The Great Resignation in Healthcare – A Great Opportunity to Renegotiate

the Great Resignation in healthcare

The Great Resignation in healthcare is producing tremendous challenges for physicians. In particular, many “senior” physicians (some as young as 50 years old) are simply throwing in the towel and resigning rather than continue with the brutal schedules imposed by many employers. As physicians leave, it is becoming increasingly difficult to recruit new talent, so in many cases the remaining physicians are forced to take up the “slack.” That “slack,” of course, represents the patient contact hours and call coverage schedule that burned out the physician or physicians who left.

 As the burden on physicians increases, the value of these physicians should also increase. That would be the case in any rational system. However, the US healthcare system is anything but rational, so in most cases physicians are forced to accept incredible burdens as “part of the job.”

 As a physicians’ attorney with 40 years of experience, I never cease to be amazed by the resilience of physicians. However, I must admit that I also become discouraged by the unwillingness of most physicians to look after their own welfare as well as they look out for their patients.

 No other professional would require this advice, but physicians should realize that the Great Resignation in healthcare, in addition to imposing incredible burdens upon them, also presents the perfect opportunity to consider renegotiating their employment agreements. Employers know that recruiting physicians is expensive and time-consuming. Physicians are in massive demand, so finding a new position will not be difficult. Employers have to worry that losing yet another physician will so overburden the remaining physicians that a mass exodus may result.

 Accordingly, the position of physicians right now could hardly be stronger. The question to me is not if the Great Resignation in healthcare means you should renegotiate – it is more appropriate to ask what should be renegotiated. The simple answer to that question is “everything.”

 If you have not compared your current compensation to Medical Group Management Association (“MGMA”) benchmarks recently, now would be an excellent time to do so. Note that MGMA benchmarks in many specialties can be filtered for years of experience, as well as minor geographical areas. Your compensation may be close to median nationwide for physicians at all levels of experience, but it may be below median for physicians with your experience in your current practice setting. A MGMA compensation analysis might uncover a serious deficiency in your pay. And don’t even get me started on the question of if all physician compensation should be average!

 A retention bonus seems like the minimum that should be requested. After all, if you left this position, your new employer would certainly offer you a physician sign-on bonus.

If you are performing administrative duties, perhaps a medical directorship should be considered (with appropriate additional compensation). MGMA has benchmarks for medical directorships.

MGMA also has benchmarks for call coverage and compensation for excess call coverage. As more physicians leave, it is likely that the call coverage requirements of the remaining physicians is in excess of MGMA benchmarks. Now might also be the time to request a limitation on call (e.g., no more than 1:5).

 Now would also be a good time to request appropriate staffing. A scribe would not only make your life easier, but would certainly be less expensive for the employer than replacing a burned out physician spending countless hours at night maintaining the EHR.

Productivity compensation also seems appropriate to compensate physicians for the increased workload they are facing.

 Does your contract discuss patient contact hour requirements? It should. Now is the time to request a maximum of 32 patient contact hours per week, to give you adequate time for charting and other administrative duties. Even if the employer only meets you halfway, 36 patient contact hours would at least give you some time to update the EHR during working hours.

 The physician benefits of many employers provide a cell phone and usage plan. Do you have one? In addition, you might request board recertification fees and payment of professional society dues separate from your CME allowance. You might also request payment of the AOA or AMA dues, as well as state and local medical society dues outside of your CME allowance. It is also a good time to revisit the physician disability  provisions in your employment agreement.

 New physicians frequently get medical school debt assistance. Is there a reason that you should not get that too?

 The Great Resignation in healthcare represents the perfect time to request limitations on where you can be assigned. You should also examine the malpractice insurance provisions in your current agreement. If tail coverage is not addressed in your contract, perhaps the employer could agree that tail coverage will be paid under all circumstances when you leave.

 For employment agreements with a private practice, you may want to consider asking for accelerated consideration of partnership.

 The Great Resignation in healthcare does not have to be an unmitigated disaster for physicians. There are numerous ways your contract (and your life) can be made better. If you do not want to do it for yourself, do it for your patients. A burned out physician will not give those patients the same quality of care as a reasonably rested physician would give. For the sake of your patients, please renegotiate your contract!

Want help renegotiating? Let us renegotiate your contract for you.

 

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Dennis Hursh

Dennis Hursh

Dennis Hursh has been providing healthcare legal services in Pennsylvania since 1982. Since 1992, he has been a physician's lawyer serving as Managing Partner of Physician Agreements Health Law, the first law firm in the country to focus exclusively on physician employment agreements. Dennis has devoted his life to serving physicians and medical practices. He is the author of the definitive book on physician contracts "The Final Hurdle - a Physician's Guide to Negotiating a Fair Employment Agreement, and a frequent lecturer on physician employment agreements.

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    How It Works

    After purchasing the physician contract review, you will receive an email asking you to transmit the agreement and any concerns you have to me. Many physicians do this by email, but I will be available by phone, too. In three business days from the time you purchase the Physician Prosperity Program® and transmit the draft physician employment agreement along with any concerns you have about the agreement and the information I will need to perform the MGMA analysis, you will receive a detailed physician contract review letter from me.

    After you receive my physician contract review letter, you will have the opportunity to discuss it with me, to make sure all of your concerns were met, and to correct any factual inaccuracies, or to point out things that were verbally promised but didn’t make it into the physician employment agreement. These discussions, and revisions of the letter following these discussions, are included in the initial fixed fee.

    Once you are completely comfortable with the physician contract review letter, you transmit the letter to your potential employer.