Orthopaedics in the Real World: The Business and Legal Aspects of Employment in 2022

As more physicians enter hospital employment on completion of their training, the details and complexity associated with these arrangements are increasing. To better position surgeons to succeed in any employment model, it is important to describe several key topics associated with these business models. First, financial modeling can be used to make smarter choices when evaluating employment opportunities. This tool, applied often in the business world, allows surgeons to truly understand the midterm and long-term financial implications of employment decisions and can help surgeons thrive financially as they progress through their careers. There are both positive and negative intricate points associated with different employment models, including hospital-employed positions. Although each model may have its minor unique differences, a thorough understanding of the basics is critical for success. Contracts and some of the common issues of concern that surgeons should be keenly aware of when negotiating their hospital employment contract are important topics for discussion, along with the concept of ancillary revenue, specifically its unique implications as it applies to hospital-employed physicians; these relationships can be very different from traditional private practice models of ancillary income. Orthopaedic surgeons should be knowledgeable about Stark Law, the Anti-Kickback Statute, and Certificate of Need laws and the potential effect of these and other regulations on physicians.