2. The presenter has no disclosures and no conflict of
interest relevant to the content of this presentation
The presenter is not a lawyer
This presentation does not represent legal advice
Disclosures and Disclaimer
3. Little published data
Considerable variability
Confounded by nondisclosure clauses
Physician Employment Contracts
4. Patient Protection and Affordable Care Act
"The economic forces put in motion by the [Affordable Care]
Act are likely to lead to vertical organization of providers and
accelerate physician employment by hospitals and
aggregation into larger physician groups.“
Ann Intern Med. 2010;153(8):536-539.
75% of all physicians predicted to be employed by hospitals
in 2014
Merritt Hawkins 2012 Review of Physician Recruiting Incentives
http://www.merritthawkins.com/uploadedFiles/MerrittHawkins/Pdf/mha2012survpreview.pdf
Healthcare industry trends
5. The results…
2013 Medscape Physician Compensation Report
http://www.medscape.com/features/slideshow/compensation/2013/public
7. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
Read and understand before signing
No “Standard Contract”
Every item is negotiable, but organization
may not be willing to negotiate
Professional help may be needed with
complex contracts.
8. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
Who are you actually
working for?
9. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
Typically 2-3 Years
Is contract renewable?
10. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
Defines your job responsibilities
Caution with vague language
12. Medscape Physician Compensation Report
http://www.medscape.com/features/slideshow/compensation/2013/public
Free
Merrit Hawkins Salary and Compensation Survey
http://www.merritthawkins.com/compensation-surveys.aspx
Call for price
Modern Healthcare Compensation Survey
http://www.modernhealthcare.com/article/20130713/DATA/130709976
$249
SHM State of Hospital Medicine Survey (Hospitalists)
http://www.hospitalmedicine.org/AM/Template.cfm?Section=Surveys2&Template=/CM/HTMLDisplay.cfm&ContentID=29857
$259 (member price)
Other Sources of Compensation Data
13. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
Protects your job if
practice is purchased.
Can your contract be sold
to another practice?
14. Parties involved
Duration
Duties
Compensation
Transferability
Termination
Basic Contract Components
How contract ends…
Expiration (term over)
With cause (“Fired”)
Without cause (any reason)
Mutual agreement, usually with
notice
16. How much?
When?
Repayment may be required if you do not complete
the term of the contract
It is essential you understand repayment terms
May be prorated by percentage of contract completed
Signing Bonuses
17. Limits – usually per claim and aggregate ($1m/$2m)
Type of Malpractice Policy
Occurrence (becoming rare)
Claims made
Tail insurance required when changing jobs
Who pays for tail insurance?
Malpractice Insurance
18. Cost of Malpractice Insurance
Tail insurance typically costs 1.5 - 2x the annual premium
http://www.acponline.org/residents_fellows/career_counseling/malpractice_insurance.htm
19. Legal in most states
Should have a clearly defined
Duration (1-2 years)
Location
City, County
Radius
Zip or Area Code(s)
Scope of practice
Buy out option
Noncompete Clauses
20. States That Prohibit Noncompete
Virginia
Prohibited if employer is
a general corporation
Tennessee
Prohibited unless employer
is hospital or medical
school practice plan
CA
MT ND
SD
American Health Lawyers Association. Restrictive Covenants in Physician Employment Relationships
http://www.bassberry.com/files/upload/AHLANonCompeteJuly2010.pdf
21. Identify and prioritize problem areas
Ask potential employer if contract is negotiable
Start by negotiating your highest priority area(s)
Have a plan if negotiations fail
Negotiating
22. When to get professional help
Lawyer
Questions about
Definitions
Enforceability
Help with Negotiation
Accountant
Questions about
Compensation
RVU based Productivity
Share of collections
Bonuses
It is essential to hire professionals with healthcare
employment contracting experience.