Physician Employment Contracts Part II: The Story Continues

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physician employment contract

Make sure to check out Part I here!
Today’s article takes a closer look at several key terms in employment contracts that can have a significant impact on a new physician – compensation methods, incentive compensation and outside work or “moonlighting”. Building on our first article that examined termination provisions, non-compete clauses, professional liability insurance and indemnification, we will identify key issues in evaluating compensation models and moonlighting and outline some of the questions to consider before signing on the dotted line. 

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Dr. Sandeep Jauhar, Author of Doctored

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sandeep jauhar

What made you decide to write your new book, Doctored? What were you hoping to accomplish?
When I was growing up, my mother wanted me to become a doctor. She told me, “I want people to stand when you walk into a room.” When I started my first job as a cardiologist, I realized I had been isolated from the changes occurring in medicine. I was a fellow in cardiology; I was learning about the human body, the heart, the physiology, and the therapeutics, but not about the culture of practice. I was shocked to see how unhappy many of my colleagues were. The unhappiness wasn’t just about paperwork, patients going on the Internet, malpractice, the usual things you hear about – it was a deeper, more existential problem. The problem was the systems of medicine didn’t allow them to be the kind of doctor they wanted to be – the same kind I wanted to be. When I entered medical school, I had this fantasy that I was going to reform the profession somehow. I didn’t know how, but I thought I would, somehow. When I got out, I started seeing physicians who were unhappy. I think their unhappiness was a response to this loss of ideals. I think a lot of physicians have had to compromise their ideals because of a diseased system. That’s why I wrote the book. I wanted to write about it and put it out there.

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Junior Doctor Stress and What Can be Done about It

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junior doctor stress

Junior doctors [and residents in the US] do a valuable and sometimes life-saving job for patients. They are the future in medicine and can bring enthusiasm and fresh ideas into the profession. Despite the importance of their role to society, junior doctors have sky rocketing stress levels and many have an appalling state of mental health.
The Shocking Suicide Rate Among Doctors
It is totally shocking that in the 21st century, so many bright young doctors fall prey to depression and around 400 US physicians intentionally end their own lives annually. This means that every year in America, a million patients lose their doctor to suicide. The chance of dying by suicide is greatly increased for those in the medical profession compared with ‘lay’ people. For instance, male doctors have a 70% increased risk of dying as a result of suicide, when comparing the death rates with men from the general population. One of the reasons there are more completed suicides – ironically – may be as a result of doctor training. Doctors know the human body intimately. They know about drug dosages, they know more about the effects of drugs on the body. They know how to save a life and because of this, how to take one. A determined doctor can calculate a fatal drug dose expertly or know where to cut that would be catastrophic. They also have access to powerful, death dealing drugs that are only available on prescription to the rest of the population. This may be why there are so many successful doctor suicides each year.

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A Guide to a Successful Gap Year

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gap year

It wasn’t so very long ago that the typical medical student went straight from high school to a premedical program and then onto medical schools itself. This traditional pathway, however, is not so traditional anymore. The question of a gap year is one which comes up more and more frequently nowadays–and it is also one which can cause aspiring medical students a lot of anxiety as they make the decision about whether to take time off from academia when the undergraduate work is finished.

This article covers different aspects of the gap year, including the reasons why students take it, the fact that is it actually becoming more popular among pre-med students and different opportunities that students can take advantage of during this year off.

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Why isn’t learning about public health a larger part of becoming a doctor?

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public health

Chronic conditions, such as Type II diabetes and hypertension, account for seven in 10 deaths in the United States each year. And by some estimates, public health factors, such as the physical environment we live in, socioeconomic status and ability to access health services, determine 90% of our health. Biomedical sciences and actual medical care – the stuff doctors do – determine the remaining 10%.
Clinical medicine can treat patients when they are sick, but public health provides an opportunity to prevent disease and poor health. But too often, medical students don’t get to learn about public health, or how to use it when they become doctors. That means many of today’s students aren’t learning about health care in a broader context.

