Welcome to the Real World!

True Democracy in Emergency Medicine

Emergency MedicinePractice Groups

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Types of Practices

•Hospital employees

• Independent contractors

•Democratic groups

Hospital Employees

• Freedom from self-employment taxes

• Enjoy benefits packages

• Freedom from administrative duties

• Freedom from personal investment and financial risk

Hospital Employees

• Subject to the will of the employer regarding type and manner of work done

• Surrender the right to control their professional fees and terms of employment

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Independent Contractors

• Freedom from administrative duties

• Greater freedom of movement

Independent Contractors

• Must meet and adhere to numerous IRS guidelines

• May be contractually obligated to surrender due process and be subject to restrictive covenants

• May find portions of their fees distributed to laypeople including corporate executives and shareholders

When someone else owns your business…

• The 1996 Annual Report and the Notice to the Shareholders of the 1997 Annual Meeting for a large non-democratic EM group detailed the following:

• A profit of $39.8 million on 140 ED contracts

• 90% of revenue was from physician professional fees

• Seven of the nine directors and top shareholders were laypeople

Democratic Groups

• The IDEAL practice for emergency medicine

• Provides opportunity to be a member of a group equally owned by physicians

• Each physician has a voice and is involved in developing business strategy, negotiating contracts, and enhancing performance improvement

• Control over professional fees

• Pride in ownership and opportunity for personal and financial growth

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Democratic Groups

• Potential personal liability for the fiscal health of the company

• Requires investment

• Business acumen not typical among physicians

Compensation Models

•Hourly

• Salary

• Incentive-based

Hourly & Salary

• Guaranteed rate

• Low variance between paychecks

• No incentive to work hard

• Strife between unequal “producers”

• Picture clock/assembly line

Incentive-Based

• Rewarded for hard work

• Positively impacts performance metrics and throughput

• Variation in paychecks

• Volume/Acuity dependent

• Content doc Picture

What’s an RVU?

•Add definition

Potential Benefits

• Health Insurance

• 401K

• Disability

• CME allowance

• Business reimbursement

• Professional dues

• Malpractice

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Malpractice Insurance

Claims-Made Occurrence

Questcare…

An excellent choice in a company and lifestyle!

Company Stability

• Stable, long-term contracts

•Continuous exploration of growth opportunities

•Dedicated to world-class patient care

•Excellent support staff

• Innovative leadership

Compensation and Benefits

• Competitive pay structure

• Paid occurrence malpractice (No Tail Required!)

• Paid long-term disability insurance

• Paid ACEP dues

• Excellent 401K with ROTH option

• Health and Dental Insurance– HSA option, Flexible Spending Accounts

• Partnership opportunity

Partner Track

• 2 year track

•Regular 6 month evaluations

• Low buy-in

• 10% raise after making partner PLUS equal profit distribution

•One partner…One vote

•Eligible to run for Board

Non-Clinical Opportunities

• Leadership Opportunities

– Local ED Group

– Hospital-based committees

– Leadership Track

• Questcare Committees

– Finance

– Risk

– Social/Teambuilding

– Legislative

• Questcare Foundation

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Job Satisfaction

•Questcare DocAssist (scribe program)

•Midlevel support

•Wide variety of practice environments

• Strong relationships with Administration and Nursing

•Optimized staffing models

•Cutting-edge Technology

Technology

• State of the art facilities

•Electronic documentation

•Electronic bedside registration

•Digital radiology

•Bedside labs

•Electronic medical records

Telemedicine

•Extends hospital specialist coverage

•Piloting EMS telemedicine

iPhone apps

Questcare Web-based Resources

•Questcare intranet

•Emergency Medicine education materials

•Peer review cases

• LLSA articles

•Web conferencing meetings

Community Offerings

• Tort Reform

• Low cost of living

• Stable housing market

• No State Income Tax

• Pleasant climate

• Excellent schools

• Major airports

• All major sports

• Performing Arts Centers and Museums

• Excellent restaurants and shopping

• DFW pics

Partners = Friends

•QC pictures

For More Information…

Questcare Partners

www.questcare.com

(214) 217-1911

Valuable Links

•EMRA article

•EmCare lawsuit link

•Brown-gupta article

•Deeppocket website link