Editor’s Note: This post – and the accompanying video below – were made in partnership with Resolve – the #1 rated Physician Contract Review company. If you use the code TPP10 when getting a contract review with Resolve, you will get a 10% discount on their contract review pricing for doctors. Over 50% of physicians will change jobs in the first 2-5 years of their practice. This transition will require them to have a very solid handle on the language in their contract. Yet, the first time that most doctors take a deep dive into their physician contract is in one of two situations. The first is when they hear a colleague discuss their contract and realize that they received a lesser deal.
“What do you mean you got a $15,000 moving bonus? And they promised to provide you a career coach when you signed your contract? You got the hospital to pay for some of your student loans?”The second is when a doctor is reviewing their physician contract because they are thinking about breaking up with their current employer or group only to realize that they are stuck. It usually goes something like this,
They want me to do what? And they aren’t going to pay any more for the extra time spent? That’s it. I’m done! Wait… what do you mean there is a non-compete in my contract?Needless to say, neither of these situations are ideal, but both could have been prevented if the doctor would have only had a better grasp on the following 5 things you must know about physician contract reviews.
1. Create Leverage – Have Multiple Physician Contracts in HandEveryone at some point is going to be disappointed in a decision made by your employer or group. That situation may lead you to apply for other jobs, and – if you weren’t aware already – you will suddenly realize that when you have multiple offers, your employer will suddenly realize your value. They are going to have to fight to keep you. Similarly, when you are looking for a new job (and, particularly, your first doctor job out of training) having multiple offers places all of the leverage in your corner. From the outset of any discussion, you have the ability to walk. You don’t have to take a raw deal. More importantly, this allows you the leverage and position to negotiate your contract. Whether that means asking for specific time off, equipment, needs, or a promise to a particular focus or location… with multiple offers on the table, the leverage in the negotiation will rest comfortably in your corner.
2. Know Your Value Prior to Physician Contract NegotiationsAnother key aspect of physician contract reviews is having good data. For example, MGMA data for your specialty can prove useful when discussing compensation and benefits. It is important to mention, however, that specifics matter. You don’t want to know what some doc in a low cost of living area is making across the country in a different job. The goal is to have specific numbers for your region of the country, your specialty, and academic/private pay. It is equally important to look at all of those specifics for someone with your level of experience. Are you fresh out of residency or fellowship? Have you been out for 10 years? Either way, know your value. That means knowing the average, median, and quartiles compensation numbers for other doctors just like you.
3. Define the Job – The Devil is in the DetailsA great way to find disappointment in life – whether in your career or at home – is to make sure that your expectations don’t line up with reality. For example, if you expected to be on Q7 call and then you show up for the job and find out it is actually Q3 call… guess what? You are not going to be a happy camper. Similarly, if you are a proceduralist and find out that your new gig doesn’t have the equipment or other needs you may have to do your job, that is going to make you look bad. That’s not going to fly. For this reason, you need to be very specific about your job expectations. How much call? Vacation? Days worked each week? Compensation? Equipment? Ancillary staff (schedulers, nursing assistants, advanced practice providers)? The devil is in the details with physician contract reviews. Make sure you don’t miss this important step.
4. Plan on TerminationContracts for doctors are like divorce for marriage. No one signs a contract expecting to hate the job or to need to make a change in the near future. Just like no one gets married with the expectation to get divorced. Yet, we know that it happens. A lot. For this reason, any contract worth its weight in salt is going to define “The Break-Up”. And, no, I’m not talking about the Jennifer Anniston / Vince Vaughn Rom-Com. I’m talking about what happens when you become a physician statistic when you change jobs in the first 2-5 years after you sign your physician contract. There are two specific details to pay attention to in the Break-Up language in a physician contract. First, you want to determine who is going to cover your tail for malpractice insurance. If not, you could get stuck with a hefty multi-thousand dollar bill that traps you in your job. No kidding, the average tail insurance costs 2.5x the annual premium. If your annual malpractice premium is $10,000 – well – you have to come up with $25,000 right when you are thinking about moving expenses and getting to your next job. Second, you need to pay specific attention to non-compete (a.k.a. covenant not to compete) clauses. Say, for example, you and your family for the last 5 generations are all from central North Carolina and your contract says – if you leave – that you cannot work at a competing facility within 50 miles. Guess what? You are going to be living an hour away until your non-compete expires. When it comes to physician contract reviews, know how the Break-Up will work before it ever happens.
5. Make the Ask – There Are Very Few “Standard Contracts”When I was a kid, my dad used to love to point out relationships that didn’t seem to make sense. Particularly, if there was a beautiful woman who was married to a normal run-of-the-mill kind of guy. Clearly, the guy was out of his league. My would love to point out how this guy landed the woman of his dreams. Dad would say,
You know the difference between that guy and all the other guys that wanted to marry her, but didn’t? He asked.The only difference is that the guy mustered up the nerve to ask. The same goes with your physician contract. What’s the worst that could happen if you ask for something to be changed, added, or addended in your contract? They say, “no”. The best-case scenario is that they give you the job of your dreams. For this reason, don’t fall for the two most common lines used by employers. It goes something like this, “This is our boiler-plate contract. It is the same one everyone gets.” Or, maybe, it sounds like this… “This is our standard contract. Please, review and sign.” However, you know from that conversation I alluded to above with your colleague who got the signing/moving bonus … that’s not true. Contracts can be changed, amended, and altered based on your requests. All you have to do is make the ask when negotiating your physician contract.