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20 Questions: Laura C. Londra, MD, FACOG, Reproductive Endocrinology

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laura londra

Laura C. Londra, MD, FACOG, is a reproductive endocrinology and infertility physician at Ohio Reproductive Medicine in Columbus, as well as an adjunct instructor at Ohio State University in the division of reproductive endocrinology and infertility, Dept. of Obstetrics and Gynecology. As a native of Argentina, Londra attended Universidad Nacional de La Plata (1988-1993), before receiving her MD from Universidad de Buenos Aires (1993-1995). She completed a residency in obstetrics and gynecology at Hospital de Clinicas, University of Buenos Aires (1995-1999), followed by a fellowship in reproductive endocrinology at the Instituto de Ginecologia y Fertilidad de Buenos Aires (2000-2002). In the U.S., Dr. Londra completed a residency in obstetrics and gynecology at Wayne State University, Dept. of Obstetrics and Gynecology in Detroit (2008-2012), and a fellowship in reproductive endocrinology and infertility at Johns Hopkins University, Dept. of Gynecology and Obstetrics in Baltimore (2012-2015).
Dr. Londra received the Pacific Coast Reproductive Society Scholarship Award (2013, 2015), Midwest Meeting Reproductive Endocrinology and Infertility Symposium Scholarship (2014), and Edward E. Wallach Fellowship Research Fund Award for fellows research initiatives in reproductive endocrinology and infertility (2014). She’s been published in numerous journals, including International Journal of Women’s Health, Fertility and Sterility, International Journal of Gynecology and Obstetrics, Seminars of Fetal and Neonatal Medicine, and Case Reports in Obstetrics and Gynecology. She is a member of the Howard Kelly Society, Johns Hopkins Alumni, and the American Society for Reproductive Medicine, as well as a junior fellow in the American College of Obstetricians and Gynecologists and fellow in Society of Reproductive Endocrinology and Infertility. Dr. Londra is a Diplomate of the American Board of Obstetrics and Gynecology, and prior to her current work, she was on staff at Instituto de Gynecología y Fertilidad (2002-2006).

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Increasing Access to Healthcare in America

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The advent of the Affordable Care Act was meant, in part, to help to increase the access that all Americans have to healthcare providers. However, while this has meant that a larger number of families now have health insurance, there is still a long ways to go before equitable access to healthcare is achieved.For medical students who will be coming into practice in the near future, an understanding of this issue and why it is important is a critical beginning to producing new physicians that are aware of the problem and are willing to be both proactive and creative when it comes to finding solutions to it. This article covers health care disparity and why it is important, as well as practical solutions to help close the gap of access to medical care in America.

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The Power of the Patient-Doctor Bond: A Conversation with Michael Clearfield, DO

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michael clearfield

Some people develop the passion for medicine at an early age. Michael Clearfield, DO, was not one of them – but once he did find that passion, he ran with it for miles.Although he’d been interested in science and math throughout college, and had a vague feeling that “something in healthcare would be something I’d be interested in,” it was ultimately a personal experience that cemented his future career goals. “Some personal issues happened in our family, where people got ill, and I was able to experience the healthcare team as it impacts you as an individual,” he told SDN at last year’s UC Davis Pre-Health Conference (UCDPHC15), where he delivered a keynote on opportunities in osteopathic medicine. “There were some very startling revelations to me; some positive, some negative – seeing how the system worked, and how it didn’t – and I decided that [medicine] would be a career that I would like to try and make a difference in.”

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The One Letter to Rule Them All

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letter of recommendation

As an undergrad, one of the reasons you devoted so much time to a research experience was to earn an epic letter of recommendation–one that speaks to your strengths, resilience, character, self-reliance, cultural competencies, ability to solve problems, and contribute to a group effort. This letter will be a comprehensive endorsement of your medical school application complete with specific examples that influenced your PI’s opinion. This one letter has the potential to outweigh all other letters from a professor whose class you attended, or from someone who oversaw a volunteer program you participated in for a semester.

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Love and Happiness… And Medicine? Our Experience in the Couples Match

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couples match

We were in the same class in medical school. It was your typical story. Boy meets girl, girl doesn’t like boy’s buzz cut, they waste a year, eventually end up as anatomy TAs working on the same dissection together, and fall in love. Standard. I knew that I was going to be a surgeon, he was thinking about ER. We moved in together. We talked about getting married. Then he went out for third year rotations and I started the Anatomy Fellowship at our school. He did Surgery mid-way through the year. To my concern, though not to my surprise, he loved it. He loved it the way I loved it. We talked seriously about what this would mean for us, both for our relationship and for our careers. We had always assumed that when the Match rolled around that we would participate in the Couples Match. Couples matching into Surgery seemed like a long shot, but we both knew we couldn’t be satisfied in another field, that we were surgeons at heart. So we decided we had to try.

