| before-you-sign-that-contract-heres-what-you-need-to-know | Before You Sign that Contract: Here's What You Need to Know | Partners in Medicine | Shared_Content/News/Membership_Memo/2025/July-11/before-you-sign-that-contract-heres-what-you-need-to-know | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2025/july/ldc-kyle-claussen-cropped.png" class="pull-right" alt="Kyle Claussen presenting at a WSMA meeting" /></div>
<h5>July 11, 2025</h5>
<h2>Before You Sign that Contract: Here's What You Need to Know </h2>
<p>"What's worth roughly $2.9 million to each of you individually?" asked Kyle Claussen at the opening of his session at the WSMA's Leadership Development Conference in Chelan in May. By the end of his fast-paced 45-minute presentation, he brought the answer full circle for conference attendees. But first, he highlighted key components of physician contracts that WSMA members should keep front of mind before they sign on the dotted line. Besides specializing in physician contract review, Claussen is married to a physician and has a front row seat to the art of the deal.</p>
<p>When you're considering your next contract, he advises keeping several things in mind.</p>
<h3>First: What types of risk should you be thinking about in your contract? </h3>
<p>He notes that physicians need to pay close attention to scheduling, duties, responsibilities, when and where you'll work, how much call you'll take, whether you can "moonlight" or consult, keep your intellectual property, supervise advanced practice providers with or without pay, and have time for administration and research. Claussen notes, "All of this is failure number one in most contracts in that they start out saying the employer controls all of it." </p>
<h3>Second: Closely review the termination section. </h3>
<p>"We have to know the notice periods and how you get out of these things," he says. It's critical to know if it's for cause or without cause, what the effects might be on the next employer, if there's "tail" coverage, noncompetes, repayment obligations, damage amounts required, or force majeure clauses. "All of these things matter," Claussen says, "and a lot of the time, physicians overlook this part in favor of what the salary and signing bonus are." </p>
<h3>Third: Research and evaluate the compensation. </h3>
<p>The typical elements of compensation are base salary, production bonus, signing bonus, relocation allowance, CME, and vacation time, etc. You may also see quality bonuses (these are generally very subjective), possibly compensation for APP supervision, student loan forgiveness, and retention bonuses. But evaluating these elements requires some data analysis. "If a percentage of your total compensation is tied to patient satisfaction, whether you show up to committee meetings or other things out of your control, we don't like that," Claussen says. "Most of what you're doing should be quantifiable or objective for your compensation." The next step is researching the data. "You have to know what the market says is the right number for your specialty," he says. "You have access to data sets on the Resolve website, where the information is verified and from physicians." </p>
<h3>Fourth: Negotiate! </h3>
<p>"Every single employer is going to tell you this is their standard contract, and every single physician has signed it," Claussen says. "I can tell you that 85% of the contracts we review get changes made." Employers use information to determine what they say is fair value, but physicians don't have access to the data being used. "That first number we talked about? The $2.9 million? That's what you leave on the table if you're underpaid by 10% for 25 years on an average salary," explains Claussen. "It's not really about the compensation-it's about being treated fairly for the work you're doing. It's about capturing the value that you create." </p>
<p><em>Kyle Claussen is the president of Resolve, a tech platform that helps physicians review contracts and provides salary data, along with contract reviews. Email Kyle at </em><a href="mailto:kyle@resolve.com"><em>kyle@resolve.com</em></a><em> or call 877.758.3318 to speak with a Resolve representative</em>. </p>
<p><em>Resolve offers an </em><a href="https://www.resolve.com/contract-review/instant-contract-review?utm_campaign=Washington%20State%20Medical%20Association&amp;utm_source=website&amp;utm_content=conference%20follow%20up%20post"><em>Instant contract review</em></a><em> to WSMA members, providing access to comprehensive compensation data for your specialty, as well as an instant review of one employment contract, powered by an attorney-trained AI model. You may also talk to Resolve's health law attorneys. WSMA members receive a 10% discount on any Resolve service by using the code </em><a href="https://go.resolve.com/wsma?utm_campaign=Washington%20State%20Medical%20Association&amp;utm_source=website&amp;utm_content=conference%20follow%20up%20post"><em>WSMA10</em></a><em>. </em> </p>
