Tuesday, November 20, 2007

Emergency Medicine Practice Group Questions

1. Department Status: is Emergency Medicine a department within the hospital with a chair that sits on the executive committee of the hospital or is EM only a division of surgery or other department without direct representation? How often does the EM chair meet with hospital administrators and other department chairs? Have their been any money spent recently on new equipment purchases or renovations in the ED?
2. Volume: what is the ED volume per year, per day, and patients per hour?
3. Shifts: what is the shift length? How many shifts qualify for full time? Is there a guaranteed minimum number of shifts?
4. Coverage: what is the physician, mid-level provider coverage. Is there a fast-track?
5. Charting: is charting done by template, dictated, voice, or computer?
6. Mental Health: how is mental health paperwork and transfer arrangements made? How long does this process take?
7. Acuity: what is the % acuity, % trauma, % admitted? What patients are transferred out to other hospitals.
8. Hearts: Cath lab vs. TPA? What is the time to cath lab?
9. Coding and Billing: How is coding and billing handled? Who decides the level of charge or any upgrades or downgrades?
10. Teaching Responsibility: is there any teaching responsibility?
11. Overcrowding: How is overcrowding handled (hall, chairs, stable admit)? How often is the overcrowding protocol used?
12. Meetings: what meeting are there, and who is expected to attend?
13. Radiology: what is the radiology coverage at night (24 hr, telerad)?
14. Ultrasound: what is the ultrasound coverage at night (tech on call)?
15. Labs: what is the lab turn-around time? What POC labs are available in the ED? Does the ED employ a lab tech? Do RN's or RT's draw ABG's?
16. Admit orders: who writes admit orders? (ED physician, on-call, phone orders)?
17. Thru-put: what are the average wait time, time to labs, time to rads, and time to admit?
18. Press Gainey Scores
19. Diversion: when and how often does the ED go on diversion? Who decides (ED or Admin)?
20. Financial Package: Productivity, RVUs, hourly, tiered, Base+bonus, night shift differential, or incentivized.
21. Remuneration: Base salary, benefits, malpractice, CME, bonus, paid vacation.
22. Turnover: How long do doctors stay in the group? Is the contract vulnerable. What is the number of physicians who have left in the last 5 years and why? Why is your group hiring?
23. Future: what is the future of the group in 5-10 years?
24. Vesting: What % of the partnership is yours. Is there delayed vesting?
25. Profit Sharing: Is profit sharing done quarterly, yearly, is it based on productivity or hours worked, acuity, or patient satisfaction?
26. Partnership: Is there a partnership track, a buy-in?How is partnership decided (unanimously)?
27. Complaints: How are patient complaints handled? Who does Q&A.
28. Leaving: what happens when I leave? Is there tail coverage? What happens if I die?