Physicians Practice - June 2008 - (Page 42) HUMAN RESOURCES Experts agree that when it comes to legally binding agreements, it’s always best to have a lawyer involved, especially one who knows the ins and outs of medical practice models. And because lawyers need time to review the paperwork, you should pull together a basic agreement even before you start the recruitment process. The last thing you want to do is cause a delay in finalizing the hiring of the candidate you’ve settled on because you didn’t have a contract in place, says Dave Witte, vice president of The Curare Group, a physician-recruitment firm based in Bloomington, Ind. “Attorneys are notorious for taking their sweet time on these things,” says Witte. “You could lose that candidate. They get tired of waiting, and they have other people who are looking at them. If somebody else puts a contract in their hands and it looks good, they’re going to take it.” But even if you talk with a lawyer first, you still need to understand what belongs in a basic physician employment agreement and why. So here’s (almost) everything you need to know about contracts but were afraid to ask. THE SIMPLE STUFF IN SUMMARY Although physician employment agreements can get complicated, candidates tend to react better to shorter contracts that can be easily explained. Some elements your practice should consider addressing in an employment agreement include: • Compensation and benefits; • Grounds for termination of the agreement; • Noncompete clauses; • A basic outline of partnership requirements; and • Malpractice coverage during and after employment. It’s important to keep contract terms fair for everyone — they need to protect not just your practice, but also the physician. Agreements that are too one-sided in the practice’s favor may never get signed. Remember that a contract is mostly there for when something goes wrong. 42 | PHYSICIANS PRACTICE | JUNE 2008 Everyone worries about the financial terms, but usually this is the easiest part of any employment agreement. Salaries and terms differ wildly from specialty to specialty, and even from one area of the country to another, but you and your partners probably already have a good sense of what is standard for your area. If you, the partners, and your accountant have done your homework, you should have a good idea how much you can afford to pay your new physician, and how much new business you need that physician to bring in to justify her income. Most candidates have roughly similar expectations. Expect to leave some negotiating room, but negotiations rarely break down over salary. The same probably holds true for basic things like vacation and benefits packages. If your practice has been in business for any length of time, you have already established a standard for physician benefits. You’ll have to outline these in the contract, but unless your practice’s benefits are vastly different than other organizations in your area, you’re unlikely to be surprised by candidates’ reactions to them. The important thing is to make sure all of the salary issues and benefits are spelled out clearly. “It’s all a lot of legalese,” says Witte. “But I think the simplest thing is to make clear in the contract what you expect from the person that you are hiring and what can they expect from you.” That means a description of what the job will entail. It may also be wise to address office hours and location in the agreement. Richard Edwards, chief operating officer at Society Hill Anesthesia Consultants, a 62-physician practice based in Philadelphia, Pa., says he tries to keep this description open-ended. “We’re a multisite organization with 13 locations,” says Edwards. “What we try to do is keep ourselves as flexible as possible by getting the right wording into the contract that basically says, ‘While you may be employed to work at one institution, there may be a need in the future for us to use you at other locations.’” Society Hill Anesthesia Consultants also addresses the issue of professionalism in its contracts. “We are a serviceoriented practice in the sense that anesthesia doesn’t have its own patients,” explains Edwards. The practice depends very much on wordof-mouth and return business, so it insists that every physician in the group lives up to a certain ideal. “We’ve tried to put in wording that reflects that we’re looking for a certain level of [decorum] from everybody.” Another area you may have to address is how new patients are allotted. In certain specialties, such as primary care, physician candidates will expect some kind of discussion about this. “Every doctor out there has heard a horror story where they join a practice and the senior doctor takes all the insured patients and gives the new person all the Medicaid patients,” says Witte. It’s all about expectations: What does it take to work at this practice? What does a physician get in return? THE REALLY, REALLY HARD PART “The best contract is the one you’re going to sign and put in a drawer and never look at again,” says healthcare attorney Joan Roediger, partner at Obermayer Rebmann Maxwell & Hippel in Philadelphia. “The only reason you have a contract is if something goes wrong.” Though none of us wants to think about it, the simple fact is that BASIC ISSUES TO COVER Beyond simple things like start date and salary, here are some other areas your physician employment agreement might cover: • Salary increases and performance bonuses; covered by the practice; • Work-related expenses • Retirement benefits; • Vacation and medical benefits; and • Office hours. WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM
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