Guide to a Comprehensive 15-Point Checklist When Negotiating Physician Contracts 

When physicians graduate from medical school all they focus on is the salary.  They typically have no idea of how they can be bound down by "non-compete, non-disclosure, non-solicitation agreements.  If those three words are confusing, that is because they are.  And in Florida, they are enforced heavily.  Physicians often have to move their families out of the area, seek other employers, and be bound by what some employers consider confidential techniques. Keep in mind, there are very very few things in a medical practice that would technically be considered proprietary, but nonetheless, some employers do try to enforce such provisions. It is very costly to get out of such hawkish employer contracts.

Here is how physicians negotiate their professional services agreement. 

Experienced physicians know that the first job will not be their last, first contracts need to be looked at very carefully to plan ahead for how their future employment opportunities will be impacted. It is an awakening when a physician resident comes out of school and loses the immunity and cocooning that they had during residency. In reality, physicians in the working world are susceptible to lawsuits, licensure complaints, and employers who are negligent in carrying out their processes, and often find themselves handcuffed into non-compete agreements that impact their future employment prospects.  

There are many things to negotiate in a Physician Employment Contract.  The terms include: (**highly important): 

  1. **Compensation Calculation: Is compensation based on a set salary or net revenues? Is performance based on wRVUs or the profitability of the business? After-hours services compensation? Earning a bonus based on performance and attracting new patient business? 
  2. **What happens post-termination: earned paid time off, return of records and equipment, access to patient records if a question comes up later.
  3. **Non-compete: who or what entity is defined as a competitor? How many miles from what location? What area of medicine/specialty? Is the non-compete nullified if terminated without cause? 
  4. **Malpractice insurance: Will the employer provide it? Does it include tail coverage, nose-in coverage, and differences between claims made and occurrence-based coverage?
  5. **Minimum Obligations of the Employee: What is the physician obligated to perform: based on the number of days worked or number of patients seen, wRVU's performed, or revenues collected?
  6. **Minimum Obligations for the Employer: Maintaining a support staff, a reliable Electronic Medical Record (EMR) system, scheduling, training, relaying patient messages, prescription refills (controlled and non-controlled), position on patient abuse of the professional.  
  7. Location: Will all the locations that the employer owns or is affiliated with apply to the non-compete? Which location is your primary location?
  8. Hours: What days and times will the physician work? Is the call schedule fair? Is it an in-house call or a home call? Call compensation?
  9. Paid time off (PTO):  How many vacation days, sick days, CME days, family medical leave, and holidays are set and calculated?
  10. Professional Expenses: Continuing Medical Education (CME), Annual Dues of various associations and licenses, obtaining certifications, related travel and lodging for annual meetings, journals, books, personal professional equipment (i.e. stethoscope, uniforms).
  11. Non-solicitation: Can a physician take other employees? Contact vendors, consultants, or pharmaceutical reps? 
  12. Confidentiality of business processes: What is the unique process the employer uses?
  13. Patient records: PHI - who is the custodian of records? And will the physician get access to them post-employment if there is a complaint against the license?
  14. Hospital Privileges: is the employment contract coterminous with hospital privileges? What happens to privileges if the physician leaves the employer?
  15. **Right of Termination: who can terminate with cause and without cause? How many days notice?

 Reasons to retain an attorney: 

Most physicians do not understand the intricacies and ramifications of physician employment agreements. To review and negotiate a contract that does not limit the future of a young physician, it is best to get legal help earlier in the process to navigate the 5 most important things. 

  • Long-lasting consequences of Non-compete  
  • Compensation is not clear or fair market value  
  • CME (Continuing Medical Education) benefits are not clearly listed – (association dues, license dues, course registration, and travel expenses) 
  • You may be restricted from serving on certain insurance panels 
  • You may have to relocate out of the area. 

What does it cost to Have an Attorney Review a Physician's Contract? 

Our firm reviews physician contracts: 

- Option 1 - for $1,250, and we will give you insights on what and how to negotiate and conduct a background check on the employer.

- Option 2 - Some physicians prefer for us to negotiate their contracts, ask us about fees if that is your preference. 

- Option 3 - If you just wish to get some legal input and do not want to retain an attorney, you may consider making a 1-hour appointment  to discuss the specifics of your situation, for a prepaid legal fee of $475, click here

Ben Mirza is not only an attorney but was formerly a CPA, with a masters of public health.  There are over 100,000 attorneys in Florida, less than 500 of whom were ever Certified Public Accountants, and even less have the trifecta combination of law/finance/strategic healthcare background.   The benefit of this combined and layered skillset works well for clients who want an advocate to approach the issues holistically.