Practical advice for young surgeons exploring their employment options, this talk provides tips for the key practice areas to assess, questions to ask, and issues to consider. Includes a link to an article on RVU-Based Compensation.

1. September 25, 2016
How to Find a Job:
Practical Tips for
Young Surgeons
Sponsored by:
DePuy Synthes Institute, LLC
Las Vegas, Nevada
Presented by:
Cheryl Toth, MBA

2. information@karenzupko.com
karenzupkoandassociates
@karenzupkoassoc
312.642.5616
www.karenzupko.com
karenzupko&associates
Cheryl Toth, MBA
CTOTH@karenzupko.com
(408) 489-5851

3. 3
Source: https://commons.wikimedia.org/w/index.php?curid=10584359
“You can’t connect the dots
looking forward; you can only
connect them looking backward.
So you have to trust that the
dots will somehow connect in
your future.”
-Steve Jobs

4. 4
THIS IS
YOUR
JOURNEY
SO
HAVE
A
PLAN

5. WHAT DO
YOU WANT?
WHY IS THAT
IMPORTANT TO YOU?
5

6. FIRST QUESTION:
Stay?
 Continue working
with the people who
trained you.
 Less disruptive to
family.
Go?
 Broaden your
experience.
 Learn a new school
of thought.
 Compliment what
you have learned.
6

7. WHERE DO YOU WANT TO LIVE?
 Where do you want to be?
• Urban, rural, big, small?
• Near family?
• Weather? Mountains? Ocean?
 What’s your lifestyle?
• Ski, run, hike, culture,
pro sports fan?
7

8. WHAT ARE YOUR GOALS AND TOLERANCES?
Join a Group Hospital Own Practice
Control Own
Destiny
Revenue Potential
Deal with
Business Issues
Meetings and
Bureaucracy
“Politics”
Work-life balance
Collegiality
CHECK YOUR BOX –
WHAT’S IMPORTANT!
8

9. 9
WHAT MAKES YOU PURPLE?

10. WHAT ELSE DO YOU WANT TO DO?
10
Board or Committee
Community Service
International Charity
Innovative Ideas

11. YOUR SUPPORT TEAM
11
Spouse or Significant
Other – Don’t make
these decisions in a
vacuum. Seek advice
from the most
important person in
your life.

12. YOUR SUPPORT TEAM
12
Attorney –
Make sure they
have healthcare
experience to
review your
agreement.

13. YOUR SUPPORT TEAM
13
Accountant –
Help you
understand your
financial
situation and
help set goals.

14. 14
YOUR SUPPORT TEAM
Mentor – Reach out
to these people, pick
their brains,
remembering that
they may have taken
a different direction
than you want.

15. 15
www.depuysynthesinstitute.com/
futureleaders/graduation-resources

16. Be a
Hospital
Employee
Join a
Group
Open a
Practice
1 2 3
16

17. THE SIX BEST WAYS TO FIND YOUR NEXT JOB
 Tap your network – Make a list of everyone
you know.
 Connect with Alumni – Grow your network.
 *Check Job Boards/Specialty Society
Sites. AAOS Career Center, hip/knee,
sports medicine societies.
17
Source: Forbes.com – March 22, 2013

18. THE SIX BEST WAYS TO FIND YOUR NEXT JOB
 Attend Events – Hosted by charities and
professional organizations. Work the room.
 LinkedIn – Powerful tool, search your target
market. Connect with HR departments.
 Contact Headhunters – Interview the
headhunters. Don’t just jump to the first one.
18
Source: Forbes.com – March 22, 2013

19. 19
6 INTERVIEWS
12 CALLS
40 LETTERS
NARROWED TO 2

20. TYPICAL PROCESS:
20
Phone/
Skype
Interview
Site Visit/
Interviews
/Meet and
Greet
Phone/
Email
Contact
Second
Site Visit
Offer

21. 21
Insist on interviewing with
the practice manager.

22. Timeless Advice!
DOWNLOAD ARTICLE
SERIES
For Checklist of
Assessment Questions
22

23. VALUES AND CULTURE
✔
How would you describe the leadership of the managing partner?
What are 3 or 4 words that describe the way the
doctors/administrator/administration treat the staff?
How would you describe the working relationship among the partners?
What qualities of the physicians are most appreciated by the current
resident and fellows?
What are the things most enjoyable about working here? What are the
least enjoyable?
What activity is valued and appreciated here?
Is there anything else you think I should know?
23

24. PHYSICIAN/MANAGER PERSPECTIVES ON TECH:
• Web site/portal
• Text/secure messages
• Automation
• Appt. Reminders
• Pre/Follow Up Apps
• Virtual visits/telehealth
• Cultivating online
ratings and reputation
24
 What’s in place or planned?

