elizabeth “libby” snelson, esq. legal counsel to the medical staff
TRANSCRIPT
Elizabeth “Libby” Snelson, Elizabeth “Libby” Snelson, Esq.Esq.
Legal Counsel to the Medical Legal Counsel to the Medical StaffStaff
Is Hospital Employment for
You?
Limited influence in decision-making — 45 percent More limited income potential — 44 percent Too many rules — 34 percent Less control over work/schedule — 32 percent Being "bossed around" by management — 30
percent Less/lack of autonomy — 27 percent Too much administrative work — 16 percent Burdensome productivity formula — 14 percent Unpleasant office culture — 11 percent Less interesting work — 5 percent Other — 6 percent
Medscape Employed Physicians Report 2014
10 Top Disadvantages
Not having to deal with the business of running a practice — 58 percent
Not having to deal with insurers and billing — 45 percent Guaranteed income and/or even cash flow — 42 percent Good benefits package — 28 percent Malpractice coverage — 25 percent More regular hours — 23 percent Limited or no night call duties — 17 percent Collegiality — 16 percent Staff provided by employer — 15 percent Signing bonus — 2 percent Other — 4 percent
Medscape Employed Physicians Report 2014
10 Top Benefits
Issues to Think About In Your Personal Contract
REMUNERATION & BENEFITS What, How and WhenBonuses/LoansDeductions for Buy-In, Insurance Coverage, etc. Personal and Dependent Health CoveragePension, Disability and Life Insurance WORKING CONDITIONSType/Location Of ServicesCall Schedule, Vacations and Holidays HIDDEN COSTSApplication Fees and Dues Professional Liability InsuranceEquipment TERMINATIONCause/Without CauseNotice ProvisionsCovenant Not to CompeteBeing Fired Effect on Medical Staff Membership
HIRE A LAWYER
Experienced representing physicians
Experienced with hospital employment
HIRE A LAWYER
Former St Vincent’s Hospital Normandy MO
Hospital Employment
Credentialing Standards Disciplinary Requirements
Medical Staff Self-Governance
Hospital Medical Staff Relations
Employed physicians should be members of the organized medical staffs of the hospitals or health systems with which they have contractual or financial arrangements, should be subject to the bylaws of those medical staffs, and should conduct their professional activities according to the bylaws, standards, rules, and regulations and policies adopted by those medical staffs.
Regardless of the employment status of its individual members, the organized
medical staff remains responsible for the provision of quality care and must work collectively to improve patient care and outcomes.
Employed physicians who are members of the organized medical staff should be
free to exercise their personal and professional judgment in voting, speaking, and advocating on any matter regarding medical staff matters and should not be deemed in breach of their employment agreements, nor be retaliated against by their employers, for asserting these interests.
Employers should seek the input of the medical staff prior to the initiation,
renewal, or termination of exclusive employment contracts.
AMA PRINCIPLES FOR PHYSICIAN EMPLOYMENT
Put It In Medical Staff Bylaws
BYLAWS APPLY“Members employed by the hospital, on a full-time or part-time basis, to provide clinical services to patients or to provide back-up call or other coverage, referred to as “employed members,” must meet all qualifications in, and otherwise comply with, the medical staff bylaws.”
COORDINATE INCENTIVES
“Any incentive offered by the hospital to any employed, contracted or other medical staff member is subject to review and authorization by the Medical Executive Committee to assure that it will not adversely affect patient care.”
Put It In Medical Staff Bylaws.2
INCLUSIVE LEADERSHIP
“Employed members may qualify for election to medical staff leadership and appointment to committees, but must disclose their employment relationships as potential conflicts of interest and to allow for balance in committee appointments.”
Put It In Medical Staff Bylaws.3
Put It In Medical Staff Bylaws.4
PROTECT EMPLOYEES
“Employed members will not be subject to employment termination or other penalties as a result of carrying out leadership and other medical staff responsibilities in good faith.”
PEER REVIEW MATTERS
“Selection of peer reviewers, including hearing committee membership, cannot be limited to members who are either employed by or under contract to the hospital.”
“Employed members are not exempt from corrective action, and are entitled to the same rights of hearing and appeals provided in these bylaws to all members.”
Put It In Medical Staff Bylaws.5
Unless specified otherwise in the employment agreement, upon termination of employment with or without cause, an employed physician should not be required to resign his or her hospital medical staff membership or any of the clinical privileges held during the term of employment, unless an independent action of the medical staff calls for such action, and the physician has been afforded full due process under the medical staff bylaws.
AMA PRINCIPLES FOR PHYSICIAN EMPLOYMENT
Annotated Model Physician-Hospital
Employment Agreement www.ama-assn.org/go/employment
AMA Principles of Physician Employmentwww.ama-assn.org/go/employment
Physicians’ Guide to Organized Medical Staff Bylaws
www.ama-assn.org
Resources
ELIZABETH A. SNELSON, ESQ.
LEGAL COUNSEL TO THE MEDICAL STAFF
find me on facebook at snelsonlaw