han14tra

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I've worked at a hospital for a few months and while I was working there I asked to meet with the CEO and CMO. I told them I wanted to return to work at their hospital, and they were very supportive. I'm meeting with the physician recruiters and CMO in the very near future to discuss a possible service contract. Before signing your life away to a hospital, what information would you ask?

BTW, I want to go into rural family practice. This hospital is a level 1 trauma, NICU, cardiac care center, etc. in a small city. It is a teaching hospital. The hospital owns a multitude of small rural health clinics throughout the county.

So far, I plan on asking:
- Do I always have to refer patients to your hospital or can I send patients elsewhere? Their hospital is the closest, but it is harder to reach in the winter time.
- Size of physician group? What will my on-call schedule look like?
- Am I able to choose the types of insurances I accept (I want to accept medicaid and medicare patients)?
- Will I be able to work in my hometown?
- Will I be able to do a combined FM/EM residency if I choose?
- Where will I do rounds? (note* there are several small hospitals that are affiliates of the parent hospital). They are Critical Access Hospitals.

I also plan of speaking with some physicians that work for the hospital, and seeing how satisfied they are. HELP PLEASE!!! I am so clueless. They've already given me a tour of the hospitals, and have looked at my resume. Residents who are dealing with physician recruiters now, help!
:shrug:
 

chiz2kul

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I honestly dont know much about this, but all I can say is be very careful before you sign your future away like that...
Time/med school does change pple's ideas/perspective on life/future...and to back out on such a contract may have some dire consequences. Use wisdom..
 

DrYoda

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I'd read teh fine print on this sort of thing very carefully. Helping you is a far second (or third) goal for them. Not saying that it can't be a good deal, but whenever I hear things like that my mind immediatly goes to...


watch your back my friend.
 
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Leinie

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I wouldn't do it. It is very common for underserved areas to offer loan repayment over a number of years of service. This applies to primary care as well as other specialties. I have two friends getting their loans repayed in anesthesiology by hospitals. That way, you have freedom to change your mind about specialties or locations. Signing any sort of commitment now regarding what you will do seven years from now is a bad idea. If you do, you better spend some money to have lawyer look over your "contract" and give you advice.
 

stooges287

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Serving underserved communities in exchange for a scholarship shouldn't be a private contract between you and this random hospital. It's a government-sponsored program, with the requirements clearly listed out. I don't remember what it's called, but you should definitely look into that first before you take a chance on this deal.
 

fahimaz7

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You have no idea what you're looking for in a practice. I wouldn't sign anything that required me to spend the x amount of years after a residency in one location.

Think more long term!
 

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It looks you're talking about a scenario that is at least 7 years in the future. You will change over those seven years. Insurance is likely to change over those seven years. The needs of the communities and the associations between the hospitals may change over those seven years.

This is very much like making a commitment while you're in middle school to work for a specific company, in a specific capacity, once you have graduated from college. No matter how much information you can gather online, you will still have the disadvantage of going into this as a naive college student, and the more you think you know ahead of time, the more handicapped you are likely to be, because I think any confidence would be a false confidence. Any contract would not be written up not with your best interest in mind, but would heavily favor them.

Don't let the warm fuzzies you feel now lock you into something that can damage your future prospects.
 
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Captain Fantastic

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Frankly, you're getting way ahead of yourself. The best they'll be able to do is tell you what the average call is for each physician. A lot of things will change in the next few years. They'll have turnover and have different needs when you start work. They might not even accept the insurance that they accept right now! They can't promise you specifics. They can tell you how things work today, but that doesn't mean anything tomorrow.

What they can promise you is a guaranteed job in exchange for paying for your medical school. You need to know a couple of things up front: what's the service obligation and what's the penalty if you abandon the obligation at a later date (i.e., interest rate on the loan, when it starts accruing, etc.).

Don't sign for more than year-for-year obligation. You can get that deal from a lot of places (military, indian services, health departments, etc.) so signing up for more is probably not the smartest investment.

Plus, if they're willing to sign you now it's because they have had difficulty recruiting in the past. Meaning, if you want to work there after residency you probably can. At that point you can negotiate an incentive program that will pay down your medical school debt, say $25K per year until it's paid off. In the end your school is paid off with a pretty similar work obligation.

Food for thought.
 

PremedIowa

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Agree with all that has been said here. You are bedazzled with getting into med school and will be surrounded by hotshots. Not the best decision making time.

Do...not...sign...anything. If they offer you a contract, take it home with you and keep it for a couple months. See how you feel.
 

han14tra

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Here is what I've been offered:

Year 1 Med School: $6,000
Year 2: $6,000
Year 3: $13,000
Year 4: $13,000
Residency: $18,000 additional funds per year.
Obligation: 3 year commitment. Any specialty. Must practice with this hospital.

