Ive never really heard about hiring contract attorneys. Is this worth the cost? What is the total cost in fee's one would be looking at when hiring one? Does this leave a bad taste in the employers mouth considering it seems like it is fairly adversarial?
A lot of time, if you are negotiating, it is with a physician executive or hospital administrator and not HR directly. It could be HR but with a specific person that deals with physician hiring. If there are 100 hospitals, there are 250 ways physicians are hired and paid, and many permutations are possible.
It also depends ... are you joining as a W2 employee, a 1099 independent contractor, or joining a private group (either as a employee, contractor, or partnership track) that have privileges at that hospital? Are you being hired by the hospital, or by the group (even if the group is owned by the hospital)
Are you paid a guarantee salary? If so, for how long? Are you paid a salary + production bonus? How are the bonuses calculated. It is wRVU generated or actual collections?
Are the moving expenses paid for, or is it a loan? If it is a loan, does it have to be repaid or can it be forgiven? What are the conditions for loan forgiveness (and you want to make sure the conditions don't violate any existing federal laws)
It's all in the wording - and a good contract will protect you when there are issues, or you want to leave (or they want to force you out)
You'll be focused on the important stuff and forget that other stuff are just as important. While you focus on income and benefits (and how to generate those income) ... other terms are important and can greatly affect your bottom line.
How much notice do you have to give if you want to leave the job? How much notice should the hospital give if they want to fire you? What are the conditions where they can fire you "for cause" without any advance notice? What are the penalties if either of you don't abide by the contract?
What if you are injured? How long can you remain out of work and not worry about losing the job?
What about account receivables when you leave - money that you've worked/generated but awaiting payment from payers - do you get to keep any of that, or does it all go to your employer?
Is there a Restrictive covenant - is it 10 miles or 100 miles? Is it measured from one facility or ANY facility own by the mega health system.
Who pays for tail coverage for insurance? It can cost tens of thousands if not hundred of thousands (depending on location, specialty, claims history, etc)
Is this a partnership track - what are the conditions to becoming a partner - what is the time limit? Does it spell out what you have to do to become partner? What is the buy-in? Will you have the right to look at the books to make sure the buy in is fair? Will you need a loan for the buy-in? Voting rights? Will you be an equity partner or a junior partner? Any debts or potential liabilities that can affect the financial viability (or even credibility) of the group?
How are calls scheduled? Is it fairly distributed or is it bottom heavy (seniority with fewer call)? Is call compensated?
Is there maternity leave? Paternity leave?
Will there be an academic appointment? (eg., clinical assistant professor from XXX school of medicine). Is there expectation of scholarship? Is there expectation of promotion to maintain employment?
Will there be expectation of non-clinical service work? (eg., hospital committees, dept and division committees, etc)
You trained to be a good physician, and along the way learned about EMRs and Medical Coding, and probably a few medicare/HHS rules along the way. You need someone who knows what they are doing, who knows the legal system and how a proper contract is written (there is a big difference if the contract says the employer SHALL vs employer MAY), employment laws in the state as well as US federal laws, and how to negotiate and what to negotiate for. It may seem expensive ($2k, $5k) but if you gain an extra $50k or $100k - it is penny wise and pound foolish. But even if you don't get extra "income" on the front end, knowing you are protected on the back end can save money or headaches, or legal issues (that will certainly cost you more in lawyer fees)
i dont disagree with you. I am just asking about perceptions. The hospitals where I worked at the lawyers did not do the negotiations, the recruitment people did and once everything was agreed upon it would be sent to a lawyer to review to make sure the contract was enforceable. So yes it would be adversarial to me as an employer if someone brought in a lawyer at that stage, at least perceptually. What else is this employee going to bring a lawyer into? is it worth the headache to deal. Maybe its an accepted practice, but that is why I am asking.
Depends on the culture of the area ... the lawyer may help negotiate for you, or the lawyer can be in the background, looking over stuff and reminding you to either ask for certain stuff, or ask for certain terms or wording or conditions to be removed/amended, and explaining what you are agreeing. Remember, if there is a disagreement, it goes to arbitration (or court) ... it's not what is said or promised, but what is written.
There's a lot at stake - that's why NBA, NFL, MLB, NHL players have agents on their behalf. Yes, there is a risk that if you cause too much of a headache, they may go with someone else. But this is a bilateral transaction - you have the service they need, and they need your service - you are negotiating. And for a lot of people, this is the first time that they realize anything is negotiable. Residency, fellowship contracts - sign on dotted line. First employment offer when you're 6-figure in debt - it is tempting to take the highest offer, and reasonable to be afraid to negotiate.
