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The Art Of The Last Minute Radiology Deal

last minute

Ever notice how most big financial deals are settled, not years or months before the deadline, but only a few days, hours, or minutes until the final click of the clock? Whether it’s the federal government’s budget, car purchases, or buying a house/investment property, the definitive signature and finalized contract only takes place at the 59th second of the last minute, right before the deal has to be done. Settling for a new radiology position or a contract with the hospital as a radiologist is no different. Many radiologists expect they will not have to play this game because they are physicians and not subject to the vicissitudes of the business world. Nothing is further from the truth. This dance is merely how businesses, including imaging practices, complete large financial packages. And, as we are part of the business world in the imaging world’s eyes, you should expect the same.

So, what are some last-minute items you should negotiate when you sit down at the table to create your final package? When and how should you walk away from the table to whet the appetite of the other party and enhance your party’s circumstances? We will divide the conversation about negotiating into two separate parts, the individual and the hospital. Let’s talk about the art of the last-minute radiology deal!

Nailing The Best Last Minute Radiology Package

Generally, the contract is partially negotiable when you finally go through the interview process and receive your offer in the radiology world. At this point, there is a bit of give-and-take with your future employers. Typically, the first parts to settle are the salary structure, years to partner, vacation time, and some of the oversized line items within the contract. Some of these items may be immutable, but what can you leave to the end so that you can harness the best deal possible?

Moving Expenses

Most practices will flip the bill for this service for two reasons:

  1. It is a tax-deductible expense for the business.
  2. It ties the applicant to the imaging company because they will need a residence close to the job. In all my positions after fellowship, moving expenses were available as an option paid for by the practice.
  3. You can request it at the last moment.

Malpractice Tail Coverage

Typically, most malpractice insurance companies do claims-made coverage. And, if a plaintiff sues after you leave the practice, you will still need malpractice coverage. This detail is where malpractice tail coverage comes into play. If an imaging business wants you as an employee, they may very well tack this bonus onto your contract at the last moment.

Percent Working At Specific Roles

Nowadays, there are fewer and fewer generalist radiologists. So, you may not want to practice mammography if you had little experience of comfort in the modality during residency. So, practices will often accept additional clauses securing the percentage of time that you want to work in a specific modality, especially if they need this service anyway. You can often easily tack this stipulation onto the contract at the final moments.

Getting The Most Out Of Your Hospital Deal Last Minute

Similar to negotiating as an individual for a position, often, you may play the role of negotiating a contract with a hospital. The extensive line items usually come first, like contracts, the functions that the practice will need to fulfill, etc. But what are some other critical parameters you can negotiate at the end?

Separation Clauses

Sometimes the deal does not work out the way that both parties expect. Therefore, you may want to find a way for the hospital and practice to part without too much hardship. This separation clause is a stipulation that may not seem important at the time of the deal signing. But, it is critical to have an out when things go south. So, it may not be the priority, but it is something that you can negotiate later on.

Support For Other Services (Chairman, etc.)

Some radiology services can be very costly but not considered at first glance. Here is where you can negotiate for extra support. Line items such as residency management, chairmanship, or other ancillary roles are some examples of fees that the institution should pay because they don’t come for free. These are great add-ons at the end of the deal.

The Art Of The Last Minute Radiology Deal!

Consider these line items to add to the contracts you might negotiate. Of course, they may not be the first items you would consider when starting a negotiation. But, they can be critical add-ons once at the end of the talks that can make a significant difference in your final contract. Every little bit counts when you are about to strike a deal in your favor!

 

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Malpractice Tail Insurance? Pop The Question Before Your Next Job!

malpractice tail insurance

Since most training programs cover their trainees for malpractice insurance, it is probably the last item on your mind. And you already have enough residency and fellowship issues to worry about right now. Nevertheless, as soon as you apply for your first job, all that will change—malpractice insurance costs tens of thousands of dollars. Tail insurance can cost even more than the malpractice insurance itself. And, if you are not aware of this insurance, you can lose a bundle when/if you decide to change jobs. So, what exactly is malpractice insurance tail coverage, and why is it so critical to know how it works before taking that next job?

What Are The Different Types Of Malpractice Insurance?

First, we need to discuss some of the basics of malpractice insurance and the types of insurance policies. The two types of insurance policies you will often hear about are occurrence and claims-made policies. The least common type of malpractice insurance is called an occurrence policy. It covers all claims made before and after you leave a practice. Why is an occurrence policy less common? Simply because it is more expensive than claims-made plans.

On the other hand, a claims-made policy terminates right after you leave your job. So, if you stop working and are sued for a claim after you leave your employment, you will have no coverage. An attorney’s fees can be costly!

Malpractice Tail Insurance- A Gap Filler!

So, what does malpractice tail insurance do? Naturally, it covers any lawsuit claims from your old job after you change positions. The old claims-made policy does not cover these potential suits. This way, you will continue to have malpractice insurance if you leave. 

How Can Practices Weaponize This In A Negotiation?

Knowledge is power when it comes to negotiating a contract. And, frequently, many residents don’t know to ask about malpractice tail insurance. So, when changing jobs, they are stuck dealing with the following practice for malpractice tail insurance coverage as a benefit. This negotiation can potentially decrease the overall compensation package at the new job. In a worst-case scenario, you may have to flip the entire bill out of your pocket. 

And this sum of money is not insignificant. One article quoted the malpractice tail insurance costing 2.5 times the cost of malpractice insurance per year. In radiology malpractice insurance, this can translate into a 40-50 thousand-dollar bill. That money could have gone to paying down debt, buying a new house, or your kid’s college savings. And you could have potentially avoided all this loss by negotiating a tail in your first contract!

The Key To Knowing About Malpractice Tail Insurance!

I want to know what you are getting into before you take your next job. Other parts of the compensation package may be too good to overlook, and a claims-made policy without tail coverage may be relatively insignificant. Or, it can be a deal-breaker. Regardless, don’t let a new practice tell you they have excellent malpractice insurance coverage, only to find that you have an enormous bill to pay when you leave. Pop the question before you take your next radiology job!