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For better or worse, your employment contract can have a huge effect on your life. This is true both in and outside of the workplace. Most importantly, your contract determines your salary, bonuses, and benefits, but there are many more nuanced terms of the agreement. Your contract also sets your schedule, outlines advancement opportunities, and entitles you to certain equipment or help from advance practice providers and medical scribes. All these pieces and more should be taken into consideration, and possibly negotiated, so you can sign the contract that works best for you. Below are some tips on contract terms to look out for and how to address them.
Salary and Bonuses
Compensation is a primary factor for most physicians when reviewing a contract and choosing between job offers. While an offered compensation package may look great at first glance, especially if it’s your first attending job, you should always get an idea of what other physicians are earning in your area. If you do not know what a typical salary or signing bonus is for your specialty and region, you will not know whether an offer is above or below average.
There are a few trusted sources for compensation data, but the one most referenced in employment agreements is MGMA. MGMA data can be broken down into various categories and filtered by specialty, location, years of experience, and more. If your agreement is referencing MGMA, it is important to access the latest report yourself, so you can negotiate on a level playing field.
There are limitations to the MGMA data set. Primarily, the data is old. It is only updated once per year, and the latest report will be based on the previous year’s data. MGMA reports are also derived from employer submissions, and like any data set, is limited by the responses received. Some smaller sub-specialties receive few responses, which limits the reliability of the information.
For compensation data that is updated every day and recorded directly from physician contracts, check out Resolve’s rData. While MGMA and other survey data should be used for evaluating your compensation, rData helps fill the gaps and gives you the most current data on what you should be earning.
Schedule and Call Hours
Proper scheduling and call are often underrated contract terms. Your work schedule goes a long way in determining your long-term happiness with a job. Signing off on the right schedule from the beginning sets boundaries for a healthy work-life balance and provides flexibility where you need it most.
When reviewing a contract, make sure your schedule and any call hours are clearly defined. Employers will sometimes use broad language such as “hours defined by employer” so they have the option to change your schedule as they please. Try to negotiate any such language to be more specific, so you do not end up working or taking call at any unexpected times.
Your benefits package can include a wide range of different pieces, some of which are crucial to have, and others that you could use as bargaining chips in contract negotiations. A few important offerings to look for include specialty-specific, own-occupation disability insurance and malpractice insurance with tail coverage.
When looking for disability insurance, physicians are often seeking out long-term disability which is specialty-specific and own-occupation. Group disability plans have a wide range of options, and you should do your own research to choose the plan that is right for you.
Malpractice insurance should be provided by your employer, but pay attention to whether it is occurrence-based or claims-made coverage. Occurrence-based coverage is generally preferred, but if you are offered claims-made, you need to have tail coverage as well. Tail coverage will ensure you are covered for any claims brought against you after your employment has ended. If this is not offered along with claims-made coverage in your contract, consider negotiating for your employer to cover the cost.
Other benefits like retirement plans, student loan repayment, CME allowances, and life insurance are more dependent on your personal needs and goals. For example, if you still have large student loans to repay, you may want to negotiate for a repayment plan. Determine what your priorities are, and adjust your negotiation strategy accordingly.
Before signing, make sure any partnership opportunities (if applicable) are explained in your contract. Private practices do not always provide a clear path to becoming a partner or shareholder. If this is the case for you, negotiate for contract language that defines whether that path is available, when it is available, and how to get there. You do not want to invest years into working at a practice only to find out they are not intending to make you a partner.
A non-compete, non-solicitation, and other restrictive covenants are put in place by your employer to prevent you from going to work for a nearby competitor and possibly taking patients or staff with you. While designed to protect your employer’s business, restrictive covenants are often too harsh on physicians and can effectively trap them in a job.
Non-competes typically specify a radius around your employer’s location(s) and a timeframe during which you are not allowed to work for another employer within that radius. For example, a non-compete might dictate that after you leave your current job you cannot practice within 15 miles of your previous employer for 2 years. If you are in a dense metropolitan area, 15 miles could cover every nearby employer, effectively forcing you to pick up and move to a different city if you wish to change jobs. No one really wants to think about leaving a job before they start work, but as a preventative measure, you should absolutely negotiate the radius or timeframe of a non-compete to be lessened, if not removed entirely.
Further Contract Terms
There are many additional contractual terms that may be important for your situation. However, if you can address the items above, you will be off to the right start. Remember, supply and demand is generally in your favor, so ask for the terms important to ensuring a good, long-term employment arrangement.
Kyle Claussen is an attorney and CEO of Resolve, a source of physician contract review services and salary data.