![]() ![]() However, after you have committed, the attention will be directed at the next pressing need and you may be left to navigate the complexities of the new health environment on your own. When interviewing, you are the focal point of the organization’s attention as they put their collective best foot forward in an attempt to acquire your services. Although no one would argue that one in two call isn’t sustainable, attempting to renegotiate the terms of your contract within the first year of employment will not be received favorably and your lack of operational knowledge prior to executing the document could lead to strained relationships with the organization’s leadership.ĭuring the recruitment process, not only do you have to ensure that you perform your due diligence in an effort to mitigate the delta that may exist between your contract language and your practice reality, you will need to recognize that the undivided attention you received during the recruitment process will be diluted after you commence your practice. Nevertheless, the impact is that you are now on call every other day and every other weekend and as a result, you want to meet and negotiate a different, more sustainable, call rotation. However, what if the call rotation you believed to be shared between four physicians is only shared by two? This occurs when physicians are exempted for tenure as outlined within the medical staff bylaws, there is unanticipated turnover, etc. For example, your contract may state that you have to take an equitable share of emergency department call. Contractual language is generally nebulous and difficult to comprehend and, unfortunately, if you don’t seek clarification prior to signing, you will not know how the terms are interpreted until they are applied to you and your practice. The most common mistake made by physicians of all specialties is attempting to renegotiate the terms of their contracts immediately after commencing their practices. Based on this premise, the purpose of this article is to highlight the common mistakes made within the first year of employment and to provide you with strategies to avoid them. Although this may not be statistically significant, it does emphasize the need to assimilate as quickly as possible. Why is this important? To prepare for a national meeting a few years ago, I had estimated that 22 physicians per business day do not make it through the first year of their contracts. ![]() With this stated, this is a relatively short courtship and will not provide you with the time required to fully comprehend what it will be like to “live” within your new working environment. On the contrary, first interviews generally last no longer than a day-and-half and second interviews may last two days with a preponderance of the time dedicated to searching for a home. The primary reason for physician turnover is poor cultural fit,* and when thinking through this phenomenon, it shouldn’t come as a surprise. Career resources content posted on NEJM CareerCenter is produced by freelance health care writers as an advertising service of NEJM Group, a division of the Massachusetts Medical Society and should not be construed as coming from, or representing the views of, the New England Journal of Medicine, NEJM Group, or the Massachusetts Medical Societyīy Thomas Crawford, MBA, FACHE, Faculty, Department of Urology, College of Medicine, Affiliate Faculty, Department of Health Services Research, Management and Policy College of Public Health and Health Professions, University of Florida and Eliana Cardona, Student, University of Florida
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