Our physician contract attorneys can review your contract, identify the areas that could improve, and assist you in negotiating the best contract possible.
Each Family Medicine physician who requests our assistance receives the following:
- Review of your proposed employment agreement
- Consultation reviewing the contract term by term
- Assistance in negotiating with the employer (if necessary)
Medical Contract Attorney for Family Medicine Physicians
A thorough contract review can benefit new residents, attending physicians, doctors entering their first employment contract, or established physicians looking for new employment. By employing an experienced attorney for your representation, you can ensure that you will be able to fully understand the extensive and complex wording included in your contract.
By having a complete understanding of agreements, you will be in a better position to decide whether or not you want to enter into the medical contract that will affect your career life for years to come.
Important Terms in a Physician Employment Agreement
The present-day conclusion is simple: physicians should only enter into agreements by having the contract reviewed by legal counsel. There is too much at risk for a physician to take medical contract matters into their own hands. In addition to the specific professional implications, terms of medical contracts can significantly impact a physician’s family, lifestyle, and future.
There are many important terms and clauses in medical contracts which can present complex and diverse issues for physicians, including:
- Non-compete clauses
- Inadequate professional liability insurance and tail coverage
- Unfavorable call schedules
- Practice support
- Production Bonuses (RVU, net income, or hybrid structures)
- Not enough paid time off (PTO) or Vacation time
- Biased Termination Provisions (With or Without Cause)
- Continuing Medical Education (CME)
- Dues and Fees (AMA, Health Care Board)
- Compensation
Review of Non-Compete Clauses by a Family Medicine Contract Attorney
Most courts find that a non-compete is enforceable if it is reasonable.
The general test for reasonableness by a court or arbitrator would be:
- The restraint is not more than required to protect the employer,
- It does not inflict any untold hardships on the employer, and
- The restraint is not detrimental to the public.
Is a Physician Non-Compete Enforceable in Every State?
Some states require a non-competition to include a buy-out. The buy-out amount usually equals one year’s compensation for the physician. No, some states prohibit or severely curtail the restrictions in physician non-competition clauses.
Those states where a physician non-compete is currently prohibited or limited include:
- California
- Delaware
- Massachusetts
- Rhode Island
- New Mexico
Breaking an Employment Agreement with a Health Care Practice
Physicians with non-competes in their family medicine contracts were initially considered restraints of trade. Thus, they were invalid in public policy at common law. However, many restraints on trade incident to healthcare contracts were upheld based on the rule of reason. Thus, restrictive covenants between physicians not to compete after the termination of employment are generally enforceable as long as it is reasonable.
However, there are a few states which prohibit non-compete clauses. Please review your state laws for non-compete rules and regulations to see the specific rules for your state.
The general test for reasonableness of these clauses holds that on termination of employment, a covenant that restrains an employee from competing with his former employer is termed reasonable if:
- The restraint is not more than required to protect the employer,
- It does not inflict any untold hardships on the employer, and
- The restraint is not detrimental to the public.
In one such case, a provider restricted from practicing his specialty after leaving the hospital where he worked had their non-competition clause considered unreasonable. The judge ruled that this would be harsh if enforced because there are only a few other hospitals in the area with subspecialties like this one. They needed to protect themselves by preventing transfers of knowledge between providers.
Some doctors in Ohio must sign family medicine contracts promising not to seek employment with a competing company before the employer can hire them. These agreements have been controversial, but the law is currently taking action on them to help keep both parties happy.
Recently people found that these clauses were only enforceable if there was some legitimate interest from the employer’s end and would damage their ability to find qualified staff later or hurt public health care. Those needing legal advice should consult an attorney before signing any contract. Hence, they know what rights may come into play when things go wrong with their current job, regardless of whether non-compete reviews by lawyers seem necessary at first glance!
Employee or physician contracts are all unique. However, nearly all healthcare contracts for healthcare providers should contain several essential terms. If these contracts do not spell out the critical terms, disputes can arise when there is a disagreement between parties regarding the details of the specific term. For instance, if the doctor is expecting to work Monday through Thursday and the employer thinks it’s Monday through Friday. Still, the particular workdays are absent from the contract—who prevails?
