I was recently asked by a practice who is looking for a doctor if it is common for the practice to have a financial penalty should the doctor leave before the end of the contract term. This is the case usually when the new doctor was paid an income guarantee, an advance, a relocation allowance, etc. If not, then a financial penalty is not usually the case. I obtained this information from Physiatry Reimbursement Specialists, Inc., a national billing and practice management company serving Physiatrists all over the U.S. for 20 years, 1-800-324-4777, www.Prsinc.com
Cover Letters
April 27th, 2013
Usually, I don’t recommend a cover letter. Most of the individuals who review curricula vitae do not have the time to review more than the curricula vitae. The only time I would recommend a cover letter is if you have something to feature about yourself which isn’t in your curriculum vitae.
I can’t provide you with a sample cover letter as it has to be specific to you but what follows is a sample of a cover letter minus your specifics. It might be helpful to include your philosophy of practice and goals, if you know enough about the practice that you’re sure they’re a match with it.
Date
Name and Address to whom you are sending the letter
Dear ____________:
I would very much like to learn more about your practice opportunity, to include your needs and the goals of the opportunity. I am certain I have the background and commitment to fill this position.
Body of the letter specific to your skills, experience, training, etc.
Thank you for your kind consideration. I look forward to hearing from you.
Sincerely,
Do you really want that person?
March 18th, 2013
I often talk about how doctors/administrators who are recruiting a doctor want someone whom they can relate to. We tend to like people who share similar interests, be they friends or colleagues. Taking this advice as an interviewee, if you notice that you have a similar interest to the doctor/administrator who is interviewing you, this similar interest is a good topic to talk about during the interview.
I recently read an article that supported the premise that interviewers often select candidates with interests similar to their own. However, the article pointed out that this is not a good criteria for selecting a new doctor. Better than relying on intuition as to who will be a good fit for your practice is to evaluate and analyze your practice needs. Do you want someone who is dynamic and will generate referrals or do you need a worker bee?
Every employer wants the best performance in relation to the investment made. Use key performance indicators to identify the right doctors for the position. What qualities did the the last person you hired who didn’t work out have? What are the needs of the position? What qualities and capabilities will make the person in this new position successful?
References
February 18th, 2013
It’s that time of the year when you might be providing references to a practice or hospital that you’re considering starting work. Here’s some pointers from me based on past experience:
* Don’t include references on your CV. This posting enables the hiring entity to contact your references without telling you first. As a matter of professional courtesy, you should always tell your reference who might be calling or writing to them.
* Use the opportunity to pre-inform your references to also advise them of your skills as they relate to what the interests are of the hiring entity.
* Please make sure that your references will speak well of you. Have candid conversations in advance with them and ask if they feel comfortable providing you with a good to excellent reference.
January 16th, 2013
PHYSIATRY REIMBURSEMENT RATES ACROSS GEOGRAPHIC AREAS
Physiatrists often ask: ” In which city or state would I earn the highest
income. ”
Medicare, and other insurance carriers, have different reimbursement rates
depending on geographic locality, which in turn is based on factors such
as practice costs (overhead, malpractice insurance). The most highly
reimbursed areas are in the big cities (and nearby suburbs). New York City
reimburses more than Los Angeles which in turn reimburses more than
Houston.
Is the variation among localities significant?
Not as much as you may think. An analysis of I/P admission code 99223
shows that the National Average Medicare Allowed amount is $195.
However, of the 90 localities in the country, 72 are within 6% of the national
average! My analysis:
- Only one locality is more than 6% below the national average-Puerto Rico.
- Only eight localities are more than 10% above the national average,
including those you would expect: San Francisco, Anaheim and their
surrounding areas, and NY cities like Manhattan, Queens, and Long
Island. Also included is Miami.
If you want to locate your practice in a highly-reimbursed location,
bear in mind that there is a tradeoff. Although you will be reimbursed more,
the cost of running your practice (rent, staff, malpractice), will be higher,
and in all probability your personal living expenses will also be higher.
Recommendation
I would start with an area in which you could see yourself enjoying, and
then looking at numbers, because by far, the most important determinant of
practice income is the quantity of procedures performed – not the
reimbursement.
But if you are looking at numbers only, the most highly-reimbursed area of
the country for an I/P admission is Alaska – a full 33% higher than the
national average. So, by the numbers, Alaska is the place to be – just
remember to pack your thermal underwear and sled dogs.
Article contributed by Bruno Stillo, Physiatry Billing Specialists, (800)835-4482, physiatrybillman@aol.com
Contract and billings
December 11th, 2012
Question from a Physiatrist Today:Is it a new and perhaps now ongoing item in contracts that if monies are due back for Medicare that the doctor employee will be responsible for his/her share?
Answer: No, the physician employee should not be responsible for anything after or during termination for this issue. This is a billing issue, that is unrelated and beyond his/her control. However, there would be one exception – if the physician is audited, and his/her documentation does not support the level of billing, and is then asking for a refund – then it could be on him/her. It depends on how the contract is written.
Answer contributed by Liz Lee, PRS, Inc., 817-284-9850, 1-800-324-4777, 817-907-0370 Mobile, Website: PRSinc.com
Personality Interview Questions
November 9th, 2012
More and more entities are asking behavioral-type questions during the interview. I even had one practice require that candidates talk with an employment psychologist. These questions require more thought than the standard questions so you should prepare your answers. They delve into your personality. Here are some behavioral questions:
1. Describe your approach with patients? Show empathy and compassion in your response. Note items such as attention to listening, interest in patient education, and engaging the patient in conversation when responding to this question.
2. Tell me about a specific patient who came to you unhappy with the care they received elsewhere. How did you handle it? Once again, show compassion and empathy when answering this question. Your answer will inform they how you deal with worried patients. The same attitude should be displayed in your answers to the following questions too.
3. Please describe a difficult patient, family member or colleague with whom you had to work and how you handled the situation.
4. Please describe a difficult patient, family member or colleague with who you had to work and how you handled the situation.
5. Tell me about a specific patient who came to you unhappy with the care they received elsewhere. How did you handle it?
Reference questions
October 4th, 2012
Perhaps you wonder what kind of questions might be asked about you when a reference is done. Some of the typical questions follow. It’s best to prepare your reference before your reference receives the call. Tell your reference who will be calling and their position. Coach your reference on the qualifications the practice opportunity is seeking and how you match/exceed the qualifications.
How does he/she rank with other you have worked with?
How would you describe his/her clinical judgment?
How well does he/she know her limitations?
What type of practice would best suit him/her?
How would you describe her abilities as a team player?
What number of patients can he/she see per day?
What will a patient’s first impression be upon meeting her?
How curent is he/she with specialty knowledge, CME and/or reading?
The Future
August 28th, 2012
Sometimes I’m asked what the future holds in physiatry needs. When one considers that the vast majority of physiatry residents are going into interventional fellowships, one might conclude that the market demands this service and it is being satisfied. On the other hand, we may be at a saturation point of interventional specialists. One might also conclude that the need for inpatient physiatrists is growing even though some rehab units and facilities have or are in the process of closing.
The upcoming election will have a strong impact on the future needs. With Obamacare, one might predict very large health care systems like Kaiser. Either way, the matter of economies of scale predict large physiatry health care systems and large physician groups. Everything seems to be consolidating. Some solo practitioners have called me looking for work as it’s too dificult to maintain referrals and deal with the business side of the practice.
My stance is to provide a variety of services so that you are not affected by the downturn of any particular service. Census’s vary, the ability of private payments vary, and the payment for interventional services changes so, as such, one has to be flexible and responsive to the marketplace.
Sharing Your CV
July 11th, 2012
Recently a physiatrist who is considering making a practice change asked me what I would do with her cv. As is the norm, she and I talked and I shared information in writing with her about the practice opportunities of potential information with her. This is my routine procedure. I find out where and about what you have an interest. If I have matching practice opportunities, I present them to you and provide them to you in writing. I always want you to know as mmuch about the opportunity as I do. I then follow-up with you in a few days to see what you think about the practice opportunity(s). It is at this point that I ask for your cv if you respond that you are interested in the opportunity(s).
I’ve written earlier that you should hesitate to provide a cv to a recruiter unless they have done the same process as I described above. I do not circulate any doctor’s cv to any practices. Your cv is your possession so it shouldn’t be released without your knowledge. Although it’s not my practice, some physician recruiters use a blind cv to canvas for potential practice opportunities. Or, they present your cv before securing your agreement to do so. Of course, this is not an ethical practice. For this reason, I always advise against presenting your cv until you have heard about a specific opportunity and have an interest in it.