If I do primary care, I can receive an additional $64,000 through the .Primary Health Care Practitioner Loan Repayment Program in PA.

Total: $156,000
What do you all think of this? Jefferson is $65,000/yr. However, Jeff says the average graduate only owes about $150,000 though. Don't understand financial aid at all.
.
 

mmmcdowe

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You might as well do one of the standard loan for work programs like the military or a service organization. That way, at least it is ALL paid.
 
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mmmcdowe

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difference being however, that you get to choose to do ANY specialty in this case
Ah, I wasn't aware of this limitation.
 

cbrons

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I'd read teh fine print on this sort of thing very carefully. Helping you is a far second (or third) goal for them. Not saying that it can't be a good deal, but whenever I hear things like that my mind immediatly goes to...


watch your back my friend.
ahahahahahahahahahahahahahahahahahahaha


 

J ROD

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OP do not sign your life away.

You will have the option later on. Why do you think they are offering you this? If it sounds good, then there is an angle.

Remember they are not a non-profit.
 

han14tra

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I'm really considering this, although I'm trying to make sure its not a trap. I met with them today. 4 high ranking men in suits + me in a conference room. This was like a med school interview x 10. They said that this is the first time they are offering a contract to a pre-med student, and they are doing it because the avg age of physician is over 55. In 7 years, there will be no physicians within an hour of where I grew up because the physicians there are retiring and the hospital hasn't had much success recruiting doctors to the rural underserved areas of the county. They said I'm probably their only hope of getting a doctor in the area where I grew up. So, it's very difficult for me to resist their offer.
 

Retsage

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Their offer is terrible. Are you insane? You're signing your life away for less than a year's worth of tuition.
 

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p30doc

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Don't do it, how do you know even where you are going to want to live in 8 years for now. You could get married (or divorced if you are married), you could end up doing residency in an unexpected place and loving it there and want to stay, it is too far away to commit like this, especially for such little reward. You will likely regret this.
 

cbrons

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I've worked at a hospital for a few months and while I was working there I asked to meet with the CEO and CMO. I told them I wanted to return to work at their hospital, and they were very supportive. I'm meeting with the physician recruiters and CMO in the very near future to discuss a possible service contract. Before signing your life away to a hospital, what information would you ask?

BTW, I want to go into rural family practice. This hospital is a level 1 trauma, NICU, cardiac care center, etc. in a small city. It is a teaching hospital. The hospital owns a multitude of small rural health clinics throughout the county.

So far, I plan on asking:
- Do I always have to refer patients to your hospital or can I send patients elsewhere? Their hospital is the closest, but it is harder to reach in the winter time.
- Size of physician group? What will my on-call schedule look like?
- Am I able to choose the types of insurances I accept (I want to accept medicaid and medicare patients)?
- Will I be able to work in my hometown?
- Will I be able to do a combined FM/EM residency if I choose?
- Where will I do rounds? (note* there are several small hospitals that are affiliates of the parent hospital). They are Critical Access Hospitals.

I also plan of speaking with some physicians that work for the hospital, and seeing how satisfied they are. HELP PLEASE!!! I am so clueless. They've already given me a tour of the hospitals, and have looked at my resume. Residents who are dealing with physician recruiters now, help!
:shrug:
Here is what I've been offered:

Year 1 Med School: $6,000
Year 2: $6,000
Year 3: $13,000
Year 4: $13,000
Residency: $18,000 additional funds per year.
Obligation: 3 year commitment. Any specialty. Must practice with this hospital.

If I do primary care, I can receive an additional $64,000 through the .Primary Health Care Practitioner Loan Repayment Program in PA.

Total: $156,000
What do you all think of this? Jefferson is $65,000/yr. However, Jeff says the average graduate only owes about $150,000 though. Don't understand financial aid at all.
.
You don't even know what health care is going to be like by then. For all I know, we could have through the roof inflation to where this amount will be mere pennies to what it is considered today. Also, for all I know, we'll have a single payer universal health care system.
 
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mmmcdowe

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Tell them to at least match the offer of the army. You CAN negotiate, even if you feel a bit out of place among them.
 

OncoCaP

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Here is what I've been offered:

Year 1 Med School: $6,000
Year 2: $6,000
Year 3: $13,000
Year 4: $13,000
Residency: $18,000 additional funds per year.
Obligation: 3 year commitment. Any specialty. Must practice with this hospital.

If I do primary care, I can receive an additional $64,000 through the .Primary Health Care Practitioner Loan Repayment Program in PA.

