RFS Connection

Summer 2014

News from the  TMA Resident and Fellow Section 


Congratulations to Newly Elected TMA Officers

The TMA Resident and Fellow Section elected new RFS Executive Council members at TexMed 2014 in Fort Worth on May 2. Spots are still available for TMA alternate delegates. Contact Christina Shepherd in TMA Membership Development at (512) 370-1443 or RFSInfo@texmed.org if you're interested in filling a vacancy.

Congratulations to the following newly elected officers:

Twisha Chakravarty, MD

Mani Akhtari, MD

Amanda Akin, DO
Fort Worth

Immediate Past Chair
Colin Son, MD
San Antonio

Board of Trustees Representative
Maryam Shambayati, DO

AMA Alternate Delegate
Habeeb Salameh, MD

TMA Delegates
Twisha Chakravarty, MD

Christopher Costa, MD

Colin Son, MD
San Antonio 

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Free TMA Publication: Business Basics

 Thanks to a generous grant from The Physicians Foundation, you can download TMA’s newest publication free. Business Basics for Physicians guides you through essential business skills like hiring and managing staff, developing a budget, crafting administrative policies and procedures, and promoting the practice. Download now

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7 Things You Must Know Before Signing an Employment Contract

A good contract by definition is one that is fair and reasonable and is a win-win situation for everyone involved. But how do physicians ensure they are getting a good contract before agreeing to work for a hospital or group practice? 

Health care attorney Norman Jeddeloh shared seven essential pointers at the 2014 American Medical Association Annual Meeting

  1. A solid contract is essential for physician employment relationships. Talking about all the negatives and “what-ifs” at the beginning of a new relationship may seem counter-productive, Mr. Jeddeloh said, but “there are a lot of very good reasons for the parties to sit down and force themselves to do a contract. It memorializes agreements. That’s very important because everybody’s memory fades.”
  2. Contract language must be clear and unambiguous. “I can’t tell you how many contracts I see that are impossible to understand,” Mr. Jeddeloh said. “It leads to disputes. One of the most important things that a contract does is it serves as a reference point between the parties in the event of disputes.” 

The standard rule of thumb is that a college sophomore should be able to read and understand the contract.

  1. All key issues need to be covered. “The contract needs to be detailed but not too detailed,” Mr. Jeddeloh said. Contracts that are overly detailed “can impose a feeling of inflexibility in the relationship going forward. It’s important to think about the really crucial issues and include those in the contract.”
  2. Understand your compensation model. Some contracts offer fixed compensation, in which the physician receives a set salary regardless of performance. This model is more typical for new physicians, while more experienced physicians can expect some version of variable compensation, in which payment is determined based on the physician's performance.

Every variable compensation model “takes into account the ‘bucket of money’ theory,” Mr. Jeddeloh said. “It’s really about how the bucket is split: the revenue, expenses, and built-in profit for the organization.”

  1. Know the numbers of your compensation. “Every contract will have a formula for variable compensation, and formulas can get quite complicated,” Mr. Jeddeloh said. “In addition to hiring a lawyer, you also ought to have an accountant look at it and run some numbers. It’s good to attach a pro forma to the contract.” 

Having an example with actual numbers can help you better understand what your compensation might be and will make it easier for a judge to understand what could be a very complex formula, in the event of a dispute.

  1. Make sure liability insurance is included. “Liability insurance is crucial,” Mr. Jeddeloh said. Some things that will need to be addressed include whether the insurance is adequate and whether the hospital or group offers tail coverage when the physician leaves.
  2. Understand what will happen upon termination of the relationship. “People clearly don’t want to talk about this at the beginning, but it’s a very necessary provision of every contract,” Mr. Jeddeloh said.

Some things to look for include whether the physician will have a way to refute charges against them if their employer tries to terminate the relationship, whether a non-compete provision is included and whether a restrictive covenant would keep the physician from practicing nearby once the relationship ends. 

For additional insight into employment contracting, the AMA offers two annotated model employment agreements: one for contracting with a hospital and one for contracting with a group practice.  

Reprinted from AMA Wire with permission of the American Medical Association. View article

TMA's A Comprehensive Guide for Physician Employment analyzes the risks, benefits, and other considerations of an employment decision. The publication is available for $25 to residents. Order a copy online, and use promotional code TMAEMPLOY for a hard copy or TMAEMPLOYPDF for a PDF version at the discounted rate.  

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Check Out TMA's Resident Video Library

The Resident Video Library MembersOnlyRed offers convenient, on-demand access to business of medicine knowledge you need during residency and to transition into active practice successfully.

Videos cover topics such as marketing your practice, staffing, disability insurance, coding and documentation, medical liability insurance, creating a financial plan, and more. Check out the current videos, and watch for more coming soon. 

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The Residents Rise Up

A recent article in Slate by Jacob Sunshine, MD, president of the University of Washington Housestaff Association and a resident in the Department of Anesthesiology, examines contracts residents sign with hospitals and outlines a potential solution to low resident wages. 

