Upload
monkey85222
View
219
Download
0
Embed Size (px)
Citation preview
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
1/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
2/74
Course Faculty
IPS 2012
Course 07
Finding Your Ideal J ob in Psychiatry
Robert S. Marin, M.D.
Wesley E. Sowers, M.D.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
3/74
FRIDAY, OCTOBER 5, 2012
1:00 PM-5:00 PM
COURSE 7
FINDING YOUR IDEAL JOB IN PSYCHIATRY
EDUCATIONAL OBJECTIVES:
At the conclusion of this session, the participant should be able to: 1) Identify corevalues and goals for personal and professional life; 2) Identify resources and limitationsthat will influence the ability to realize these goals; 3) Appreciate career opportunities inpublic service psychiatry and 4) Understand key strategies for seeking a job, evaluating
job opportunities, and negotiating a desirable job contract.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
4/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
5/74
C05 Creating Your Ideal Job in Psychiatry
Time Schedule/Agenda
1:00 - 1:10 Introductions and Observations of Typical Career Planning Processes
1:10 - 1:30 The Changing Environment for Health Care Services
1:30 - 1:50 The Impact of Health Care Reforms and Finances on Career Planning and Options
1:50 - 2:20 The Rise of Public/Community Psychiatry: Scope and Opportunities
2:20 - 2:50 Career Planning Exercise: Creating a Personal Life Vision
2:50 -3:00 Break
3:00 - 3:15 Career Planning Exercise II: Articulating Your Vision
3:15- 3:30 Lessons Learned: Relevance of Vision to Career Planning
3:30-4:20 Getting Down to Business: Negotiating Your Vision
4:20-5:00 Reflections, Questions, and Strategies
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
6/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
7/74
C05 Creating Your Ideal Job in Psychiatry
Course Instructors: Wesley Sowers, MD (WS) and Robert Marin, MD (RM)
1:00 - 1:10 Introductions and Observations of Typical Career Planning Processes (WS)
How most of us get our first job What we are told about career planning The value of self-advocacy
1:10- 1:30 The Changing Environment for Health Care Services (RM)
Systems Transformation Person-Centered, Recovery Oriented Services Financing Reform, ACA Integration of Services Preparation
1:30 - 1:50 The Impact of Health Care Reforms and Finances on Career Planning and Options (WS)
Privately Funded Practice Publicly Funded Services Academics Subspecialty Practice Administration and Leadership Clinical Practices
1:50 - 2:20 The Rise of Public/Community Psychiatry: Scope and Opportunities ( WS and RM)
Funding and Shifts in Practice Community Based Practice and Deinstitutionalization Training Opportunities Diversity of Options and Experience Value Based Job Satisfaction
2:20 - 2:50 Career Planning Exercise: Creating a Personal Life Vision
Participants will complete a brief questionnaire related to elements to beconsidered in creating a life vision and then discuss it with a partner in the class.
3:00 - 3:15 Career Planning Exercise II: Articulating Your Vision
Participants will report on their partners vision and their reaction to it.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
8/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
9/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
10/74
Wesley Sow
Director, Center for Public Service Psyc
Western Psychiatric Institute and
Robert Ma
Associate D
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
11/74
Course Objectives
Identify core values and goals forpersonal and professional life
Identify resources and limitations thwill influence the ability to realize th
goals Appreciate career opportunities in p
service psychiatry Understand key strategies for seek
jobs, evaluating job opportunities, a
negotiating a desirable job contract
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
12/74
In Practical Terms
Enable you to clearly articulate youlifes vision, both professionally andpersonally
Obtain a broad view of our field, ho
changing and how it can accommoyour vision Appreciate the scope of potential
opportunities and how to tap into th Basic skills of self advocacy and va
behind it.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
13/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
14/74
Traditional Concerns
Will anyone really want to hire me?
Do I really know what Im doing?
Who will be there to help?
How will I manage in a new system
How will I figure out what is needed
How much money will I be making?
What will it be like to finally be a reaDoc?
