urban. The payer mix is usually poor and the practice that now has to pay you will no longer want you.

Partnership makes sense in practices that generate large sums of income. A primary care practice may not be worth the expense of buying in if the cash flow is poor. There are some practices that have severe cash flow problems. Who wants to buy into a business that is losing money. The problem is that practices will not tell you if they are having financial problems but must hire someone because they can't handle call on their own.

Also make sure that your new practice has a buy out if they have a buy in.
Can you imagine spending 200k to buy in and leaving it behind when you leave. It has happened.

CambieMD