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Apply Now for RFS Council, Committee Appointments

Resident representatives and alternate representatives serve one-year terms on TMA boards, councils, and committees. Apply now for the 2014-15 term by submitting an application to your section coordinator.  

Save the Date

Mark your calendar for TMA Fall Conference Sept. 12-13 at Hyatt Regency Lost Pines Resort & Spa in Bastrop. The conference provides an opportunity for physicians of all ages to conduct TMA business, obtain continuing medical education, and network with peers. 

This year, the conference visits a new venue just 30 minutes from downtown Austin. Situated on the banks of the Lower Colorado River, the Lost Pines Resort combines the natural beauty revered by early Native Americans with the colorful, regional history and culture of the Lost Pines Region for a true Texas wilderness escape. In addition to conference events, attendees can enjoy a variety of amenities including golf, spa time, horseback riding, hiking, archery, tennis, and the water park.

TMA’s special room rate is $199 for single or double occupancy. Reserve a room by calling (888) 421-1442 and asking for the TMA Fall Conference discount, or reserve your room online. The deadline to receive this special rate is Thursday, Aug. 21. Sleeping rooms are subject to a 7-percent occupancy tax rate. Local sales tax is 6.75 percent.

Register online today. The conference is a free benefit to TMA members; the fee for nonmember physicians is $125. Contact the TMA Knowledge Center at (800) 880-7955 or knowledge@texmed.org with questions.  

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AMA Annual Meeting Wrap-Up

Delegates aggressively called for rapid intervention into the scandal-plagued Veterans Administration health care system, set new telemedicine policy, and adopted guidelines for physician-led health care teams at the 2014 Annual Meeting of the American Medical Association House of Delegates.

More than 100 Texas physicians, residents, medical students, and alliance members representing TMA, various sections, and national specialty societies participated in the June 7-11 meeting in Chicago. TMA's Resident and Fellow Section sent four resident physician delegates to the AMA Resident and Fellow Section. 

The Texas delegation left the meeting having elected all three candidates it ran for AMA office and winning adoption of numerous Texas policy statements.

Be sure to save the date for the AMA Interim Meeting in Dallas Nov. 8-11. 

Texans in the Spotlight
Delegates enthusiastically elected former TMA President Sue Rudd Bailey, MD, of Fort Worth to a fourth term as vice speaker of the AMA house. At the conclusion of the meeting, Texas delegates announced Dr. Bailey will run for speaker in June 2015. The current speaker — Andrew Gurman, MD, of Pennsylvania — will vie to become president-elect.

In a close race with eight candidates seeking one of five positions, Houston's Russell Kridel, MD, won a seat on the AMA Board of Trustees. "I hope to further the AMA's goals of preserving the patient-physician relationship and improving the health of the nation," said the facial plastic surgeon, who is a former president of the TMA Foundation.

As one of four candidates running for four available seats on the AMA Council on Medical Service, Dr. Lockhart won his post by acclamation.

Some younger Texans also won elections at the AMA meeting:  


  • Nnenna Ejesieme, MD, of The University of Texas (UT) Southwestern Medical Center, is the newly elected chair of Region 3 of the AMA Resident and Fellow Section.
  • Elected to the Medical Student Section Region 3 Executive Council were: Angie Hamouie, UT Medical Branch at Galveston, secretary; and Tennessee Bailey, UT Health Science Center at San Antonio, membership chair.  


Delegates voted to support all or most of three other resolutions the Texans brought from the TMA House of Delegates. They direct AMA to:  


  • Take strong action — including protection of state prompt pay laws and the development of alternative financing solutions — to help practices deal with the stress and uncertainty of providing care to patients who are in the 90-day grace period for not paying their Affordable Care Act marketplace insurance premiums.
  • Compare government estimates to actual time and costs incurred by physicians to comply with such government mandates as the Physician Quality Reporting System and the meaningful use electronic health record incentive program.
  • Convene delegates to the U.S. Pharmacopeial (USP) Convention to protest and seek changes to the "immediate-use" exception to USP Chapter 797 guidelines, including the "one-hour rule."  


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New-to-Texas Physicians Can Start Here

Are you a new Texas physician? Have you recruited a physician from out of state?

TMA’s Welcome to Texas webpage can help new or returning Texans get their practices up and running. The page provides links doctors need to obtain a Texas license, plus contact information for relevant state and federal agencies and links to resources such as practice consulting for setups, health insurance plan contacts, and employee salary data.

TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more. 

Good Health Grants Available From TMAF

TMA Foundation is accepting applications for its 2014-15 Medical Community Grants and Medical Student Leadership Grants programs. Eligible applicants include TMA county medical societies, and alliance and medical student chapters.

TMAF is seeking programs that feature collaborations among medicine, business, and community and that address TMA priorities such as obesity, tobacco, immunizations, health disparities, unplanned pregnancy, mental health, environmental health, violence, and disaster preparedness and response. Society and alliance chapters may apply for up to $7,500; medical student chapters may apply for up to $3,000. 

Find out more, including summer deadlines, on the TMAF website. 

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Stay Connected

Keep up with important news and connect with colleagues across the state through the RFS Facebook page

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