Negotiating an Employment Agreement

Taking stock of what matters most to you, personally and professionally, will help you hone in on key points.

At first glance, reviewing a multi-page employment agreement can be daunting. While most of the language is generally boilerplate for the practice you’re joining, there are a few key points that are worth special attention – and perhaps, negotiation.

Most career transitions are prompted by the desire to improve one’s lifestyle, and that means different things to everyone. Making an inventory of the things that matter most to you in choosing a new position will help inform where to focus your negotiating energy.

Most practices have a standard employment agreement for physicians and advanced practice providers, and that is usually the first one with which you will be presented. While not every item in a contract is up for negotiation, there are a few that often spring to the top of the list.

Start Date and Term of Contract

A start date is usually mutually agreed upon, giving a physician enough time to relocate or give notice at a previous position. It’s also dependent on the practice’s ability to significantly credential a physician on payor panels, and this may be indicated as a caveat to the starting date in your agreement. Confirm whether the contract is open-ended or for a fixed period of time.

Hours, Locations

Make sure that you understand the number of hours you’re expected to spend in a patient-facing environment and how many hours per week the practice considers full-time. Ask the practice manager or other physicians how much time they spend outside of the clinic managing other tasks. Also, if a practice has several locations, make sure it’s clear in which offices you’ll be working and how often.

Reimbursements, Allowances, and Time Off

Most practices have standard amounts for CME and equipment reimbursements or allowances but may be willing to negotiate. Time off is often negotiable but may be regulated by HR policies, the state, or other entities.

Non-Compete and Non-Solicitation

A non-competition clause protects a practice if a physician leaves, disallowing the provider from opening a competing practice within a geographic range, advertising to patients, or recruiting staff. Practices often have different ranges depending on whether a location is in a metro or more rural setting. Mileage and timeframes may be regulated by the state or other agencies but can sometimes be negotiated. A practice will consider competition in the area and other factors before reducing these restrictions and may hold firm.

Compensation and Partnership Opportunities

Generally, compensation and partnership opportunities are discussed well before a contract is presented. Make sure that the contract language represents the discussions you’ve already had. If you wish to negotiate your compensation, now’s the time to do it.

As with any contract, it’s good practice to have it reviewed by an attorney who specializes in employment law or has specific experience in physician contracts. The American Medical Association, and in many cases, state medical associations, can provide a list of lawyers specializing in this area. Most practices will expect (and even appreciate) this level of diligence, so don’t hesitate to ask for time to review any agreement with your counsel of choice.