Total: $156,000
What do you all think of this? Jefferson is $65,000/yr. However, Jeff says the average graduate only owes about $150,000 though. Don't understand financial aid at all.
.
Get all the information and then review it with an attorney who has represented physicians in disputes with their employers or with hospitals and discuss it with some physicians in terms of what the value is compared to what you are giving up. I don't think this is the place to review a complex agreement like that (although you might want to ask a question or two). While this may be exactly what you are looking for, you really need to understand what might go wrong. It's a bit like a marriage ... you are less worried about what happens if you have a couple of kids and live happily ever after. What you need to know is what if your perception and the reality don't match in a very unfortunate way.
 

Chemist0157

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I'd hate to limit myself that way. Who knows what you'll be doing and want to be doing in the next few years? I come from a rural community as well that has a small hospital, and while I was volunteering in the ER, this sort of contract was mentioned to me. I dismissed it immediately for above reasons, and I want to say they were willing to pay more than what you have written.

Don't let the $$$ fool you!
 

Vihsadas

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I'm really considering this, although I'm trying to make sure its not a trap. I met with them today. 4 high ranking men in suits + me in a conference room. This was like a med school interview x 10. They said that this is the first time they are offering a contract to a pre-med student, and they are doing it because the avg age of physician is over 55. In 7 years, there will be no physicians within an hour of where I grew up because the physicians there are retiring and the hospital hasn't had much success recruiting doctors to the rural underserved areas of the county. They said I'm probably their only hope of getting a doctor in the area where I grew up. So, it's very difficult for me to resist their offer.
If they are truly that desperate, they should have no problem offering you the same or better when it comes time for residency placement. Be smart. Keep your options open. If I were you, I would not do this, but I would turn them down in a way which doesn't burn your bridges.
 

han14tra

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How much do you think that a hospital should pay for a 3 year service commitment in any specialty? The hospital itself has offered me $24,000 during medical school and $18,000 of loan repayment for each year of residency.
 

MilkmanAl

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If you're as interested in rural primary care as you've claimed to be in the past, you'll have hospitals and state health departments beating down your door to pay for your education if you're willing to sign service contracts with them. Don't sign anything now unless they're going to pay for your entire education for a small (2-3 year) commitment and you'll be in an area you're "sure" you'll want to stay in for awhile.
 

han14tra

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I'm 90% sure I'll end up doing FP. However, I'm not willing to give up rural EM as an option. Both are critically needed in underserved areas. If I was 100% sold on FP, I'd go for NHSC. But, I'm not so I'm talking to this hospital. I KNOW I want to work for this hospital in the future. They are absolutely great, and have done wonderful things for my family and my community.
 

variablistic

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I agree with everyone who has posted so far. The money they're offering is practically nothing, and nobody has any clue what our field will look like in 4-7 years. Someone above posted about something like the national health service corps.

You do not get your choice of specialty with them. They want you to do one of the primary care specialties. (IM, Ob/Gyn, Peds, FP... I'm forgetting one.) However, since you want to do primary care, that's not that big of a deal, and it's a lot better deal than you're being offered.

Don't do it!
 
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Droopy Snoopy

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I'm 90% sure I'll end up doing FP. However, I'm not willing to give up rural EM as an option. Both are critically needed in underserved areas. If I was 100% sold on FP, I'd go for NHSC. But, I'm not so I'm talking to this hospital. I KNOW I want to work for this hospital in the future. They are absolutely great, and have done wonderful things for my family and my community.
Every single post has told you this is a bad idea. It seems you're hellbent on doing this ridiculous thing, so go do it and have a nice day. Not sure what else you want to get out of posting here. Are you looking for the one SDNer who also likes this idea so the two of you can start the Worst Business Decisions of America Club?
 

DeadCactus

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You're making a crappy decision based on an irrational fear of debt. You think any of the areas that need physicians enough to offer to cover medical school will suddenly be full up on physicians in a decade? The same places are going to offer the exact same thing after you finish residency. But go ahead sign a contract to get something that would just be waiting there for you anyway. I mean it's not like anything could change in the next decade...
 

Captain Fantastic

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I'm 90% sure I'll end up doing FP. However, I'm not willing to give up rural EM as an option. Both are critically needed in underserved areas. If I was 100% sold on FP, I'd go for NHSC. But, I'm not so I'm talking to this hospital. I KNOW I want to work for this hospital in the future. They are absolutely great, and have done wonderful things for my family and my community.
FPs staff rural EDs all the time. We don't have a glutten of EM boarded docs running around. As a consequence, FPs can work the EDs in the sticks if they like.
 

jtimmer1

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In my opinion, you would be foolish to commit to this so far ahead. There are so many variables to this equation; variables that you could not even begin to think about. Think of how much could change for you in 7 years. Don't sign away years of your life for any amount of money, especially in a vastly changing field such as medicine.
 

han14tra

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Honestly, I'm scared of having $240,000 in debt. Going into a high paying specialty probably won't happen due to my lack of interest. How am I going to pay this off without a hospital or the government helping me out?
 

