Integration Seminar Preparing for your first job as a CNM Barbara Hughes, CNM, MS, MBA, FACNM May 23, 2011

Projecting a Professional Image Making a GREAT 1st Impression Initial Contact: In Person, Telephone or E-mail Dress Jewelry Shoes Hair, Nails & Make-up Voice “Carriage” Habits Follow-up

Models of Clinical Practice What’s the best fit for you? “You can dream, create, design, and build the most wonderful place in the world, but it requires people to make the dream a reality.” Walt Disney “Treat employees like partners and they act like partners.” Fred Allen

Clinical Practice Models What’s the best fit for you? Provider Owned Private Practice Group Specialty Private Practice Multi-Specialty Group Practice Hospital Based HMO Based Community Based Faculty Practice Birth Center Practice Home Birth Practice Military Contracts Per-Diem Locum Tenens

Finding the right “FIT” What is the model of practice? What is the level of clinical care at the institution? What is the consultative arrangement? What will your role be in the practice? New kid on the block in a group practice? Are you the first non-physician provider in the physician practice? Are you an Equal Partner? Are you a Solo Practitioner? Has the practice worked with new grads before? Who will be your boss? How would a patient feel in this practice? How will YOU feel in this practice?

Points to Consider in Negotiating your Ideal Employment Situation “What’s money? A man is a success if he gets up in the morning and gets to bed at night, and in between he does what he wants to.” Bob Dylan “I don’t want to make money, I just want to be wonderful.” Marilyn Monroe

Points to Consider in Negotiating your Ideal Employment Situation Where to begin looking for a position? Networking Professional Organizations Provider Newsletters Journals Internet Head Hunters

Preparing for the Interview Do your homework about the practice: Who are the other players? What is their reputation? What do they want? Marketing yourself: Develop a professional CV Identify “value-added” skills you will bring Dress for success Prepare critical sound-bites

Making the Decision Is this a good philosophical fit? Are Professional Standards respected? Will you feel valued? Do you have an opportunity to grow? Do you like your boss? Do you like your colleagues? Will you have the tools you need to do your job?

Employment Contract Issues Practice Responsibilities What is expected of you? Hours of clinical time (outpatient & inpatient)? Call schedule? Typical work week? Business support (Marketing, Statistics, Finance)? Extra compensation for extra work? Other Activities Moonlighting? Fees for consulting, case review, public speaking?

Employment Contract Issues Benefits Package Vacation Holidays Sick Leave Health, Dental & Life Insurance Disability (Long & Short term) Maternity Leave Continuing Education Relocation Assistance Retirement Plan Options

Employment Contract Issues Malpractice Insurance Who is the carrier? Annual cost? Who pays? Level of coverage? Type of plan: Occurrence Claim’s made Tail provision?

Employment Contract Issues Practice Operational Issues Facility: Who furnishes the office space? Cost of lease or rent? Maintenance & cleaning? Practice Necessities: Pager Cell Phone Answering Service Dictation Lab coats Electronic Computer Resources

Employment Contract Issues More Practice Operational Issues Office support staff Do they work exclusively for you? Do you have input into hiring or evaluation? Bilingual? FTE’s of support staff per provider? Patient files Electronic Medical Records Remote Access available? Who do they belong to? Access upon termination? Will you be notified if records are requested by an attorney?

Employment Contract Issues Provider Credentialing Hospital Credentialing Allied Health Independent Practice Health Insurance Plans Contracted provider vs “incident to” Who does the paperwork? Who pays the fees? Non-Compete Covenant Required? Enforced? Try to leave it OUT of the contract!

Employment Contract Issues Term of Contract Length Renewal provisions What happens upon expiration? Buy-in provision At-will employee Annual Performance How can the contract be terminated? By employee? By employer? Disability? Death? Notice required?

Employment Contract Issues General Contract Provisions Arbitration if dispute arises Attorney fees provision Which law applies?

Employment Contract Issues General contract recommendations: If your prospective employer does not offer a contract, present one! When preparing to sign a contract, ask for a draft you and your lawyer can review. Know all of the penalties you may risk if you default. Obtain a signed copy of the contract and keep it at home. Obtain a copy of the Certificate of Insurance for your malpractice coverage and keep at home.

“The culture of midwifery: It’s all about listening to women, caring for women, empowering women, and doing the right thing for our future and the future of our children.” Barbara Hughes