25. FINANCIAL DUE DILIGENCE
✔
Are there any capital projects being discussed or in process?
Have there been any recent tax audits?
What is the shareholder loan policy? Any big ones outstanding?
What is the “retirement policy” including any pull-back policies.
Any specific age? How funded?
Malpractice policy and claim history?
Any capital reserves?
What is the group’s debt history? Line of credit? Borrowing power?
25 This information is provided for general guidance and not intended to be all inclusive. Please check with
your financial consultant for guidance on specific information which may be important to you.

26. Net
Collection Rate*
Days in
A/R
% A/R >
90 Days
Dr. X 94.0% 30 22%
KZA Rec 98-100% 20-25 <20%
IMPORTANT A/R METRICS
26
*Collections / [Charges – Contractual Adjustments]

27. OPERATIONAL QUESTIONS
✔
What are the specifics around call coverage?
Which computer systems and other technologies are used?
(PMS, EHR, appointment reminders, patient portal, payment tech).
What new technologies are planned?
Does the practice collect patient responsibilities at the point of
service? Pre-surgical deposits? Recurring payment plans.
Who does the coding? What is the physician’s participation in the
process? Does the practice conduct internal coding reviews?
What’s the expected turnaround for op notes, charting?
Who does the credentialing and how will I work with her/him?
27

28. ELECTRONIC MEDICAL RECORDS
28
 How are they
incorporated/utilized?
• Clicks
• Dictation
• Scribes

29. Pre-Reg and
Scheduling
Encounter
Pre-surgical
Coordination
Surgery –
Charge Capture
Claims Prep
and Submission
3rd Party Payer A/R
Management
Payment Posting
Adjustments
Patient A/R
Management
Patient
Portion
Collected?
Emergency
HOW IS REVENUE CYCLE STRUCTURED?
29

30. 30
American Journal of Orthopedics, Sept/Oct 2016
ASK ABOUT
ONBOARDING

31. REQUIREMENTS VS. NICE-TO-HAVE’S
31
WRITE DOWN YOUR:

32. Salary $_________
Bonus $_________
Health Insurance $_________
Life Insurance $_________
Disability Insurance $_________
Malpractice Insurance $_________
Pension Contributions $_________
Automobile Expenses $_________
Cellphone $_________
CME Registration $_________
CME Travel $_________
COMPENSATION IS A “PACKAGE”
32
SALARY
+
BENEFITS

33. RVU-BASED COMP
33
Sarah Wiskerchen, MBA, CPC
KarenZupko & Associates

34. GET CLARITY
34
 Precedent
 Hours/Week
 On Call
 Emergencies
 Independence
 Practice Building

35. OTHER EMPLOYMENT AGREEMENT ITEMS
 Scope of employment
 Term and termination
 Expense reimbursement
 Liability protection
 Confidentiality
restrictions
 CME
 Invention assignment issues
 Disability and death
 Post-employment
limitations
 Disability resolution
Source: http://www.forbes.com/sites/allbusiness/2013/11/11/negotiating-employment-agreements-checklist-of-14-key-issues/#7d4af8475fee
35

36. NEGOTIATION MYTHS
1. “This is a business transaction; it’s not personal.”
2. “I can’t ask for more money/stand-up desk/time
for research.”
3. “Why would they say yes to ____? After all, I’m
right out of school…”
36

37. GOOD ADVICE:
1. Never “assume.”
Get the details in
writing.
2. Ask questions.
3. Check the math.
37

38. FINAL THOUGHTS…
Know What You Want
Culture/Operations Matter
Ask About Physician Precedent
Don’t Be Afraid to Negotiate
38

39. WWW.KARENZUPKO.COM

40. ABOUT KARENZUPKO & ASSOCIATES (KZA)
KZA is a consulting and education firm that has been helping
physicians increase revenue, optimize efficiency, reduce risk, and
improve the patient experience for more than 30 years.
We specialize in practice management, revenue cycle improvement,
and coding and documentation review. Our education and training
programs teach physicians and staff how to code correctly, manage
effectively, and maintain a successful and profitable practice. Our
team has deep expertise in the operational and strategic challenges
that practicing physicians face every day.
KZA is known for its significant knowledge of surgical specialties,
including orthopaedics, otolaryngology, neurosurgery, plastic
surgery, general surgery, and vascular surgery. We also work with
dermatology, interventional pain, and critical care providers.
40
• Practice Evaluation
• Revenue Cycle Assessment
• Practice Check Up
• Coding and Documentation
Review
• Coding and Documentation
Education
• Practice Management
Education
• Hourly Coding and
Management Guidance
• Physician Employment
Contract Review
• Administrator Recruitment
and Onboarding