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
15/74
Staying Put
Many of those concerns lead us towthe familiar
For those who like gradual transitio
find other strong attractions to whethey have been, this is a good choiBut
Still can make a big difference if yo
able to structure you job to meet cldefined career objectives
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
16/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
17/74
Preparation
For the most part, residency trainingprovides very little practical informatioabout finding jobs or negotiating skills(Conflict of interest?)
Generally do not encourage a diversitexperience outside the training system
Learn by experience? Big Gamble
Conditioned to be embarrassed by seconcernsupposed to be altruistic
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
18/74
Value of Self Advocacy
Self Advocacy is not inconsistent waltruistic values
We have to take care of ourselves order to take care of others
Burning out and breaking down helone
We should advocate for ourselves scan advocate for others
This means much more than mone
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
19/74
The Morning
The Changing Environment for HealthServices
The Impact of Health Care Reforms a
Finances on Career Planning and OpThe Rise of Public/Community Psych
Creating a Personal Life Vision
Business: Negotiating Your Vision
Questions and Answers
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
20/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
21/74
The Private Sector
It has become increasingly difficult a solo practitioner
Significant administrative expenseshave contributed to the limited scoppractice
Larger practice groups face many osame forces and must adopt a busplan to stay afloat
Contracting and employment comm Consultation to PCPs may be an
important future option ACA relief?
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
22/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
23/74
Public Sector Practice
Impact of managed care and margprivate benefits
Typically a more captive population
mobility Most psychiatrists will spend at leas
portion of their time in publicly fundpractice.
Growing demand to be discussed infollowing section
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
24/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
25/74
Academics
No longer subsidized to the extent tthey once were
Faculty generally expected to genesalary support
Teaching is not typically compensawell or valued within departments
Research support is highly compet
Stress? Security? Compensation?Satisfaction?
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
26/74
QuickTime and a
decompressorare needed to see this picture.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
27/74
Subspecialty Training
Psychiatry as primary care?
Specialization has been increasing inPsychiatry as in other medical discipli
Growth of PG fellowships
Growing emphasis on primary care anintegration will discourage specializatand likely reduce incentives
Politics aside, makes economic and p
health sense to reduce prevalence
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
28/74
QuickTime and a
decompressorare needed to see this picture.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
29/74
Administration and Leadersh
Role of psychiatry has diminished irecent years
Limited training and opportunity fee
one another Few compensation mechanisms, m
create added value to organizationjustify cost
Recent increase in training opportuand creativity in expanding influenc
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
30/74
Clinical Practices
Biomedical reductionism?
Fee for service, managed care, misplpriorities have narrowed the scope of
clinical practice Lack of creativity, diversity in job crea
Acquiescence to financial pressures
Significant opportunities to improve q
Impact of current scrutiny of evidence
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
31/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
32/74
The Scope of Practice and Opportunities
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
33/74
Factors Influencing Shift to Public
Sector Service
Financing Shifts:
Limited Private Benefits
Growing Reliance on MA Dollars
Growing Demand for Services: Deinstitutionalization
Social Drift/Health Care Access in PrivSector
Hassel Factor: Decline of Private Prac Expanded Public/Community Services
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
34/74
Deinstitutionalization
Influenced by a variety of factors overpast sixty years (expense, meds, pubawareness)
Increases states access to federal futhrough MA
Expanded demand for community baservices
Olmstead Act- least restrictive environ
Civil Rights of People with SMI
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
35/74
Community Based Practic
Desire for diverse practice
Distaste for business aspects ofprivate work
Economic Security (shifting locus orisk)
Social Consciousness?
