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

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

3. 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

4. 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

5. 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?

6. 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

7. 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

8. 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

9. 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?

10. 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?

11. 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

12. 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?

13. 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

14. 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?

15. 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!

16. 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?

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

18. 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.

19. “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