</div> | 7/11/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |
| risk-mitigation-during-medication-and-specialty-shortages-equipment-recalls | Risk Mitigation During Medication and Specialty Shortages, Equipment Recalls | Partners in Medicine | Shared_Content/News/Latest_News/2025/risk-mitigation-during-medication-and-specialty-shortages-equipment-recalls | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2025/may-june/cover-wsma-may-june-2025-645x425px.jpg" class="pull-right" alt="May/June 2025 cover of WSMA Reports" /></div>
<h5>May 13, 2025</h5>
<h2>Risk Mitigation During Medication and Specialty Shortages, Equipment Recalls</h2>
<p>By Heather Edwards, RN</p>
<p>
As many in health care will recall, the nation saw a dramatic shortage of iodine in 2022, after a two-month COVID-19 lockdown resulted in manufacturing interruptions. Doctors, clinics, and hospitals scrambled to respond to the shortage, contending with delays in treatments, patient backlogs, and less-than-ideal alternatives. Rallying to provide guidance, organized medicine stepped in, with the American College of Radiology Committee on Drugs and Contrast Media offering recommendations to help imaging specialists address the shortage until supplies could resume.
</p>
<p>
Medication shortages in the U.S. have become increasingly prevalent in recent years, predating the pandemic. But that's not all: The U.S. is also seeing an increase in medical equipment recalls and delayed procedures due to local or statewide staffing shortages. These events can have consequences for patient care, from delays in care to missed diagnoses. Considering that claims are often filed years after an adverse event occurs, it is essential for physicians and physician organizations to develop appropriate risk mitigation strategies for health care shortages and recalls.
</p>
<h3>Medication shortages</h3>
<p>
Drug shortages can be caused by many factors. As the medications listed on the U.S. Food and Drug Administration Drug Shortages Database are constantly changing, the level of threat to the patient can range from minimal to devastating. Consult recognized societies and associations when available. They may provide best practice recommendations.
</p>
<p>
The recommendations offered by the American College of Radiology in response to the iodine shortage in 2022 may contain useful principles that can be applied to other situations, as well. Those recommendations advised specialists:
</p>
<ul>
<li>Use alternative studies, with or without contrast, appropriate for patient circumstances.</li>
<li>Use alternative versions of contrast media or sourcing from different vendors.</li>
<li>Discuss strategies that may be appropriate for repackaging of higher-volume single-use vials (involving infection control and pharmacy).</li>
<li>Reduce waste by minimizing individual doses.</li>
<li>Identify studies for which higher concentration agents are needed for optimal visualization.</li>
<li>Use recognized and approved alternatives to nonionic contrast for oral, rectal, and genitourinary administration.</li>
<li>Collaborate with other departments that use iodine-based agents in order to prioritize use.</li>
</ul>
<p>
Further, if contrast media was in short supply, specialists were advised to develop mitigation, prioritization, and procurement strategies, as well as communicate with ordering physicians. Since substitutions in the contrast media drug, the concentration, or the indications may have led to confusion and resulted in administration errors, the society recommended that a "contrast time-out" be added to any imaging procedure to ensure that the correct agent, amount, and concentration is being used.
</p>
<h3>Documentation and communication</h3>
<p>
Concerns arise for malpractice exposure when a needed medication is not available or if a substitution is used to bridge the gap. Documentation and creating a detailed plan play critical roles for patient safety. Share the plan with staff involved in patient care and make sure it includes documentation standards. Include the following type of information in the patient's medical record, adapting details to specific circumstances:
</p>
<ul>
<li>The health care crisis or situation impacting patient care.</li>
<li>Alternative medications or studies considered and used in accordance with any revised clinical guidelines.</li>
<li>Patient factors taken into consideration</li>
<li>Shared decision-making with the patient.</li>
<li>Any deviations from the norm (dosage, concentration, medication, changes in studies, etc.).</li>
<li>The use of procedural "time-out" prior to administration in cases of a major deviation.</li>
<li>Plans for future care.</li>
</ul>
<p>
The Institute for Safe Medication Practices, ECRI, and the FDA have resources available to help manage drug shortages. They can assist with developing policies and processes and help identify when limiting or extending beyond use date should be used as a countermeasure.
