ACS Bulletin - July 2016

48 |

Building on longstanding safety practices in the military and in the aviation industry, the surgical profession has embraced the use of checklists, which are generally defined as long sets of tasks or actions that need to be accomplished in a specific order to ensure a safe and effective outcome. In fact, many books and articles have been published describing the benefits of a checklist—a tool that all members of the operating room (OR) team are expected to acknowledge and follow.

Building on the success of OR checklists, which are now standard practice for all ORs, the Surgeon Workforce Subcommittee of the American College of Surgeons (ACS)

Board of Governors Surgical Care Delivery Workgroup proposes that the complex, multistep process of bringing a new surgeon into a group or surgery department would benefit from a checklist template. The Onboarding Checklist for Surgeons developed by the workgroup delineates action items for both a new surgeon and the hiring partner, group, or hospital.

During and after recruitment, the onboarding process involves important negotiations that might affect key factors such as the type of cases the surgeon will be expected to perform and the nature of the surgeon’s future clinical career. Hospital systems’ human resources departments and lawyers representing private practices generally provide new recruits with an overview of behavioral expectations as well as information regarding compensation, benefits, insurance plans, regulations, licensing requirements, and expectations regarding call, vacation, incentives, and practice routines.

The Onboarding Checklist for Surgeons includes both practice life preparation action items and items related to an employment contract. This checklist is intended to serve as a discussion guideline and is not intended to represent mandatory requirements.

Why is an onboarding
checklist needed?

The Onboarding Checklist for
Surgeons is a working document
for both parties involved in an
employment negotiation. The
checklist is useful in preparing
questions for the initial
discussion about a position, but
is even more valuable when
finalizing the recruitment of a
candidate and for setting up a
practice. For the young surgeon
evaluating a first or second
offer, the goal is to discuss and
find consensus regarding key
issues before beginning a new
practice relationship. Ideally,
such negotiations should avert
potential misunderstanding,
and later, dissatisfaction.

Typically a surgeon will seek out a legal review before signing an employment contract.

The Onboarding Checklist for Surgeons helps to ensure that essential issues are included in the practice agreement, saving costs and avoiding delays for all parties involved. It should be noted that, although helpful, the checklist does not replace the need for expert legal review, particularly as some issues are unique to specific practice agreements and environments.

The checklist does not define the advantages or disadvantages of different types of employment arrangements, ranging from private practice to multispecialty groups or academic faculty practices.