Opportunity
Controlled Schedule Focus on Health
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
36/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
37/74
Diversity of Practice
Community Mental Health Centers
Addiction Treatment Programs
Correctional Psychiatry
Homelessness- street, shelter, hou Residential Services
Treatment Team Orientation
Full recovery spectrum
System based interventions
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
38/74
Experience
Never boring
Manageable
Adventure
Balance of work and private life
Cultural diversity
Public Service
Insight
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
39/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
40/74
Satisfaction
Influence
Autonomy
Valued
Compensated
Secure
Challenging
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
41/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
42/74
Getting Started
Know yourself
Geography
Social context and activity
Family needs Economic needs
Work conditions and nature
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
43/74
Geography
Climate
Urban vs. Rural
Exiting the urban chain everything cu
Family proximity Geographic culture
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
44/74
Social Context
Hobbies and activities
Religious heritage
Vacation / Holiday needs
Work Schedule
Work Culture
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
45/74
Family Context
Health and welfare of family of orig
Spousal social and employment ne
Education opportunities
Special needs children
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
46/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
47/74
Work Environment
Practice preferences
Special interests
Diversity preferences
Compatibility with practice environm
Compatibility with agency values
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
48/74
Non-Monetary Compensat
Professional
Education/CME
Teaching/Research
Administration Benefits
Insurance
Retirement
Family
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
49/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
50/74
QuickTime and adecompressor
are needed to see this picture.
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
51/74
Pre-Interview Screening
Geographic preference
Social / cultural special needs that deal breakers
Work preferences and need for div
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
52/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
53/74
Rules for Onsite Interviews
Always take your spouse or significanother
Take your time
Explore community on your ownTalk with other psychiatrist in the
organization or who work with theorganization.
Talk with other potential team membe Pay attention to organizational culture
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
54/74
Rules for Onsite Interviews
Understand the financial situation of tagency
Ask to see last years financial statement?
Meet with financial officer
Get contact info for key staff you mayto follow up with later
Ask for any forthcoming offer to be inwriting
Be clear about your decision timetabl
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
55/74
Establish Compensation Issu
How do you want to be compensat
Figure out how much revenue you generate for the organization
How much will it cost the organizathire you?
This will be the basis of negotiationthe contract-
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
56/74
Key Elements of Negotiati
Define the mutual benefit or contribto mission
Responsibilities of each party to the
other Benefits & monies to be exchange
Expectations of behavior
Reporting responsibilities
Terms & termination
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
57/74
Topics
What is a contract
Types of contracts
Key elements of a contract
Legal nuances for caution
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
58/74
What is a contract?
An Agreement between two or moreparties in which the agree to do or ndo specific things
Normally produces a mutual benefi
Frequently defines clearly the termrelationship
Usually legally binding
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
59/74
Developing the Contract:
Often have a standard format
Alterations of contract may require
Since they are not easily altered,
specifics of the position should bewritten into an attached job descrip
If special arrangements are agreedupon, get them in writing!
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
60/74
Employment agreement
Generally define the terms of emplo
Should reference a job description
Always have the following:
An effective date: hire, benefits, proba
Reporting relationship
Responsibilities
Benefits & compensation
Termination conditions
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
61/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
62/74
Conditions for Termination
Employer may terminate for goodcause, bad cause, or no cause at-a
Employee may terminate as well Notification period is usually specifi
the contract, same for both parties
Unique termination requirements?
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
63/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
64/74
Flexibility of An Employment
Agreement
Should be broad enough toaccommodate changing circumstan
Cannot be so specific that changes
work environment require contractchanges they will not happen!
Attention to termination restrictionsespecially important in this regard!
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
65/74
Independent Contracting
Agreement with an agency to provispecified services
Designated compensation arrangem
Usually no benefits, including healtmalpractice insurance
Be aware of these expenses whennegotiating the rate
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
66/74
Business standards
Severability
Records & documents manageme
Reporting
Non-discrimination Compliance with applicable law
Assignment
Entire agreement clause
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
67/74
Caution areas:
Indemnify & hold harmless clause
Third party relationships & sub-contracting
Non compete
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
68/74
Value of Negotiation
Remember that in most cases, theyneed you more than you need them
Dont be afraid to questions and ma
requests When everything is clear at the out
is less likely that there will be confliahead
You will feel more secure and value
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
69/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
70/74
C05 Creating Your Ideal Job in Psychiatry
Background Articles:
AACP, Keystones for Collaboration and Leadership: Issues and Recommendations for the
Transformation of Community Psychiatry, Sowers, W.E., MD and Thompson, K.S. (Eds.),
www.communitypsychiatry.org 2007
Ranz, J. et al, The Role of the Psychiatrist: Job Satisfaction of Medical Directors and Staff Psychiatrists.