</p>
<h3>Specialty care shortages</h3>
<p>
Lack of access to specialty care is another challenge in health care that can have devasting consequences for patients. To ensure patient safety, it is vital that staff involved are aware of the situation, of your mitigation plan, and of the required documentation and ongoing interim care until a patient can be seen. Delays in care should be clearly documented in the patient record. Considerations:
</p>
<ul>
<li>Make sure your patient understands the situation and be certain that all risks are known to the patient if surgery or a referral will be delayed.</li>
<li>Provide your patient with options. For example, you can offer to refer them to a specific physician who can treat them at a different facility if you do not have privileges at that organization. If necessary, consider appropriate physicians or practitioners in nearby communities. Save in the patient's chart a record of all communication attempts with other physicians and clinics for referral.</li>
<li>If the patient understands the risks and chooses to delay care rather than go to a different physician, document the options you offered and the fact that the patient chose to delay care. Summarize the plan for future patient care.</li>
<li>Indicate the current status of the patient.</li>
<li>Implement a system to track overdue surgeries, procedures, and appointments and create a process for ongoing monitoring of patients who are waiting. It is important to document any change in a patient's condition that would indicate a necessary escalation in care.</li>
</ul>
<p>
Lack of access to specialty care is not an opportunity to reduce safety criteria so patients can be seen more quickly. For example, a patient with comorbidities requiring a hospital colonoscopy cannot get their procedure in an ambulatory surgery center to avoid delay. Patients must still meet the criteria for care in an ASC.
</p>
<h3>Equipment recalls</h3>
<p>
The variety in recall types in health care underscores the importance of implementing a plan throughout your organization. Recalls can impact a small or large number of your patient population. Patients' dependence on mechanical and electronic technologies is increasing, and a sudden loss of access to these, as well as to medications, can be challenging. Managing the risks associated with recalls is a critical aspect of patient safety. Considerations:
</p>
<ul>
<li>Develop a recall policy that identifies state and federal requirements for documentation of lot numbers, serial numbers, and other identifying information needed to effectively manage medication and equipment recalls.</li>
<li>Create a plan that outlines the procedures for managing the specific recall. Include details such as identification, communication, notification, equipment retrieval, and documentation.</li>
<li>Work closely with the equipment manufacturers or suppliers to ensure you understand their guidelines, the recall classification (voluntary or mandatory; not likely to harm or serious risk), and the support they will provide.</li>
<li>Implement a system to quickly identify the recalled equipment, implant, or medication.</li>
<li>Identify patients affected by the recall. When possible, have alternative medication, equipment, or procedures in place to avoid disruption of care.</li>
<li>Develop a clear message that all staff should use when communicating or discussing the recall, including appropriate details such as:
<ul>
<li>What the equipment or implant or medication is (model number, manufactured date, lot number, etc.)</li>
<li>Reason for the recall</li>
<li>Potential risks</li>
<li>Steps the patient should take</li>
<li>Point of contact</li>
</ul>
</li>
<li>
Choose the appropriate communication method(s):
<ul>
<li>Personalized letters</li>
<li>Phone calls</li>
<li>Patient portal</li>
<li>SMS alert</li>
</ul>
</li>
<li>
Ensure that staff is prepared for a potential influx of calls and inquiries. Staff should be well-informed about the
recall and trained on how to handle patient concerns.
</li>
<li>
Schedule appointments, if necessary, for alternative treatment or checkup, if indicated.
</li>
<li>
Maintain thorough records of all recall-related activities, including notification received, actions taken, and the disposition of recalled equipment.
