Whether you’re interviewing for your first physician job or you've been practicing medicine for years, considering an offer from an employer can be both exciting and stressful. It's highly recommended that you hire a physician-focused lawyer to assist you with contract review and negotiation.
Know which type of lawyer to hire
When you get an offer or a letter of intent (LOI), hire a lawyer to review it before you sign anything. But don’t hire just anyone.
Because health care is extensively regulated, physician employment agreements frequently have to comply with highly specific legal requirements that don't apply to typical employment contracts. Consequently, a general business lawyer, such as an attorney who handles real estate transactions for your family, may not be the right lawyer to review your contract or LOI. Just as there are physicians who specialize in different aspects of the practice of medicine, there are lawyers who specialize in reviewing physician employment agreements.
“Employment law is tricky, and representing physicians complicates it even further because physicians are so highly regulated for things that other employees are not,” said Elizabeth A. Snelson, president of Legal Counsel for the Medical Staff PLLC, which specializes in working with medical staffs, medical societies and medical staff professionals. “Your lawyer needs to be someone who does physician employment contracts.”
Snelson is the author of the AMA Physicians’ Guide to Hospital Employment Contracts (PDF), free for AMA members, which provides expert guidance to physicians contemplating, entering into or working under employment contracts with hospitals or related entities.
The 83-page guide provides sample language in more than 20 crucial contract areas, including peer review, restrictive covenants and even termination.
“These are complicated issues. There's a lot to think about,” Snelson said. “We need to physicians to understand that even if they read every word of the guide, they need to hire a lawyer for help with the contract before they sign it.”
Think beyond compensation
“In my experience, almost all doctors in hospital contract negotiations—but particularly those who are just coming out of residency—focus on the money to the exclusion of a lot of other really big issues,” Snelson said. These include:
- Being specific about physician duties.
- Fixing other potentially burdensome clauses.
- Having an exit plan.
- Protecting your professional judgment.
- Seeing and understanding the medical staff bylaws.
Retaining an attorney experienced in handling physician employment agreements can not only help you avoid land mines in individual contracts; it can also help you choose between competing offers.
For starters, an experienced attorney may know a great deal about the employer’s local health care market and your prospective employer. Depending on the size of the employer, the attorney may have previously reviewed and negotiated employment agreements for other physician clients involving the same employer.
If so, your attorney may be able to provide insight into what the employer may or may not be willing to negotiate. For example, your attorney might know that the employer does not, as a matter of course, negotiate restrictive covenants, and that it would be a waste of your time and money trying to obtain concessions in that area.
In addition, the attorney may be able to give you insight into some of the questions you have regarding the employer and market. For example, your attorney may be able to give you a good sense of the employer’s reputation for quality in the community, competence, stability of its leadership and how it treats its physicians. This could prove invaluable to understanding whether the prospective employer would be a good fit for you.
Where to find the right lawyer
Finding attorneys that specialize in physician employment contracts is not difficult. Contacting the state medical association in the state where you will be working is one of the best ways to find lawyers who are qualified to review and negotiate your physician employment contract.
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Just make sure to find an attorney licensed to practice law in the state where you will be working because state legal requirements, as well as federal laws, may apply.
“Much of what physicians can do in one state is absolutely a crime in the next,” Snelson said.
Legal fees are flexible
Legal fees vary across the country. However, there are a few things that affect how much a lawyer will charge, such as the fee arrangement and what you want the lawyer to handle for you.
One way to pay your lawyer is per hour. Another is to pay a flat fee.
Also, you can specify what you want the attorney to do for you. For instance, you can ask a lawyer to review the employment contract to identify any traps and suggest a few major points that you may want to address, then you will negotiate the offer directly with the prospective employer. Some physicians choose this type of arrangement because they feel comfortable negotiating with the employer directly or want to keep legal costs down. Many physicians, though, prefer to have an attorney review and negotiate the contract.
The AMA has assembled a variety of resources to help physicians flourish in the employment setting. That includes developing the Annotated Model Physician-Group Practice Employment Agreement (PDF) and featuring experts’ perspective on collective bargaining for physicians.
Learn more about understanding employment contracts.