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What You Should Know: Talking to Your Patients About Their Mental Health

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mental health

Even student doctors who have not yet completed all of their medical training have probably realized that awkward, difficult or delicate conversations are part and parcel of a physician’s practice, and for a number of different reasons. Few conversations you will likely to have with your patients can feel more uncomfortable–for patient and doctor both–than those involving a patient’s mental health. Despite energetic advocacy for the mentally ill in recent decades, the stigma of mental illness remains and many patients may feel embarrassed, upset, or ashamed to discuss these issues with their healthcare providers. A doctor who is comfortable with this topic and can put their patient as ease, however, can more easily screen patients for mental health disorders and, more importantly, get them referrals and contact with community resources that many of them so desperately need.
But how do you start this conversation?

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Chronicles of a Med Student: All Aboard the Financial Struggle Bus

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Chronicles of a Med Student

I remember the sheer joy of ripping open the letter that granted me a medical school spot. Everything was roses and rainbows, and I was thrilled that my dreams were coming true. This cute little fantasy carried on until I received the tuition numbers a few weeks later . . . wow. I had no money, and I was being expected to pay how much? Regardless of what you hear from other people about how doctors make enough money to quickly pay back their debt, those five digits after the dollar sign per year are still scary.

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Time to Start Thinking About Your Medical School Application

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If you are planning to start medical school for the 2017 Fall Semester, it’s already time to start thinking about your application!
You will apply using the American Medical College Application Service® (AMCAS®) for your medical school applications – the 2017 application cycle opens in early May. AMCAS is the primary application method used by most US medical schools. For you, this means that you’ll submit only one online application, regardless of the number of medical schools you choose to apply to.
We’ve highlighted tips and resources to help you begin to prepare for completing your application whether you are applying for this upcoming cycle or sometime down the road.

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5 Soft Skills Every Pre-Med Student Needs

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soft skills

Though the emphasis of the medical school application process lies on academic achievement, there are a number of personal qualities that pre-medical students should strive to develop if they wish to become superior physicians. The development of these soft skills may also make students more competitive medical school applicants when they are evident in interviews and letters of recommendation. Such soft skills include:
1. The ability to work effectively in a team
Modern medicine requires immense coordination between various clinicians and providers. Doctors must collaborate with nurses, social workers, specialists, therapists, and others in order to adequately care for their patients in today’s complex medical and social climate. The ability to lead and to collaborate with team members is a necessity for today’s medical trainees. Pre-medical students can develop this skill while working in a team setting in their college coursework (e.g. group projects and presentations), extracurricular activities (e.g. student government and student interest groups), and other major experiences (e.g. philanthropic organizations and research laboratories). Students should actively strive to lead, but they should also work to see the perspectives of all team members, and to incorporate effective strategies to help their team meet common goals.

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Spring Break: Should You Spend It On The Beach Or At The Bench?

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spring break

For most researchers, working in the lab over a holiday break is somewhat different from working in the lab during the rest of the year. For example, if an experiment has flexibly, it can be started or stopped when it’s convenient for the researcher instead of planned around seminars, classes, and campus parking issues. In addition, some researchers take a vacation, adopt unconventional work hours, or hide in their office to work on a manuscript and only visit the lab to search for inspiration, a snack, or a temporary distraction.
I regularly direct several undergrad projects at the same time, work with other members of my lab team, and pursue my own research projects. And even though I enjoy mentoring my students, the researcher in me wants to take full advantage of holiday breaks. For me, a holiday break is an opportunity to set my work schedule as I please or conquer a particularly difficult experiment without being interrupted much. Alternatively, I might start an experiment, or run out to do errands and share a meal with friends, only to return to the lab when it’s convenient for me. I also want to spend some time relaxing—perhaps on my couch playing Halo—because I benefit from taking a break from directing other’s projects and thinking about how to solve a labmate’s bench woe.

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Book Review–Doctored: The Disillusionment of an American Physician, by Dr. Sandeep Jauhar

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book review doctored

“It is our obligation to remove the biases that stand in the way of good medicine. We need to assure no consideration of economic self-interest will prevent us from giving our patients the safest, most effective, and most economically responsible health care possible.” So spoke the president of the American College of Cardiology to a group of inductees in 2005. In the audience sat many young doctors, including Dr. Sandeep Jauhar, a New York cardiologist struggling with many aspects of the American healthcare system. The convocation speech is filled with platitudes such as this one, and virtually no doctor, especially at the outset of his/her training, would disagree with these sentiments. The struggle, writes Jauhar, is to actually make convocation speeches come to life. How do we keep these sentiments from just being banal and clichéd statements and instead enact them, creating a real impact in the way we practice medicine? This question and the effects of our failure to answer form a central theme in Jauhar’s memoir Doctored.

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