</li>
<li>
Send follow-up communication to all patients who have not responded or have not taken the necessary steps.
Document all patient communications in the patient record.
</li>
</ul>
<p>
Depending on the nature of the recall, a consent or declination-of-care document may be needed.
</p>
<p>
Every situation is unique and may call for tailored support. Do not hesitate to reach out to Physicians Insurance or your professional liability coverage provider for personalized assistance and guidance.
</p>
<p>
<em>Heather Edwards, RN, CPHQ, is a senior clinical consultant with Physicians Insurance. Physicians Insurance members can access detailed guidance including sample documentation at <a href="https://phyins.com/resources">phyins.com/resources</a>.</em>
</p>
<p>
<em> This article was featured in the May/June 2025 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 5/13/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |
| the-power-of-giving | The Power of Giving | Partners in Medicine | Shared_Content/News/Latest_News/2025/the-power-of-giving | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="Northern Capital Management logo" class="pull-right" src="/images/membership/why-join-the-wsma/partners-in-medicine/northern-capital-management/northern-capital-management-logo.jpg" />
</div>
<h5>May 8, 2025</h5>
<h2>The Power of Giving </h2>
<h5>Sponsored content </h5>
<p>By David Holloway, Northern Capital Management.</p>
<p>During lunch with my father around 30 years ago, he suggested that I give serious consideration to intentional giving on a regular basis. Assuring him I'd think about it, the reality was this: I was in my mid-thirties with a five-year-old (and another one on the way) amidst a job change and with variable income. In short: no way.</p>
<p>Weeks later, Dave Ramsey, a newly syndicated radio talk show host (now worth over $200 million) was speaking about the wisdom of giving.</p>
<p>Prompted twice, further exploration seemed prudent.</p>
<p>While the term giving is often associated with monetary giving, generosity can be practiced by giving time to a person or organization, or providing a needed skill that is not easily replicated. This discussion will deal primarily with monetary giving and some potential tax benefits.</p>
<h3>Why consider giving? </h3>
<p>Health benefits: <a href="https://health.clevelandclinic.org/why-giving-is-good-for-your-health">Giving makes you feel better</a>. </p>
<p>As you help someone or give a gift, your brain secretes "feel good" chemicals such as: </p>
<ul>
<li><a href="https://my.clevelandclinic.org/health/articles/22572-serotonin">Serotonin</a> (which regulates your mood). </li>
<li><a href="https://my.clevelandclinic.org/health/articles/22581-dopamine">Dopamine</a> (which gives you a sense of pleasure). </li>
<li><a href="https://my.clevelandclinic.org/health/articles/22618-oxytocin">Oxytocin</a> (which creates a sense of connection with others). </li>
</ul>
<p>Cortisol on the other hand is considered a "stress hormone." Elevated levels of cortisol over time can have negative health impacts including hypertension and diabetes. One study found <a href="https://doi.org/10.1093/geroni/igy023.283">cortisol output was attenuated on days when respondents volunteered compared to days when they did not volunteer</a>. </p>
<h3>Tax planning benefits </h3>
<p>Along with health benefits, there are numerous tax and estate-planning benefits derived from charitable giving.</p>
<ul>
<li>Cash gifts: Easiest to do, simply donate cash to a charitable organization you wish to support. Itemize deductions and you can deduct up to 60% of your <a href="https://www.nerdwallet.com/article/taxes/adjusted-gross-income-agi">adjusted gross income</a> using charitable donations, but you may be limited in some cases.</li>
<li>Appreciated assets: Gifting of highly appreciated stock or real estate can be considered. In most cases, the donor will receive the current value of the asset as a donation and is relieved of the capital gains tax burden. </li>
<li>Know someone who's retired? While most IRA distributions are taxable, gifts made to a charity directly from an IRA (who's owner is at least age 70.5) are considered a non-taxable distribution.</li>
<li>Cars, boats, airplanes, etc.: Many organizations accept gifts-of-use assets, and you qualify for a charitable deduction. In the Inland Northwest, Union Gospel Mission accepts vehicles, and the tax benefit is described as follows: </li>
</ul>
