ANES 506: Professional Issues PROFESSIONAL CONTRACTS Bernadette T. Roche, CRNA, EdD

Hospital employed CRNA – no contract, subject to general employee compensation and benefits. Group employed CRNA (anesthesiologist or CRNA group): Renewable contract specifies compensation and benefits.

Compensation & Benefits Compensation: Base salary Call pay Annual bonus Compensation increases Opportunities for partnerships

Benefits: Insurance: malpractice, health, dental, life, & disability. Pension/Retirement Plan. Paid time off: vacation, holidays, sick time. Professional support: license renewal, professional dues, continuing education expenses. Other: pagers, cell phones, travel expenses.

Malpractice Insurance Corporation provides professional liability insurance for employee duties within the scope of their employment. Corporation may provide a reporting endorsement (“tail coverage”). may not provide if contract is terminated for any reason before expiration date.

Termination Without Cause Upon 90 days of written notice from corporation or employee. Cooperation may terminate immediately and pay salary for 90 days.

With Cause - immediate termination by cooperation without prior notice for: Violations of standards of care. Criminal/fraudulent acts towards corporation. Felony conviction. License/certification suspension or termination. Loss of malpractice insurance. Medicare exclusion. Chemical impairment while on duty.

With cause: employee may terminate agreement by written notice to cooperation without prior notice because of a material breech of agreement but only if breech remained 30 days after employee submitted a written notice of the breech. Automatic Termination death of employee. dissolution of corporation.

Indemnification Employee shall hold harmless and indemnify employer from all claims, actions, liabilities, costs, damages, expenses, court costs, and attorney fees that are a result of or are attributable to acts or omissions of employee.

Restrictive Covenant Employee may not provide anesthesia services for another group or institution. Upon separation from corporation, employee: must resign from medical staff at the hospital(s) and can not reapply for privileges for two years. cannot work within a restricted area for a specific period of time. cannot recruit any corporation employees. cannot recruit any corporation patients.

Injunctive Relief Corporation may prevent former employee from practice at a restricted site through a court ordered injunction. Usually for violation of a restrictive covenant.

Independent contractor Institution or corporation does not: withhold income tax. pay FICA for individual. provide unemployment insurance. provide workers compensation. provide paid time off. Individual: files a 1099 with institution responsible for paying all income and payroll taxes (15-20% of gross income). can claim work-related expenses.

Locums Tenens Latin “ place holder” Contract should address job requirements, professional reimbursement, lodging, malpractice insurance, and other expenses. May be considered employee or independent contractor.

CNN – Top Paying Jobs 2009 1. Anesthesiologists - Median salary: $292,000; Top pay: $408,000 2. OB/Gyn Median salary: $222,000; Top pay: $338,000 3. Psychiatrist Median salary: $177,000; Top pay: $279,000 4. Nurse Anesthetist Median salary: $157,000; Top pay: $214,000

CRNA Compensation Benefit (Median) Amount % of Total Base salary $132,934 77% Bonuses $200 0% Social Security $7,510 4% 401k/403b $4,819 3% Disability $3,248 2% Healthcare $5,390 3% Pension $4,314 2% Time off $14,542 8% Total: $172,959

Anesthesiologist Compensation Benefit Amount % of Total Base (Median) salary $280,854 79% Bonuses $6,090 2% Social Security $9,741 3% 401k/403b $7,602 2% Disability $7,001 2% Healthcare $5,390 2% Pension $6,804 2% Time off $31,343 9% Total $354,825

National CRNA Compensation

Self-Employed CRNA Compensation

CRNA Salary - Illinois