As an independent broker and advocate for the interests of the physicians I serve, the growing trend of hospital and health system employment is concerning and sad. With well over 20 years of being in the medical malpractice insurance business, I have witnessed this cycle repeat itself probably three times or more, usually with the same outcome.
After years of sacrifice, living hand to mouth and coming out of medical school with a lot of debt, the hope is that the autonomy and potential for a fair income and will be forthcoming. Many toil in modest success towards the goals set forth, only to succumb to the promise of a panacea in employment.
Consider This First
If my view seems jaded, it is because most of the physicians that I have worked with going into these employment relationships I have then assisted in some capacity on the way back out of these relationships.
Most of the time, these return transitions are due to un-kept promises, unmet income promises, mismanaged expectations and changes in hospital administration or “strategic vision.” Sadly, these are peoples lives that negatively affected by these changes in “strategic visions.”
Fortunately, I am happy to report that many of the physicians that have returned from the employment side have survived and/or thrived from the life lessons learned from the experience.
Consult & Discuss Your Options Thoroughly
For those of you considering the opportunity of employment, please consult with your peers. A wise man once told me, “it is not about the marriage, as much as it is the divorce.”
Ask the tough questions on the way in and, please, consider the use of a consultant/attorney/advisor that has experience in developing and deconstructing these deals. Many physicians have gone through what you will be face with and challenged by the “school of hard knocks can sometimes be the best teacher.”
Consultation may also include a discussion with your professional liability broker. Many of my long time clients have successfully retained their current coverage and the benefits earned through that relationship. This is beneficial in many ways. As an independent advocate of your interests, I will be pursuing what is still best for you, rather than what is best for the health system’s bottom line.
You will also retain accrued benefits such as tenure towards your free retirement tail, financial contributions for customer loyalty made by the medical malpractice insurance carrier and many other tangible considerations that may be lost in an acquisition of your practice. It has also been my experience that the premiums offered through the direct relationship with a broker are lower than that of the health system’s “program.”