Job Relocation Tips for Emergency Room Doctors

February 10th, 2012 by admin No comments »

Finding the right emergency medicine jobs can mean relocating to another city or state. Set yourself up for success with your new EM job by asking all the right questions before making the big move and being prepared for moving day.

Dr. Robert W. Strauss, Jr., MD, presented a course on contract negotiation during the American College of Emergency Physicians’ annual Scientific Assembly in October. In the course syllabus, he points out key factors to consider before signing on the dotted line and committing yourself, and your family, to a major move.

-Will you be an employee or an independent contractor? If it is the latter, will it meet the Internal Revenue Service guidelines?

-For employees, can vacation time and sick days accumulate?

-What is the length of your contract, and the length of the group’s contract with the hospital? Is it automatically renewed?

-What are the terms of contract termination? There is “for-cause” and “not-for-cause” termination. Find out if you must give and will get 90-day notice of termination; is there a “cure” period; what are the “causes” and are they reasonable?

One more thing to find out about when in contract talks is if moving expenses are covered. When signing a two to three year contract, these costs might be covered, but be cautious of extravagant signing bonuses and covered moving expenses. These kinds of perks might be a red flag that it’s a bad location or bad emergency physician job.

If your moving expenses are not covered, they are at least tax deductible.

Other tips for relocating apply to any move, not just for those in emergency medicine jobs.

-Have an emergency cash fund set aside to cover any unexpected costs during the move. If nothing else, there will be lots of eating out or ordering in meals before and during your move.

-Use packing as an opportunity to lighten your load. Donate clothes to a local charity and shred old documents rather than box them up to store in your new place. When packing, consider photographing or videotaping everything and mark every box so you can easily unpack.

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Emergency Room Insurance Coverage – ER Policy Supplement Shopping Guide

January 23rd, 2012 by admin No comments »

Emergency room insurance supplements fall into two main categories. ER plans that cover accidental bodily injuries is the first category. The second form of ER plan is a Critical Illness Insurance plan that covers emergency room related expenses for sickness and disease such as life threatening cancer, heart attacks, and stroke.

To cover bodily injuries someone can shop around for a personal accident insurance plan. Other names for this type of injury plan include 24 hour accident coverage, accident health insurance policy, accident medical expense benefit, supplemental accident coverage, and personal injury insurance supplement. These association based plans aren’t actually insurance at all. They are indemnity insurance plans which act as a form of compensation insurance.

Accidental injury indemnity’s like this are guarantee issue with no health questions or underwriting. Plans are automatic acceptance up til age 65 or so and can be used with any doctor or hospital. Plans don’t have a strict network because injury type plans are for emergencies and trauma situations. Accident policy holders can use the ER supplement at any licensed hospital, doctor, or clinic. Plans usually have a $100 to $250 USD deductible. Deductible is what you pay before accident plan pays. Accident benefits are paid per injury and each claim is treated as a separate event which is a valuable benefit. Emergency room insurance policy only pays up to the predetermined policy face value.

Here’s a list of typical personal accident insurance plan benefit levels and the lowest rates I could find online so far:

Individual – $36.00 US dollars a month for a $10,000 policy value.
Individual – $29.00 a month for a $7,500.
Individual – $24.00 a month for a $5,000.

Family – $47.00 US dollars a month for a $10,000 policy face value.
Family – $41.00 a month for a $7,500.
Family – $35.00 a month for a $5,000.

Personal injury insurance plans only cover accidental bodily injuries and no medical conditions like strokes, heart attack, and cancer. To cover these health conditions health insurance agents in the know usually suggest Critical Illness supplements.

Critical Illness plans are also called cancer and stroke insurance plans. These policies pay plan holders a lump sum cash benefit to compensate individuals upon diagnoses of heart attacks, stroke, and cancer. These cancer heart health insurance policies are also indemnitys. The following prices are from a leading critical illness plan that covers these conditions up to $10,000 in compensation.

Husband and wife plan (2 people): $48.00 US dollars each month.
Individual person coverage: $25.00 US dollars each month.

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Emergency Room Errors

January 23rd, 2012 by admin No comments »

Emergency Rooms, or ER’s, at hospitals all over the country are the most stressful worksites in the healthcare profession. The standard of care in United States hospitals is high quality. Doctors, nurses, surgeons, and all other healthcare professionals take pride in this. However, the fact remains that malpractice occurs in the medical profession and today’s hospitals need to improve the care provided in their Emergency Departments.

Errors in hospital Emergency Rooms are a common occurrence infrequently talked about and rarely reported to the media. That is why you don’t hear about these types of cases on the news. Understaffed hospitals, ill-equipped emergency rooms, and poorly trained staff may lead to fatal errors when dealing with patients requiring emergency treatment. Let’s face it – when you arrive at your local hospital ER you know absolutely nothing about who will be taking care of you and there is no time to research the competency and track record of the ER staff.

There are many ways that errors or malpractice may occur in Emergency Rooms. The following is a partial list of some of the Emergency Room medical negligence cases we have handled:

Medication Errors
Prescription Errors
Failing to diagnose impending heart attacks and strokes
Diagnosis Errors
Errors in interpreting x-rays, CT scans, and MRI studies
Discharging patients who are critically ill

Over 225,000 people die from medical malpractice related injuries in a single year and nearly half of these deaths are from emergency room errors.

The following is a partial list of the more common medical errors which arise in the Emergency Department:

Failing to administer prophylactic antibiotics in patients with open fractures. An open fracture is one in which the bone has broken through the skin, and as such, these fractures present an increased likelihood of infection. The best outcome for these patients is dependent upon prevention of infection and obtaining a quick union of the fracture. Prophylactic antibiotics reduce the risk of infection and should be given as soon as possible.

Failing to diagnose compartment syndrome in patients with tibial fractures. The tibia is the larger of the two bones of the lower leg and is the weight-bearing bone of the shin. A compartment syndrome is a serious complication which occurs when the pressure in a closed fascial compartment rises sufficiently high to cause nerve and tissue injuries. Without timely diagnosis and treatment, compartment syndrome can cause permanent loss of use or function in the involved extremity (legs or arms). The clinical signs of compartment syndrome include pain out of proportion to the injury, pain on passive range of motion, and loss of distal pulses. Immediate consultation with a surgeon is the preferred course of treatment.

Failing to treat a perirectal abscess in a diabetic patient as an emergency. Patients who are diabetic present many unique challenges to their health care providers. A perirectal or perianal abscess is a pool of pus that forms next to the anus, often causing considerable tenderness and swelling in that area and pain on sitting down and on defecating. These abscesses or infections have a tendency to rapidly progress to deeper, more serious infections in diabetic patients. The abscess can develop into Fournier’s gangrene, a life-threatening infections with a reported mortality rate of 9% – 43%. Again, prompt consultation with a surgeon is the preferred course of action.

Failing to provide the proper airway for patients with facial or skull fractures. Establishing and securing an airway is one of the first steps addressed by all Emergency Departments. There are several ways to accomplish this goal but the main techniques are tracheal intubation (either oral or nasal), bag and mask, or a surgical procedure known as a cricothyroidotomy. Emergency physicians should almost never attempt a nasal tracheal intubation in patients with facial or skull fractures due to the possibility of passing the tube into the cranial vault and thereby cause even more serious injuries.

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