Employment Arrangements for Emergency Physicians

I meet once a month for breakfast with our EM residents. I learned this from my mentor, David Wagner, who started it well after I was no longer his resident and was serving on his faculty. I know the residents loved having his ear for an hour and there was a lot of give and take. I've been doing this now for five years and our sessions have never had much give and take. The ground rules for the hour are that I have to be able to act on information that I hear, but that nothing I hear will be attributed to the individual. Sometimes more is said than other times, but last year it finally occurred to me that some structure might be useful, particularly if focused around content not usually part of the core residency educational program. While all residents get some exposure to administrative topics, it seemed logical to focus more on these areas.

So as with many things, "Breakfast with the Chair" at my shop in 2008 has become more structured than what I fantasize Dave's were, back in the day. I'm using these sessions to talk to the residents about "life, the Universe and everything." Or at least to discuss some of the basics of selecting life, disability, travel and other sorts of insurance and what's on every senior resident's mind at this time of year: getting a job.

Tomorrow morning I'll discuss the various models of employment offering complete descriptions and trying to avoid judgments, though commenting on the strengths and pitfalls of each as I understand these. On the list will be the following:

• Hospital Employed
• Corporation Employed including single owners, small and large ownership groups, publicly traded corporations
• Independent Contractor models with and without your own Professional Corporation
• Locum Tenens
• Democratic Group grant/earn-in/buy-in models

I'm going to point them to this page with the suggestion that they pose their comments and questions here, too.