How Would You Schedule Your Supervision Agreement?

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How would you negotiate the following:

- compensation: the more the mid-level is seeing, the more liability I would have and the more compensation I would need
- malpractice: how does this work for a supervising physician?
- ability to walk away from supervision: if the mid-level is not teachable, how to walk away?
- compensation for legal issues: what is fair hourly rate if I take time away from work due to legal issues because of mid-level?
- lawyer fee to review contract (payable even if negotiations falls through)

How do you find a good lawyer that is experienced with supervision agreements?

 

[PikminOC]

One billion dollars

 

[Merely]

Compensation per mid level is around 8-12k per month, you should not accept lower than that..this is your license we’re talking about not a joke..you’re entire future could end as a result of the mid level so you should be paid accordingly

 

[PikminOC]

Compensation per mid level is around 8-12k per month, you should not accept lower than that..this is your license we’re talking about not a joke..you’re entire future could end as a result of the mid level so you should be paid accordingly

Compensation for supervision? Really.?

 

[Merely]

Compensation for supervision? Really.?

What?

 

[MBBSMOM]

Compensation for supervision? Really.?

I have never heard of anyone receiving compensation for supervising mid-levels. When you're an employee it's kind of expected for you to supervise mid-levels for no additional revenue.

 

[Ironspy]

I tell employers it's a deal breaker for me. I will not supervise NPs in any capacity at this pint. I am in an independent practice state but many large hospitals around here still requires MD supervision of NPs. I know others feel differently

 

[TexasPhysician]

I have never heard of anyone receiving compensation for supervising mid-levels. When you're an employee it's kind of expected for you to supervise mid-levels for no additional revenue.

Compensation is common and expected in psychiatry. $5k/month would be my minimum.

 

[AD04]

I usually say no supervision. But there are a few cases I would make an exception (e.g. a mid-level who is an excellent clinician due to being a physician in another country and who I have worked with before). And this is not required for my job as there is no way I'll take a job that requires me to supervise. This is apart from my job and I will definitely demand compensation for this.

I do plan to draw up treatment guidelines and list medications the mid-level can prescribe without my input. I also plan to read and sign every single note from the day during the same night.

Still all this is up in the air.

For those with fixed monthly fee, is there a patient cap?

 

[Merovinge]

I have never heard of anyone receiving compensation for supervising mid-levels. When you're an employee it's kind of expected for you to supervise mid-levels for no additional revenue.

Whats expected of you as an employee is outlined in your contract as an employee. If you didn't agree to it, you don't have to do it, that's how contracts work. If you agreed to it, then you would need to understand what that entailed when you signed it.

If someone is looking to start it anew, I would agree that bare minimum I would consider it for is 5k a month if I knew the provider or had no-fault way of opting out with say, 3 months notice.

Physicians are SO terrible at getting ramrodded by MBA's. We have horrible education regarding the law, business, contracts, and what we are worth and what it has led to is a huge erosion in the practice of best medicine, higher costs to patients, and way more private jets for MBA's. You do not need to be complicit in the practice of sub-optimal medicine, even if other people have learned to be yes-sir doctors and do so to avoid confrontation.

 

[FlowRate]

Whats expected of you as an employee is outlined in your contract as an employee. If you didn't agree to it, you don't have to do it, that's how contracts work. If you agreed to it, then you would need to understand what that entailed when you signed it.

If someone is looking to start it anew, I would agree that bare minimum I would consider it for is 5k a month if I knew the provider or had no-fault way of opting out with say, 3 months notice.

Physicians are SO terrible at getting ramrodded by MBA's. We have horrible education regarding the law, business, contracts, and what we are worth and what it has led to is a huge erosion in the practice of best medicine, higher costs to patients, and way more private jets for MBA's. You do not need to be complicit in the practice of sub-optimal medicine, even if other people have learned to be yes-sir doctors and do so to avoid confrontation.

Also the majority of our training pipeline fosters learned helplessness/deference to "authority."

I guess if you spend 10 hr per month reading all the NP's notes for 5k that would probably be doable. They would have to chart really clearly. There's still the problem that you haven't actually "seen" the patient and thus have no clue if their reporting is accurate.

 

[calvnandhobbs68]

Whats expected of you as an employee is outlined in your contract as an employee. If you didn't agree to it, you don't have to do it, that's how contracts work. If you agreed to it, then you would need to understand what that entailed when you signed it.

If someone is looking to start it anew, I would agree that bare minimum I would consider it for is 5k a month if I knew the provider or had no-fault way of opting out with say, 3 months notice.

Physicians are SO terrible at getting ramrodded by MBA's. We have horrible education regarding the law, business, contracts, and what we are worth and what it has led to is a huge erosion in the practice of best medicine, higher costs to patients, and way more private jets for MBA's. You do not need to be complicit in the practice of sub-optimal medicine, even if other people have learned to be yes-sir doctors and do so to avoid confrontation.

100%

Life lesson here for people stating they’re “expected” to supervise midlevels without getting anything extra for it is to stop getting bent over by the hospital administration. The whole point of midlevels in the outpatient office for all specialities is to boost revenue and minimize expense by allowing physicians to “extend”. If you’re doing that for free and getting paid nothing for taking on the extra liability, you’re just letting yourself get screwed.

If they arent going to pay you to be a liability sponge, then they don’t need supervision and can stand on their own two feet when they get sued.

 

[MBBSMOM]

Whats expected of you as an employee is outlined in your contract as an employee. If you didn't agree to it, you don't have to do it, that's how contracts work. If you agreed to it, then you would need to understand what that entailed when you signed it.

If someone is looking to start it anew, I would agree that bare minimum I would consider it for is 5k a month if I knew the provider or had no-fault way of opting out with say, 3 months notice.

Physicians are SO terrible at getting ramrodded by MBA's. We have horrible education regarding the law, business, contracts, and what we are worth and what it has led to is a huge erosion in the practice of best medicine, higher costs to patients, and way more private jets for MBA's. You do not need to be complicit in the practice of sub-optimal medicine, even if other people have learned to be yes-sir doctors and do so to avoid confrontation.

I do not supervise any mid-levels at all others at my job do and receive no compensation.

 

[finalpsychyear]

I was very iffy on the idea of it and still don't like it. I only agreed after the med director took the new mid level and gave me one with 20 years experience who is competent. I am a 1099 contractor and agree that an employed doc should never have it in the contract they eventually sign and negotiate that separate if it comes up. Remember they only care about making money while reducing cost. They can hire a doc for 200k or a mid level for 80-100k and make about the same amount in productivity the admin are clearly going with with the midlevel. so if they pay you 60k for a year plus 80-100k midlevel they still save 40k-60k vs hiring another doc. Don't let them get away with any less.

 

[Merely]

I was very iffy on the idea of it and still don't like it. I only agreed after the med director took the new mid level and gave me one with 20 years experience who is competent. I am a 1099 contractor and agree that an employed doc should never have it in the contract they eventually sign and negotiate that separate if it comes up. Remember they only care about making money while reducing cost. They can hire a doc for 200k or a mid level for 80-100k and make about the same amount in productivity the admin are clearly going with with the midlevel. so if they pay you 60k for a year plus 80-100k midlevel they still save 40k-60k vs hiring another doc. Don't let them get away with any less.

So how much are you being paid to supervise the mid level..?