Public Policy

Your First Job

Within the next few months, many of you will have a new job as an attending hospitalist. As daunting as that may seem, now is the time to think about what you can do to ensure a smooth transition and successful beginning to your career.

Although residency prepared you to face the medical challenges ahead, here are 10 pointers that may help as you move to the next stage of your professional life.

CONTRACT PRIMER

Prior to committing to your first job out of residency, review the contract with a keen eye. Get the advice of a healthcare lawyer before signing a contract and agreeing to the stated conditions. This can prove invaluable especially during contract negotiations. Pay particular attention to the following items:

Malpractice Policies

Identify the type of malpractice coverage your employer provides. The types include:

  • Occurrence malpractice insurance: Provides coverage of claims regardless of when the claim was filed for incidents occurring during the policy period. This insurance will offer seamless coverage even in the event of an insurance policy or job change.
  • Claims-made insurance: Provides coverage of a claim only if the incident occurred and the claim was filed during the policy period. If your claims-made policy is canceled or expired, then coverage no longer exists for any filed claims. “Tail” coverage (liability insurance) is needed at this point.
  • Liability insurance: Provides continued coverage against claims after your claims-made policy has ended. It can be expensive, but prevents gaps in coverage and protects the physician in the event of litigation.

If your contract states you will be provided a claims-made malpractice policy, get details about your liability insurance in writing. Find out how much liability insurance costs, who pays for it, and what affects the cost if you must pay for it. These variables can include tenure with the group as well as circumstances for departure from the group.

Restrictive Covenants

Also called noncompete clauses, these prevent hospitalists from practicing within a geographic region of a previous employer for a certain amount of time. Most noncompete clauses are enforceable by law.

Understand the terms of any restrictive covenant and make sure you’re comfortable with them. Carefully assess any geographic restrictions and how long you’ll remain subject to them. Given the dynamic environment of hospital medicine and the growing demand for hospitalists, these clauses are especially vital.

1) Familiarize yourself with the licensing/credentialing process: Do not underestimate the amount of time it takes to get this paperwork approved—up to six months in some cases. Many new hires’ first days on the job are delayed because they didn’t complete this step. Check with state licensing boards for special requirements unique to that state. Also, every hospital has its own gauntlet of infectious disease, HIPAA, and information- technology hoops to jump through. Getting your applications in as early as possible puts you in position to begin on your planned start date and prevent last-minute catastrophes for your new program.

2) Gain valuable insight through observation: Study your current hospitalist group to gain perspective that will help in your new setting. All programs and hospitals operate differently and have room for quality/process improvement. Interview hospitalists, ask questions, and observe the workflow in your current hospital(s) to help in your new job.

3) Contemplate your career direction: Think strategically about your strengths and plans. Although you will learn an incredible amount about hospital medicine careers after you begin, having a sense of direction will help your new group and its leadership get you where you want to be. Making connections and making your goals known within your new program before you start will put your new career on the right path.

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