Checklists for a Family Medicine Physician’s Employment Agreements
Spelling out the details of a physician’s job is crucial to avoid healthcare contract conflicts during the employment contract term.
Below is a checklist of important terms that contracts should contain (and a brief explanation of each term generally discussed in negotiations):
- Practice Services Offered: What is the clinical patient care duties? Is there time for a review of administrative tasks? How many patients is the physician expected to see?
- Patient Care Schedule: What days and hours are employees expected to provide patient care per week? What is the surgery schedule? Are employees involved in the planning of their schedules?
- Locations: Which facilities will the employer schedule the employees to provide care at (outpatient clinic, surgical sites, in-patient services, etc.)?
- Outside Activities: Are employees permitted to pursue moonlighting or locum tenens opportunities? Does a physician need permission from the employer before accepting medicine-related positions?
- Disability Insurance: Is disability insurance provided (short-term and long-term)?
- Professional License: Will the practice offer reimbursement for licensing? Will an advisor be provided?
- Practice Call Schedule: How often is the employed physician on call (after-hours office call, ASC, hospital call (if applicable))?
- Electronic Medical Records (EMR): Will the employer provide training resources or time to review the system before delivering care?
- Base Compensation: What is the annual base salary? What is the pay period frequency? Does the base compensation increase over the term of the agreement? Is there a yearly review or quarterly review of compensation? Is there a group management relationship?
- Productivity Compensation: If there is productivity compensation, how is it calculated (wRVU, net collections, patient encounters, etc.)? Is there an annual review?
- Practice Benefits Summary: Are standard benefits offered: health, vision, dental, life, retirement, etc.? Who is the advisor of human resource benefits?
- Paid Time Off: How much time off does the job offer? What is the split between vacation, sick days, CME attendance, and holidays? Is there an HR guide?
- Continuing Medical Education (CME): What is the annual allowance for CME expenses, and how much time off do they offer?
- Dues and Fees: Which business financial expenses are covered (board licensing, DEA registration, privileging, ASA membership, Board review)?
- Relocation Assistance: Is relocation assistance offered? What are the repayment obligations if the contract is terminated before the expiration of the initial term?
- Signing Bonus: Is an employee signing bonus offered? When is it paid? Does the employee have to pay it back if they leave before they complete the initial term? Are student loans paid back? Is there a forgiveness period for student loans?
- Professional Liability Insurance: What type of liability insurance (malpractice) the employer offers: claims made, occurrence, self-insurance? License and litigation defense? Can you negotiate tail?
- Tail Insurance: If tail insurance is necessary, who pays for it when the agreement terminates?
- Term: What is the length of the initial term? Does the agreement automatically renew after the initial term?
- For Cause Termination: What are the grounds for immediate termination for cause? Is a review provided to dispute the termination?
- Without Cause Termination: How much notice is required for either party to terminate the agreement without cause?
- Practice Post-Termination Payment Obligations: Will the physician receive production bonuses after the agreement terminates?
- Non-Compete: How long does the non-compete last, and what is the prohibited geographic scope?
- Financial Retirement: Is a financial retirement plan offered?
- Non-Solicitation: How long does it last, and does it cover employees, clients, patients, and business associates?
- Notice: How is the notice given? Via hand delivery, email, US mail, etc.? Does it have to be provided to the employer’s attorney?
- Practice Assignment: Can the employer assign the agreement? Will the healthcare agreement require ongoing compliance with a new employer?
- Alternative Dispute Resolution: If there is a conflict regarding the contract, will mediation or arbitration be utilized? What is the standard attorney review process for disputes? Who decides which attorney oversees the process?
Lawyers for Family Medicine Physician Issues
Coming into a new organization with a favorable contract can put the physician in a positive financial situation for years to come. Before signing the most important contract of your life, contact an experienced Family Medicine Contract Attorney for assistance.