MilkmanAl

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The point is that you can get your loans forgiven if you sign a contract after residency if you want to. There's no reason to sign a contract now unless it's too good of a deal to pass up (like full tuition paid in exchange for a 2-year commitment in your dream location or something like that). Bottom line: WAIT to sign a contract until at least after med school.
 

HolyGrail

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In my opinion, you should follow your own opinion.

People said that I would change "OH SO MUCH! LOLZ" in college, but I didn't change pretty much anything about myself. I'm still a cantankerous, argumentative, self centered curmudgeon, except for the fact that I can cook better, I clean up after myself more and... I can't think of anything about life I think differently because of college, give me a break.

If you've done your homework on yourself(Which I can't believe people don't do), then you should know who you are, and what you eventually want to do. If you don't know who you are, or even think you don't know, then you probably don't and should not enter into any contracts.

P.S. I'm really not cantankerous etc...
 

bioteach

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This seems like an absolutely insane idea to me. You haven't even started med school yet and already are going to commit to a specific hospital?

From you MDapps it looks like you are only 21. Seven years from now you will be almost 30. What if:
(1) you get married while in medical school, (2) to someone you haven't even met yet so you know nothing about their future goals, (3) get divorced if you are already married, (4) get pregnant and have to consider children, (5) fall in love with opthamalogy (or insert any other speciality here), (6) fall in love with another part of the country, (7) have a family member in another part of the country get sick and you want to be closer to them, (8) fail out of medical school, (9) just plain decide something else sounds better.

Almost everyone graduates medical school with debt. They all figure out a way to pay it off without indenturing themselves to a hospital in order to do so. There are plenty of loan-repayment type programs if you do choose to go into primary care in a rural setting.

Honestly, you have much more pressing things to worry about directly in front of you (starting classes, etc.) than where you will practice when you are 28.
 
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cbrons

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Yes it definitely does seem quite ridiculous to commit to a hospital before you even start medical school. For all you know, you could absolutely hate medicine and want to choose another career. I mean, it happens.
 

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OP, i hope you make the right choice. there is an overwhelming consensus not to do this. i didn't see any post that said go for it.
 

group_theory

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This hospital is a level 1 trauma, NICU, cardiac care center, etc. in a small city. It is a teaching hospital. The hospital owns a multitude of small rural health clinics throughout the county.
In 7 years, there will be no physicians within an hour of where I grew up because the physicians there are retiring and the hospital hasn't had much success recruiting doctors to the rural underserved areas of the county. They said I'm probably their only hope of getting a doctor in the area where I grew up. So, it's very difficult for me to resist their offer.
Right now you think the hospital you are working at is great. But ask yourself this - why is this hospital having such a hard time recruiting physicians - and desperate enough to invest in their future with premedical students? There are plenty of rural hospitals in this country - not all of them are this desperate for physicians.

Why go through the effort to invest money on someone who won't be able to generate any revenue for the hospital for at least 7 more years?

And one more thing - if you sign this contract - they will OWN you and there is nothing you can do about it without taking a HUGE financial hit/penalty. Don't like the administration? Tough, you can't leave. Don't like the inane policies? Tough. Poor ancillary support staff? Don't like the payer mix (you're seeing all medicaid/medicare/uninsured) - tough. The hospital expecting you to work 6 days a week as well as be on call at all hours for admissions? Tough.

A lot can happen within the next few years. The hospital can be under new management. It could be bought by another healthcare entity. It could turn into a specialty hospital to generate profit for the new owners.

Basically you lose all leverage you have with that hospital by signing that contract. They can dictate the terms, the working conditions, their requirements and you are helpless to do anything about it.

As a premedical student, there is NO way you know what working as a physician is like and what to look for/ask for specifically. No amount of shadowing will prepare you for it. But there is a big clue/warning sign that this particular hospital isn't the utopia that you paint it to be - why would a teaching hospital (with multiple specialty services) have such a hard time recruiting physicians (even amongst its graduating residents) that it is willing to invest money on a premedical student (who is at least 7 years away before that investment can start generating money)? Why is it so hard to recruit new physicians to that hospital or area?

Why would the hospital CEO, CMO and whatever suits they have - arrange to meet with you to discuss your future? Why are they so desperate?

Most hospitals and healthcare centers do not do this, even in rural underserved areas. Something just doesn't sound right.

But it's your life, your future, your financial and emotional well-being. Caveat emptor.
 
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