| Are you a Physician Looking for an Emergency | | | | "open-books" policy, where the physicians are kept |
| Medicine Job? | | | | up-to-date with the amount of collections, expenses, |
| Whether you are a seasoned attending or just coming | | | | and the salaries/reimbursements to the rest of the |
| out of residency, one critical aspect that will affect | | | | partners. |
| your career is the type of practice you choose to join. | | | | In "Contract Management Groups" the physician is an |
| There are many types of Emergency Departments to | | | | employee of a company that provides EM |
| work at (community, academic, military, rural, urban, | | | | professional services to a particular ED, that is, the |
| etc...), but what I'm referring to here in terms of | | | | company holds the contract with the hospital. The |
| "practice" is the sort of contract you enter into with | | | | contract management group deals with all the financial |
| your employer. There are 3 basic types of practices, | | | | management and human resources aspects, and |
| and this article attempts to shed some light on the | | | | subsequently pays the physicians either a salary, hourly |
| subject. | | | | wage or a productivity based type of pay. The |
| The "Democratic Group" practice is a type of practice | | | | physician may either be employed directly by the |
| that has been getting much support in recent years. In | | | | group, or work as an independent contractor on behalf |
| this type of group, member physicians are equal | | | | of the group. Traditionally, the physician provides clinical |
| partners in terms of having a vote within the groups | | | | care and has little input as to the finances of the group |
| operations. Members are,in a sense, business partners | | | | and how they are to be managed. The benefits of |
| that share a portion of the collected revenue, vote on | | | | working for CMG's are the significant economies of |
| important decisions, and are active in the group and | | | | scale that they offer; these groups save much on |
| subsequently hospital politics and committees. The | | | | billing, insurance and hiring costs due to their typically |
| group is responsible for maintaining its own financial | | | | large sizes, and therefore stay competitive in terms of |
| management, human resources, contract management | | | | pay with closely located democratic groups. |
| and the like. Such obligations typically entail a senior | | | | The last type of practice is the hospital employee, |
| member of the group to direct such operations. While | | | | whereby the physician works directly for the hospital |
| members of the group are equal, not all employees of | | | | entity rather than a physician group. There is no |
| the group may have voting rights until a certain period | | | | negotiations of the ED contract nor does the physician |
| of time has passed (typically 1-5 years) and often | | | | have to concern themselves with the financial |
| times with a significant "buy-in", that is an outlay of | | | | management of the practice. This type of practice |
| money required on the part of the physician prior to | | | | ensures that physicians are not vested in their own |
| becoming a member of the group. The buy-in period | | | | practice in that they are hospital employees, much like |
| typically occurs via reduced reimbursement of the | | | | a surgeon or radiologist may be, and therefore have |
| physician until enough is accumulated to become a | | | | less of a "practice group" mentality but rather a |
| partner. True Democratic Groups have an | | | | hospital supporting role. |