While we spend the better part of our late teens, 20s and early 30s preparing and training to be neurosurgeons, we are often ill-equipped to smoothly navigate the increasingly complex process of early employment as practicing neurosurgeons after our years of formal training are finally over. In other words, in looking for a first or second job as a neurosurgeon, what should one consider in the process?
To this end, we sought to try to address this gap by developing an educational bundle around Contract Negotiation and some of the critical elements that prospective independently practicing neurosurgeons should consider — and in so doing, also share some of the considerations that those of us who actively recruit neurosurgeons also have on our radars when assessing prospective partners. We identify standard and nonstandard components in an employment contract, discuss workplace and health system factors that influence employment contracts, and more globally, describe the role of the negotiation process in building the working relationship.
We asked some of our field’s foremost neurosurgical leaders, versed in the spectrum of employment models (academic, employed, private practice, government) and with decades of experience hiring neurosurgeons to share their wisdom on such critical topics as the approach to employment; standard and negotiable parts of a contract; important constituent parts of physician compensation and its benchmarking; how an academic healt system is constructed and thinks and how the component parts interact; malpractice insurance and critical differences between academic, private practice and employed opportunities.
Before a contract is even negotiated, our experts provide important counsel around differences in employment models. What distinguishes private practice from being employed, either in an academic, government or community system? What are the unique benefits of private practice; what personality traits may find this model most appealing; what are the headwinds in this model; what does partnership look like? What is the future of physician-owned hospitals, and how is private equity poised to disrupt our field? What is instrumental is a successful academic health system contract? What are national trends?
Once the candidate begins the process of contacting prospective employers with a view towards initiating the interview process, there are standard and well-accepted behavioral norms which may seem outdated and overly conservative, but which are eminently important for those who hire — practice leaders, chairs and health system leaders. Simply put, stakeholders are interested in hiring professionals, and candidates shape that impression from the very first interaction. It’s 2023 — does how I present myself matter in person, on the phone or over email? You bet it does, and our seasoned neurosurgical leaders will provide standard advice to avoid very common pitfalls in this generation. These tips are designed so that candidates represent themselves as highly professional prospective colleagues. Moreover, we emphasize that the prospective relationship with a future employer begins with the first correspondence.
Should the journey proceed to contract review, we provide an insider’s view of the backbone elements of a contract — deconstructing what is standard, and what is usually eminently negotiable. Contract duration, compensation elements, benefits, scope of work, malpractice, licensure, titles, expected clinical load and call, clinical and research space and support and administrative staffing are just some of the items reviewed. Our experienced negotiators also share elements of a deal which are usually not offered, but which may be provided for the right candidate should they be requested. Universally, our experts share their belief that the most important part of this process is the development of mutual trust.
Compensation is a core part of negotiating a contract, and we discuss standard and variable compensation models and the metrics that underlie them in addition to standard benchmarking agencies. Interwoven through the video episodes are foundational insights from our national leaders on how a health system works; how funds flow in any health system and how your worth is measured beyond standard professional fees and important insights around how insurance carriers and government payers acknowledge our clinical work through RVUs and other means.
For further information, please click here to hear first hand the decades of insights and advice shared by Dr. Linda Liau; Dr. Aviva Abosch; Dr. Daniel Sciubba; Dr. Joseph Cheng; Dr. Nino Chiocca; and Dr. Jean-Pierre Mobasser. Furthermore, we provide a simple infographic with “dos” and “don’ts” during your employment odyssey.
