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In developing an employment contract, the first order of business is to get everything discussed and agreed upon in writing and make sure your lawyer reviews all documents before signing, advises Boston health care attorney Lee Dunn. Whether you are a resident looking for a first-time job or a seasoned practitioner, here are some physician employment contract basics Dunn presented at the American College of Physicians-American Society of Internal Medicine conference, held March 29-April 1 in Atlanta:
• Employment status. Does your contract make you an independent contractor or an employee? That affects your tax planning and determines who pays legal fees and judgments if you are named in a malpractice suit. (If you’re an independent contractor, you will be on the hook unless you have a clause guaranteeing the practice will pay such costs.)
• Pay. It may seem obvious, but what — and how — you are going to be paid needs to be spelled out. This means you’ll need to analyze the group’s compensation package carefully and determine what it means in terms of your specialty and career/personal needs. Another point to consider is determining when the regular salary paydays are as well as other payout dates for bonuses, risk pool distributions, etc.
Tip: Before agreeing to a deal, have your lawyer or accountant examine the practice’s billing-to-collection ratio to get an idea of its financial health. If the ratio is low, the group may be on the verge of a cash flow crisis.
• Benefits. Does your health policy cover pre-existing conditions? How are vacation days and times determined?
• Work hours. Does the contract specify the minimum and maximum number of hours you’ll be expected to work in a week or month? What is the practice’s policy on call duty and contingency plans for covering other physicians?
• Restrictive covenants. Can you live with any covenants in the contract designed to prevent you from competing head-on with the group should you leave?
• Termination. Does the practice want to retain the right to fire you without reason or cause, or do certain conditions have to be met first? Are you being asked to sign away your due process rights to examine evidence, confront witnesses, or examine charges against them during disputes?
• Education. Are continuing medical education classes taken on your time or the practice’s time? Will you be paid for study and test time when have to renew your license?
• Outside activities. "If you want to continue to do something that’s very important to you, get it in the contract," says Dunn.