Do Physicians Need Agents?

Negotiating and signing your first physician contract can be a time-consuming process filled with many unknowns. In light of the complexities of a contract and the relatively high income that is at stake, many physicians are turning to agents to job hunt, and more importantly, negotiate their contracts.

Whether this growing trend is fiscally successful for physicians is arguable and depends upon several factors. Up front, it will cost you; some agents charge an hourly fee, while others may take a percentage of your first year salary. On the other hand, having an expert that fully understands your fair earning potential could net you a much larger salary than you might be able to negotiate. Physician agents also have experience and knowledge regarding non-compete clauses, bonuses, and fringe benefits. In addition to their expertise and the possible financial benefits, an agent will surely save you time.

There are other questions to consider before deciding whether hiring an agent is best for you, such as how your prospective employer will feel about working with an agent or even how you go about finding an agent. Synerge is a physician representation agency that addresses several general FAQ about agents. Physicianjobs.org also has a section on physician agents and liaisons.

Exactly how much an agent might improve your overall employment package will vary based on your specialty, prospective employer, and location, among other factors. Determining the advantages of hiring an agent is somewhat of an inexact science, but then again, so is negotiating your first contact on your own.

The Emergence of the Health Coverage Coalition for the Uninsured

The lack of affordable health insurance and the number of Americans that live without it is undeniably a problem. In 2006, insurance premiums for an employer-sponsored health plan for a family of four averaged $11,500. Those prices have resulted in, at last count by the Census Bureau, 46.6 million uninsured Americans, or 15.9 percent of the population. Many of those uninsured Americans are children. Those figures don’t look like they will be improving anytime soon. In 2007, children’s health insurance programs in 17 states face a budget shortfall of $800 to $950 million, which could affect over 500,000 low income children.

On Thursday, however, a historic coalition of national organizations announced a proposal to confront those problems by expanding health coverage to the uninsured. The coalition, known as the Health Coverage Coalition for the Uninsured (HCCU), is made up of 16 organizations, ranging from the U.S. Chamber of Commerce to Johnson & Johnson to the Catholic Health Association. The groups have met 15 times over the past two years, but have not been in the public eye until yesterday.

The HCCU unveiled its plan to help reduce the number of America’s uninsured through tax breaks and by expanding existing programs. While the first phase of the plan is focused on enrolling eligible children in Medicaid and the State Children’s Health Insurance Program, the second phase would allow states to expand Medicaid to low-income adults.

The HCCU did not offer concrete ideas for paying for their plan, but seems content to “provide a roadmap” and let Congress take action from there. There is still skepticism about how Congress will react, though the new Democratic majority seems open to change in healthcare legislation. In addition, the diversity and influence of each individual organization behind the HCCU can only benefit its proposal.

The Essentials of a Resident's Disability Insurance Policy

Several months ago, this blog addressed the wisdom and foresight of having disability insurance as a medical resident. Just as important as having disability insurance is understanding which policy is best for you. This blog will help you sift through financial and insurance jargon and determine what you actually need in a policy.

There are three features that any policy a resident is considering must have:

• Own Occupation Coverage – Considering a physician’s earning power, this is especially important. An own occupation policy considers the insured totally disabled even if he or she can work in another occupation. For example, if a surgeon making over $200,000 per year is disabled and can no longer perform surgery, but can still work as a professor (with a considerably smaller income), an own occupation policy will help compensate for that loss of income. Plans that are not own occupation specific may only cover total disability and not pay benefits if the policyholder is partially disabled or can do other work. Social Security Disability Insurance (SSDI) only covers total disability and the inability “to adjust to other work” because of medical conditions.

• Future Increase Option (FIO) Rider – This benefit allows the insured to increase coverage at later dates without providing further evidence of medical insurability. An FIO Rider gives you the flexibility to add coverage even if your health status declines.

