hospitalist jobs

12 Tips for OBGYN Hospitalist Job Contracts

1 The first tip is if you do not ask, then you will not get. Too many physicians accept the “standard” contract, sign it without a careful review, do not ask nor negotiate more favorable terms, and do not pay the $500-$1000 to have an attorney review it.

2 It is harder to get major changes in subsequent contracts then it is in the first one. But even in subsequent contracts, it is easy to ask for things like pay raises, more paid time off, more paid CME, and if on salary-to ask for fewer shifts per year. You will be surprised to find that the human resource people, or whoever reviews your contract, frequently will grant you these increases, BUT ONLY IF YOU ASK!

3 If your hospitalist group all have their contracts renew at once, it is worthwhile getting together to try and negotiate a better deal for all of you. You can share the cost of the attorney to review for you (and possibly negotiate for the group).

4 Compensation: Read the salary survey results in www.societyofobgynhospitalists.org . Have a good idea what other OB/GYN hospitalists are being paid in the geographical area. Just call them up and ask. Most colleagues will give you a general idea. After all, you would do the same for a newcomer, correct?

Most OB/GYN hospitalists get either hourly pay or salary for so many shifts per year with only the exceptional position also having productivity factored in. Beware “bonus” additions to salary—be sure they are easily obtainable (ask currently employed hospitalists if they have received their “bonuses”).

5 Watch out for restrictive covenants—how long and how large a geographical area (footprint)? Are they restricted to OB/GYN hospitalists versus general OB/GYN in private practice? Will you have to leave the area if this hospitalist job does not work out for you?

6 Malpractice insurance: Do not sign unless employer provides occurrence malpractice insurance or claims made with employer paying “tail coverage.” If you are working part-time and pay for your own malpractice insurance, ask for an increased hourly wage because the hospital (or employer) does not have that expense in your particular case.

7 Especially with your first contract, engage an attorney who concentrates his or her practice on physician employment agreements. Let them negotiate the deal for you without you alienating your future employers. You can let the attorney be the “bad guy.” You can just say, “I don’t understand this legal stuff,” or “My attorney is making me ask for…”

8 Ask for a sign-on bonus and/or ask for moving expenses (why not? They can just say no).

9 Negotiable costs: Employer paid CME, medical staff dues, DEA fees, transportation costs, and medical Society dues are all negotiable, while disability, health insurance, and retirement packages are generally less negotiable.

10 Other negotiable expenses: Payment of previous malpractice tail insurance, debt, and/or loans can sometimes be negotiated over years of service (generally at least three years).

11 Not-for-cause termination: 90 days is common; try for 120 days—the duration should be the same for both you and the hospital (employer).

12 If you are working for a staffing company, will there be “ownership” opportunities in the future-stock options, etc.?

Further resources:

As an independent contractor, I have been negotiating my own contracts for over eight years (using my accountant as an advisor) I have taken some of these ideas from a recent book I reviewed: The Final Hurdle: a Physician’s Guide to Negotiating the Fair Employment Agreement by Dennis Hursh, published 2012.

Also…

Information for Hospitalists on Legal Issues, Contracts, and Negotiation:

Click here to open webpage in new window

A sample hospitalist contract:

Click here to open PDF

I, of course, am not an attorney and I am not offering legal advice here or anywhere, but I have spoken to a lot of different OB/GYN hospitalists about their contracts and would be glad to share my experience if you would like to contact me.

Good luck in negotiating your own contracts!

Rob Olson, MD, FACOG

What Does a Typical ObGyn Hospitalist Look Like?

One of the reasons I started up my website, ObGynHospitalist.com, was to connect with other ob.gyn. hospitalists that I knew were out there. I wanted to know if they were experiencing the same challenges I was, what their program model looked like, if they were part time or full time, and what their pay and benefits were.
As the website membership grew, it was a logical step to ask members these questions directly.

The first Salary and Employment Survey was sent out in 2011 and had 106 respondents. This year, our third survey had 313 respondents and allowed us to clearly see consistent trends, particularly in ob.gyn. hospitalists’ experience levels, the types of shifts we work, and overall pay and benefits for both part time and full timers.

So, what does a typical ob.gyn. hospitalist look like? Our survey tells us that they are mostly male, between 40 and 59 years old, and are at least 6 years post residency.

Most ob.gyn. hospitalists work in hospitals that average more than 1,000 births per year, with most (45%) working in hospitals with 2,001-3,000 deliveries per year and 19% who work in hospitals with more than 4,000 births per year.
Most describe their primary practice activity as obstetrics with emergency department coverage including emergency gynecologic surgery and inpatient gynecologic consultations. They work full time and have had no change in their employment status over the last 12 months.

The most common full-time work schedule is exclusively 24-hour shifts. Those full-time hospitalists who don’t work 24-hour shifts mostly work 12-hour shifts and are happy with this arrangement.

Ob.gyn. hospitalists are “very satisfied” with their career, variety of work, management, recognition, and professional relationships.

Most work with other ob.gyns. and maternal-fetal medicine physicians only rather than with family practitioners or midwives. Half work as perinatology extenders doing some or most of their deliveries and half use perinatologists only as a consultant, like a private practitioner would.

The majority have ob.gyn. physicians sign out to them, and a third supervise midwives.

Most full-time and part-time hospitalists are hospital employees and are almost evenly split between receiving an hourly gross wage and a salary.

The most common full-time hourly rate (41% in 2012 and 34% in 2013) is $101-$110/hour; 4.5% earn more than $140/hour. Most part-time hospitalists earn less per hour than do full-time hospitalists, with an hourly rate of $91-$100/hour.

The most common full-time salary range (31%) is between $224,000 and $249,000; 4.7% earned between $325,000 and $349,999. The most common part-time salary range is less than $150,000. About 40% of full-time salaried physicians receive incentive compensation based on quality, not production.

A third of respondents stated that they need more physicians in their hospitalist program and that they do not have an adequate emergency backup call system in place. This is an important area for safety, and all programs should address the solution of emergency backup for the hospitalist.

It’s exciting to have this information, not only to know what experience our fellow ob.gyn. hospitalists around the country have, but also it’s interesting to know how other programs are structured, what responsibilities are commonplace, and how our salary and benefits compare with our general ob.gyn. colleagues. The 2013 report can be viewed at ObGynHospitalist.com/news, where you can also find previous survey reports, too.