Community Mental Health Journal, vol. 37, no. 6, Dec. 2001
Ranz, J. et al, The Role of the Community Psychiatrist as Medical Director: A Delineation of Job Types.
Psychiatric Services, vol. 51, no. 7, July 2000
Garfield, R.L. et al, Health Reform and the Scope of Benefits for Mental Health and Substance Use
Disorder Services. Psychiatric Services, vol. 6:1081-86, 2010
http://www.communitypsychiatry.org/http://www.communitypsychiatry.org/http://www.communitypsychiatry.org/7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
71/74
C05 Creating Your Ideal Job in Psychiatry
References:
Garfield, R.L. et al, Health Reform and the Scope of Benefits for Mental Health and Substance Use
Disorder Services. Psychiatric Services, vol. 6:1081-86, 2010
Sowers, W.E., Transforming Systems of Care: The American Association of Community Psychiatrists
Guidelines for Recovery Oriented Services. Community Mental Health Journal, vol. 41, no.6, December
2005
Peebles, S., et. al., Immersing Practitioners in the Recovery Model: An Educational Program
Evaluation, Community Ment Health J, vol. 45, p 23-45, 2009
Willing, C.E., et al, Transforming Administrative and Clinical Practice in a Public Behavioral Health
System: An Ethnographic Assessment of the Context of Change, Journal of Health Care for the Poor
and Underserved, vol 20, 2009
Aarons, G.A., Transformational and Transactional Leadership: Association with Attitudes Toward
Evidence-Based Practice. Psychiatric Services, vol. 57, no. 8, Aug. 2006
Ranz, J. et al, The Role of the Psychiatrist: Job Satisfaction of Medical Directors and Staff Psychiatrists.
Community Mental Health Journal, vol. 37, no. 6, Dec. 2001
AACP: Guidelines for Psychiatric Leadership in Organized Delivery Systems for Treatment of Psychiatric
and Substance Disorders,http://www.wpic.pitt.edu/aacp/finds/leadership.html
Ranz, J. et al, The Role of the Community Psychiatrist as Medical Director: A Delineation of Job Types.
Psychiatric Services, vol. 51, no. 7, July 2000
http://www.wpic.pitt.edu/aacp/finds/leadership.htmlhttp://www.wpic.pitt.edu/aacp/finds/leadership.htmlhttp://www.wpic.pitt.edu/aacp/finds/leadership.htmlhttp://www.wpic.pitt.edu/aacp/finds/leadership.html7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
72/74
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
73/74
C05 Creating Your Ideal Job in Psychiatry
Self Assessment Questions:
1. Career opportunities in psychiatry are changing as a result of:a. Health care reform and financingb. Recovery principles and patient centered clinical practicec. Incentives for integrating physical and behavioral health care.d. All of the above
2. Service integration in the mental health system is important for all of the following except:a. Addictions and co-occurring disordersb. Physical and behavioral health carec. Adolescent and adult Cared. Forensic care and financial reform
3. Health care reform will probably:a. Eliminate private practice as a career pathb. Increase the emphasis on chronic care and health homesc. Decrease the importance of health maintenance and preventiond. Reduce the emphasis on objective measures of mental health services
4. Career satisfaction in the public sector is associated with:a. Opportunities for leadership and consultationb. Integrating personal life goals with professional life goalsc. Understanding the culture and structure of the employer organizationd. Learning to negotiate broader and more flexible job descriptionse. All of the above
5. Which of the following is NOT an important element in evaluating a job opportunity?a. The culture of the prospective employer organizationb. The employers contributions to a political partyc. The previous years budget statement of the employerd. Location
6. In evaluating a job opportunity, its a good idea to:a. Visit the employer community with your spouse or partnerb. Avoid questions about the employers overall budgetc. Meet only with the prospective supervisor and physician colleaguesd. None of the above
7. Which of the following is a common mistake made by persons entering the job market for thefirst time?
a. Wearing inappropriate clothingb. Relying too heavily on non-monetary forms of compensation.c. Accepting offers without negotiating for what they really would like
7/27/2019 IPS 2012 - Finding Ideal Job in Psychiatry
74/74