• Guaranteed Renewable and Non-Cancelable – These policies cannot be canceled or altered by the insurance company due to change in health status or age (up to 65), and can be renewed at the same premium for as long as the policyholder desires.

Besides the aforementioned essentials, there are also other things to watch for. With the long-term nature of disability insurance and its payable benefits, choosing an insurance company that is financially strong and highly rated is essential. For example, Doctor Disability recommends companies with nothing lower than an “A” rating by AM Best. Doctor Disability also offers some additional shopping tips.

If you have specific questions about what you should look for in a disability policy, feel free to post them below and I will answer as soon as I see them.

Will the Government Negotiate Medicare Prescription Drug Prices?

The result of the midterm elections – a new Democratic majority – could have a wide-ranging effect on the healthcare industry. While some issues, such as the House stem cell debate, are based primarily on ethics, many issues are largely fiscal in nature. Congress reconvened last week, and Speaker of the House Nancy Pelosi said that several of these issues will be voted on within its first 100 hours.

One hot topic concerns Medicare prescription drug prices, which have been determined by private health care plans since the Medicare Modernization Act of 2003. On Friday, the Democratic majority will introduce a bill that would allow the secretary of the Department of Health and Human Services (HSS), Mike Leavitt, to negotiate prices directly with pharmaceutical companies. Private health insurers would still be able to offer lower prices on Medicare prescription drugs than those negotiated by the HSS, but this bill would give the government an option in price setting.

The HSS, however, seems to be balking at the idea of negotiating prices. In a recent press release, they project decreasing Medicare costs. In addition, Secretary Leavitt recently stated that, “consumer choice is working” and “government interference will not lead to lower drug prices.”

In its 2007 advocacy agenda, the American Medical Association also generally mentions improving Medicare, along with several other specific issues. The AMA did not address the negotiation of Medicare drug prices in its advocacy agenda, but it has applauded Congress for other legislation.

While opinions on the Democratic agenda vary, what ultimately happens on Capitol Hill could alter your daily practice. The price and availability of prescription drugs, number of patients you see, or your patient demographic are just a few things that could change due to new legislation. By being aware of current events, you can anticipate these changes and prepare yourself accordingly.

Volunteering as a Physician

Daily practice provides physicians with the opportunity to help others, but volunteering allows them to help people that might not otherwise be fortunate enough to receive regular medical care. Because practicing medicine is strenuous and time-consuming, it might seem that taking time to volunteer will make life more hectic, but many physicians find just the opposite to be true; the rewards of volunteering remind them why they chose to practice medicine in the first place. Volunteering can be enjoyable and even help prevent vocational burnout.

There are countless opportunities for physicians to volunteer their professional talents—from weekend aid in their own town to performing surgery overseas. Due to the large number of organizations dedicated to physician volunteering, you may find it easiest to browse websites that offer lists of organizations rather than search individually.

The American College of Physicians categorizes their list of volunteer sites into four groups: Domestic Volunteerism, Overseas Volunteerism, Disaster Response, and Caring for the Underinsured and Uninsured. The American Medical Association has a list of 32 health, relief, and human rights organizations that seek volunteers. Diversion Magazine has brief summaries and contact information for nearly 100 organizations.

If you volunteer, there are some insurance and legal issues to consider. In terms of malpractice liability, your insurance carrier should cover volunteer activities, but you must notify your insurer before you start. It would also be a good idea to check state licensing and liability laws for volunteer physicians, since they vary by state.

Financially, volunteering does offer a few tax breaks. A physician cannot deduct the value of his or her volunteer time or services, but can deduct expenses incurred that relate to those volunteer services, such as dues or fees paid to an organization of the cost of supplies or equipment.

Whether you are an accomplished volunteer or your last volunteer experience was when you were trying to bolster a medical school application, the opportunities are plentiful. You can volunteer your professional services for years at a time or for a just an hour or two. No matter how you volunteer, the results can be valuable and rewarding both personally and professionally.