Hello To All,
I am Lisa Whitty Bradley, M.D, FACS, founder and CEO of Chicks With MDs, LLC.
Four and a half years into my practice as a Plastic and Reconstructive Surgeon, I was diagnosed with Multiple Sclerosis. In order to preserve my health and continue to provide for my family, I had to ‘re-invent’ myself, so to speak.
I transitioned from an extremely physically rigorous clinical practice and created an education-based, mobile medical practice that focuses on education, advocacy and empowerment of both patients and physicians.
My goal has always been to educate and provide for my community, which includes the vast arena of medicine. This commitment to continue educating and providing for both patients and healthcare providers, resulted in the creation of Chicks With MDs, LLC.
I spend the majority of my time traveling and expanding my internet based medical practice, doing lectures and disseminating information, regarding a variety of topics that are critical to our overall well being.
After I signed my initial contract, and then later on when I had to review my malpractice and disability policies, I realized that I was extremely ignorant to the main things that were critical to my survival and success in medicine and life.
This short review summarizes Five of the Critical Issues that I think all physicians-in-training, as well as ‘Seasoned’ Physicians, should consider when contemplating a job offer.
CONTRACT NEGOTIATION
Five Critical Factors To Consider Before Signing Your First ‘Real’ Job Contract…….
1.
Make sure that there are stipulations for Short and Long term disability.
*Best To Obtain During Medical School or Training…..The healthier and younger, the better*
The majority of physicians I know, including myself, who are disabled, have likely been diagnosed during practice. Therefore knowing the stipulations of your contract are paramount.
Know the Elimination Period (the time you must wait after becoming disabled until your disability benefits will start). Usually 90-180 days.
Your monthly benefit….make sure it covers ALL of your expenses. Adjust your policy when your position/income changes.
Monthly/annual premium-the actual cost of your disability policy. Make sure that you have a policy that discontinues your premiums once you become disabled and refunds any premiums you paid while you were disabled.
Pay your premiums with POST TAX DOLLARS, so that your benefit is not taxed, if you become disabled.
****Know how your policy ‘defines’ disability****
ALWAYS, ALWAYS, ALWAYS obtain ‘Own Occupation’ coverage/rider. This insures that if you cannot perform ‘your area of specialization’ that you will receive your disability benefits.
Ex. If you are a pilot and you can no longer fly, you will receive your benefits, even if you can still teach flying courses/simulation labs.
Make sure that the policy covers you until AGE 65.
Make sure that you have a Cost of Living Adjustment/Rider, so that the amount of your monthly benefit goes up Annually.
2.
Potential For Practice Acquisition…..
In this Era of solo, multi-physician and multi-specialty medical practice acquisition by big healthcare conglomerates, make sure you know the stipulations in your contract, whether you are an employee or a partner.
Make sure that you know what happens to your position/salary/health benefits/disability/malpractice/call obligations/teaching obligations/retirement/buy-in or buy-out/real estate investments tied to the practice, if the practice is acquired by a separate financial entity.
If you are an employee, do you have the opportunity to buy into the practice before the acquisition, so that you can benefit from any ‘windfall’ from the financial agreement?
What happens to you as an employee or partner once the acquisition is complete?
Do you have the option of keeping your bookkeeping/finances separate from the larger financial entity?
Discuss this with an attorney and accountant.
This is your life.
3.
Is the practice/hospital where you will be employed ‘Self-Insured’?
Whether it is or it isn’t, make sure you are aware if your malpractice policy is a Claims-Made (requires tail coverage if you leave the practice, state or malpractice carrier) or an Occurrence Based (does not require a tail, covers you from the date of the initial occurrence of the ‘injury’, which may have been months, years or potentially decades in the past, not from the date at which you are served with the claim) policy.
If you do have a Claims Made Policy, are there stipulations in your contract for the practice you are leaving to ‘cover your tail’, so that you do not have a large financial obligation if you choose to leave that practice?? If so, is there a time commitment that must be met before they will ‘cover your tail’?
4. Build a SQUAD (Attorney, Financial Advisor and Accountant)
Discuss your contract with your Attorney, who specializes in medical contract negotiations and practice formation/building. An added bonus would be someone with experience or expertise in malpractice policies.
You also need an Accountant/Financial advisor. Please obtain the services of a seasoned professional who has expertise dealing with physicians and wealth building.
Ask your colleagues and mentors if they have advisors that they trust and would recommend.
Please avoid references from family, friends or colleagues who are recommending people because of intimate relationships, rather than these professionals having expertise in the issues discussed above.
This is your life and your professional well being…..keep this in mind, always.
You will see many physician-friends, colleagues and associates, who succumb to the recommendations of bad advice and/or investments, and then suffer the losses from these relationships for the rest of their lives.
5.
Does your policy have a ‘Restrictive Covenant’ or ‘Non-Competition Covenant’?
This prevents a physician, who leaves a practice, from providing medical services within a certain ‘proximity’ to the practice they are leaving.
Make sure you know the specifics of this contract.
It is enforceable and can result in financially prohibitive legal fees for a single physician trying to establish a new practice.
The specifics are sometimes negotiable.
Other Essentials……
You are all probably wondering why salary, moving expenses and bonuses were not on the list.
Well, salary is always negotiable, and is absolutely critical, especially for many of us who exit training in a tremendous amount of debt.
However, the factors that follow you, and can haunt you for the rest of your career, and possibly the remainder of your natural life, are the things that I’ve listed above.
Other Things to Consider and Negotiate:
*Maternity/Paternity Leave **Health Insurance ***Retirement Contribution ****Vacation/CME *****Professional Society Fees/Dues/Board Review Courses ******Protected Research/Academic Time *******RVU based salary/bonus ********Call/Teaching Requirements ********* Do You Have a Guaranteed Salary or Income Guarantee?? (One is a salary, the other is a LOAN…critical for you to know the difference!)
In Summary:
Contract Negotiation Can Be Challenging and Daunting, So take a look, think it over and please consider everything offered to you. If you think of additional questions or concerns, feel free to leave a comment or reach out to me on social media…..The doctor is always in.
As always,
Take care.
Much success.
Be well.
Enjoy the path that you have created for yourself.
Lisa Whitty Bradley, M.D., FACS
CEO & Founder
Chicks With MDs, LLC
www.chickswithmds.com
************NEXT UP*************
The next module will review:
1.Call Obligations
2. Maternity/Paternity Leave
3. CME
4. Salary
5. Health Coverage
See you soon!
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References
- http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/financial-strategies/what-physicians-need-know-about-restrictive-cove