<p>*If your car sells for more than $500, you claim the sales price as your deduction, including improvements made by UGM Motors, with the exception of major repairs, like an engine swap or transmission rebuild. Deductions from the sales price would be itemized on the donor's 1098C form. </p>
<h3>Planned charitable giving and estate planning benefits </h3>
<p>These methods of giving are used when tactical giving situations arise or are part of an estate plan to mitigate current year tax or estate-tax liabilities. To emphasize the importance of engaging planning strategies, a reminder that Washington state currently levies taxes (10-20%) on estates valued at more than $2,193,000 when the surviving spouse passes. Ouch! </p>
<ul>
<li>Donor-advised funds (DAFs): Funding a DAF is a great way to receive a current year deduction (in case of high tax liability year) and control timing of charitable distributions. Contributions are made into the DAF and the donor then recommends amounts and timing of distributions to supported charitable organizations. DAFs are low cost and simple to administer.</li>
<li>Charitable remainder trusts: Planned giving where assets are transferred into a trust for the benefit of a charity, and the donor retains an income stream from the trust for a period of time or until death. Ultimately the trust assets go to the specified charity.</li>
<li>Charitable lead trust: Assets are transferred into a trust that provides income to a charity for a set period, then ultimately passes to the donor's heirs.</li>
<li>Gift annuities: A contract between a donor and charity where the donor gifts money, securities, or possibly other assets to a charity. In return, the donor is eligible for a partial tax deduction and a specified lifetime income stream.</li>
<li>Private foundations: A similar strategy to the donor-advised fund, but the donor incorporates and funds a private non-profit foundation. Transferred assets are then invested and certain levels of gifting are required of the foundation annually. A private foundation can be a useful tool for future generations to continue a founder's charitable intent. Administrative and corporate filing duties can be cumbersome. </li>
</ul>
<p>Other trusts such as irrevocable life insurance trusts, generation-skipping trusts, and grantor-retained annuity trusts are designed to shield assets from estate tax and are not primarily designed for charitable intentions.</p>
<h3>Ready to go? </h3>
<p>Always a good idea to employ the advice of a CPA, and in cases of trusts, a tenured tax and estate attorney. </p>
<p>Verify the charity you want to support is using resources wisely: </p>
<p>For tax deduction purposes, be certain the charity is a qualified 501c(3) organization. Check with the secretary of state where the charity is headquartered.</p>
<p>Most charitable organizations are required to file a Form 990-PF. This IRS form will show how the entity is directing their income and expenditures. Verify funds are being used for mission specific work, and not overly burdened by administrative costs. You can find 990-PFs <a href="https://apps.irs.gov/app/eos/">here</a>.</p>
<p>Use a research group like Charity Navigator or BBB Wise Giving Alliance. These organizations provide a rating system for many qualified charities.</p>
<p>Gifts to charities you feel strongly aligned with will be remembered far more fondly than most of the other spending you do.</p>
<h3>Questions? </h3>
<p><a href="https://northernwelcome.com/wsma-members">Northern Capital Management</a> advisors are certified financial planners with extensive experience working with medical professionals. </p>
<p>You may reach us by utilizing our WSMA member contact <a href="https://northernwelcome.com/wsma-contact">form</a>.</p>
<p>The WSMA is a client of <a href="https://northernwelcome.com/wsma-members">Northern Capital Management</a> and Northern Capital Retirement Services and receives compensation for promoting our services. As a result of the compensation arrangement there is an inherent conflict of interest. Review the disclosure. </p>
<p><em>--This article is brought to you by WSMA's preferred partner, </em><a href="[@]wsma/membership/why_join_the_wsma_/partners-in-medicine/northern-capital-management.aspx"><em>Northern Capital Management</em></a><em>, providing WSMA members financial planning and wealth management support tailored to the unique needs of the physician community.</em> </p>
</div> | 5/8/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |