ࡱ> CI( / 0DTimes New Roman(0(:A 0 DWingdingsRoman(0(:A 0  DArialngsRoman(0(:A 0 @ .  @n?" dd@  @@`` oj'(' "#$&%'!PA3B<     <AA f@8  uʚ;2Nʚ;g4BdBd@:A 0ppp@ <4!d!dl$ 0y<4ddddl$ 0y 0___PPT10 f ___PPT9H @ (*""))$$*%%&&**8     8 *    '8*? % 8JOBS IN HEMATOLOGY 'The Private Sector Daniel Rosenblum, MD*((Before you look: Take stock of yourself &)f(xLikes and dislikes Hematology Colleagues Patients Diseases Goals Long and short term Seek work you enjoy and do well. " d(" d" d" d#" d(!LocationrRegional concentration of hematologists Life style Environment Economic Academic Cultural Access and opportunity h@" d" d" d@ CultureIndependent  solo, sharing, sublet Small group - < 6 Large group  6 or more Manager Administrative structure Governance Stability:N " 6 " N6$"Types of Practice" Solo  dinosaur Office sharing Partnership Professional Association (tax/legal) Corporation Other Models (following slides)& " `+)<Staff Model HMO  disappearing" Provides insurance Hires doctors Assumes full risk (translation: If it doesn t make money, neither do you.)l " l&$0Group Model HMO  Kaiser" Insurance company Provides insurance Full risk HMO Hires doctors May have other clients/contracts Professional risk only (translation: they have to pay you, even if they are losing money.)  " Z " Z " Z " Z'%IPA  Independent Practice Association  a contracting organizationD" D0Contracts with insurance companies to provide care  fees, patients Contracts with doctors to provide care Contracts with other  providers (translation0 "   " (&vNetwork  a multi-specialty health care provider (hospital)<" <SContracts with insurers to provide care Internal administration, governance, staffT " TS,*Follow the money" eWho pays? How much? When? Special needs (cash advance, loan) Payroll deductions Overhead obligations :e "  " ed /Specialty Services You or Practice Will ProvidenHematology Hematology-Oncology Sub-Subsepcialization Coagulation Hematologic Malignancy Transfusion Transplant>5" d:" d5: Location?Office Hospital Multiple sites (distance traveled/day or /week)@ " @ Nature of Work$Consultation only Consultation and primary care of specialty Consultation and primary care Emergency services Special procedures Bone marrow transplant Plasma Exchange Cell separation j" d8" d" d8 Nature of WorkTeaching responsibilities Teaching hospitals/academic position Community hospital Nurses and other staff Community physicians Research Clinical trials Laboratory Other opportunities  legal/pharma/political " Z8" Z," Z " Z" Z-" Z" ZZ8,    /   Nature of WorkAdministrative responsibilities Promotional activities Committee work  office, hospital, community Volunteer activities  advocacy groups, ASH, ASCO Reimbursement  service to insurance companies, CMS, state and local boards " Z Earnings expectations $o wGuaranteed vs risk-taking Regional differences Overhead determination Sharing with senior partners Ethics Outside jobs ,w " ox LAgreements  Before you agree to work2'o fMake sure all agreements are in writing Review all agreements with a trusted adviser, e.g. an attorney If you don t understand something, ask. What you don t know can hurt you badly (see next slide) What are the requirements for partnership? Who owns the practice?*  " ZB  PWhat you don t know can hurt you badly Z)"  f    fDebt/Credit/Capital/Lease obligations Investment/improvements/expansion Covenants/restrictions/buy-sell Disability/departure/30-day no fault/6 month probation6 " HV  If You Think You Like the Job" Deal breakers Negotiables Numbers - patients, time, space, staff, parking, equipment, on-call, holidays, Religion Troublemaker, disabled, retiring Previous hires "  Contract "  "IN WRITING  read it carefully Pay  amount, frequency, formula, bonus Debt  overhead, buy-in Requirements  time, productivity, other Penalties* " fsContractRight to purchase shares Equipment, lease Meeting attendance  rules, payment Vacation, sick leave, disability, health insurance, retirement plan Start up costs(furniture/equipment) Liability coverage First year guarantee-obligation ( " Contract Don tsoJExpect the group to change Expect favors or new ventures Assume anything Trust memory of oral agreements Ignore hunches or discomfort Act too quickly  look around 0 "  "  !ONCOLOLOGY PRACTICE INCOME  "!# ONCOLOLOGY PRACTICE INCOME  'If you are going to work for a Hospital (" ( Hospital administrators, facilities , profit, staff, community physicians. Talk to people  be a snoop Have an attorney read the contract Investigate hospital, community, local industry, financial arrangements History matters! " KHMOs/care contracts - what must you do to generate revenue when you work?BLo 4Forms  number, time Interim arrangement Fee sharing Hours Dollars Patient assignmentsX " XLicensing and credentialing (o fLicenses and permits Medical associations Malpractice history  yours, theirs Personal history  yours, theirs Don t put it off. Get your forms in early. You ll be glad you did.Jo " E " of4f)'SUMMARYbCharacterize yourself/define the job Check options/details  assume nothing Credentials and licenses  do it early Trust your instincts  if it smells bad, it is bad Have Fun!  " $  Rsum or Curriculum Vitae $o Formal document Update regularly Prepare yourself Research/publish Administrative and business skills Teaching experience Procedure trainingP3" [" ! [  )CV Blank (4 slides) Personal Information *o* Legal Name Mailing Address Social Security Number Home Telephone Number Work Telephone Number Birth Date Citizenship Military Service Family (optional) " " Z" Education "   FHigh School College Medical School Internship and Residency FellowshipG " G Work Experience: *"   Name of Employer: Address and telephone number Dates of Employment: Job Title: Description of duties and Responsibilities:  "  Other InformationaEducational Programs Honors and Awards Special Skills/Special Qualifications Board Certification b " b Other InformationMedical Licensure Language skills Knowledge, Skills, Abilities Medical society memberships Academic appointments Research interests* " " b Other Information("  Professional activities: Hobbies and other interests: Publications: I. Abstracts And Unreviewed Articles II. Reviewed Articles. III. Books IV. Major Public Talks 8 "  ! 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P ,  R$720 @` P <4?  ,  R$360 @` P <? ,  NChemo/yr   @` P <?   N$325 @` P < ?P    N$300 @` P <? P  N$250 @` P <?  N$200 @` P <?  P Service/yr   @` P <.? \ L65 @` P <6?P \  L60 @` P <>? \P  L50 @` P <G?\  L40 @` P <J?\ P Hours/week   @` P <R?  \ M200 @` P <b?P  \ M150 @`  P <k? P \ M100 @`  P <]?  \ L50 @`  P <v? \ UNew Consults/yr @` P <?0  `Oncology Practice Income @`fB $P 6o ?00`B %P 01 ?  `B &P 01 ?\\`B 'P 01 ?`B (P 01 ?  `B )P 01 ?, , fB *P 6o ?  fB +P 6o ?0 fB 0P 6o ?0 `B :P 01 ?  `B ;P 01 ?  `B  "P  >  x    ?d #"*deef   "d <> ?   T$425 @` !d <> ?@   T$292 @`  d <> ?@ @  T$148 @` d <> ?p @  T$110 @` d <> ?  p  QNet @` d <> ?A   N$210 @` d <> ?@A   N$140 @` d <> ?@ A @  N$100 @` d <4> ?pA @  M$60 @` d <<> ? A p  MOther @` d <> ? A  M$50 @` d <? ?@ A  M$44 @` d < ? ?@ @A  M$36 @` d <L? ?p @ A  M$20 @` d <? ?  pA  T Rent/capital   @` d <p? ?#  T$1,440f @` d <,? ?@#  R$864f @` d <D6? ?@ #@  R$576f @` d <>? ?p#@  R$290f @` d <pH? ? #p  YChemo cost (2002) @` d <P? ?# N$200 @`  d <pZ? ?@# N$140 @`  d <b? ?@ @# N$110 @`  d <pl? ?p@ # M$80 @`  d <t? ? p# MStaff @`  d <p~? ? T$2,125 @` d <? ?@ T$1,380 @` d <p? ?@ @ R$970 @` d <? ?p@  R$560 @` d <? ? p T Gross Income   @`fB #d 6o ? `B $d 01 ? `B %d 01 ? ##`B &d 01 ?   `B 'd 01 ? A A `B (d 01 ?   fB )d 6o ?   fB *d 6o ?   `B +d 01 ?pp `B ,d 01 ?@ @ `B -d 01 ?@@ `B .d 01 ? fB /d 6o ? H d 0޽h ? 33ff̙ B:`+;p(  px % 9p #"*S% "p <?   ] $2,125 $1,851 @` !p <x?P  ] $1,380 $1,216 @`  p <X? P  Y $970 $860   @` p <?   Y $560 $505   @` p <l?  KTOTAL @` p <0?    [ $1,800 $1,526 @` p <?P   Y $1,080 $916   @` p <? P  W $720 $610   @` p <?   W $360 $305   @` p <?   NChemo/yr   @` p <x?   R$325 @` p <?P    R$300 @` p <H ? P  R$250 @` p <?  R$200 @` p < ?  P Service/yr   @` p <x)? Q L65 @` p <H2?P Q  L60 @` p <;? QP  L50 @` p <C?Q  L40 @` p <,M?Q P Hours/week   @` p <@V? Q M200 @`  p <^?P  Q M150 @`  p <h? P Q M100 @`  p <p? Q L50 @`  p <y?Q UNew Consults/yr @` p <L{?% gOncology Practice Income (2004)   @`fB #p 6o ?%%`B $p 01 ?`B %p 01 ?QQ`B &p 01 ?`B 'p 01 ?  `B (p 01 ?  fB )p 6o ?fB *p 6o ?%fB /p 6o ?%`B 1p 01 ?`B 2p 01 ?  `B 3p 01 ?P P `B 4p 01 ?  RB :p s *D ` RB ;p s *DP P H p 0޽h ? 33ff̙     1Al< (  lx    @l #"*   l <? ?  X$425 $56   @` l <x? ?@  X$292 $86   @` l <? ?@ @ X$148 $72   @`  l <(? ?p @  X$110 $80   @`  l <? ?  p QNet @`  l <? ?   N$185 @`  l < ? ?@   N$122 @`  l <(? ?@ @  M$86 @` l <D@ ?p @  M$50 @` l < @ ?  p  MOther @` l <@ ?`   M$50 @` l <@ ?@`   M$44 @` l <p@ ?@ ` @  M$36 @` l <(,@ ?p` @  M$20 @` l <5@ ? ` p  T Rent/capital   @` l <\>@ ?`  T$1,440f @` l <G@ ?@`  R$864f @` l <\P@ ?@ @`  R$576f @` l <Y@ ?p@ `  R$290f @` l <[@ ? p`  R Chemo cost   @` l <]@ ? 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