Non-competes!

[JumpingShip]

Does anybody have personal experiences with "non-competes" in medicine or obviously more specifically radiation oncology?

I've heard everything from they are not at all enforceable in some states (but then why would they even be in the contract?) to the hospital will sue your pants off and take your first born if you try to make a living within 50 miles (even from one of their satellite centers 100 miles from where you actually previously worked), and more seriously they are enforceable but the employer would only act upon it if you did something crazy like steal all the patient charts and call patients to come to your new place of employment.

After a quick google search of a few larger states it looks like in California they aren't enforceable, in North Carolina and Texas it would be very hard to prove, but in Florida and New York it wouldn't apply to an MD? At least not to a lowly staff radiation oncologist leaving one job to go to another?

North Carolina: https://www.smithlaw.com/media/alert/273_Non-compete Laws North Carolina _w-000-2726_.pdf

Florida: Statutes & Constitution :View Statutes : Online Sunshine

New York: https://ag.ny.gov/sites/default/files/non-competes.pdf

"A non-compete is only allowed and enforceable to the extent it (1) is necessary to protect the employer’s legitimate interests, (2) does not impose an undue hardship on the employee, (3) does not harm the public, and (4) is reasonable in time period and geographic scope."

#1 and #4 seem subjective to me but wouldn't it always be the case that a radiation oncologist who is unemployed and then takes a job in a busy clinic full of cancer patients who need care would but is blocked from doing so because of a non-compete could easily argue that #2 and #3 invalidate the non-compete? What could be more of hardship to the employee than being unemployed or moving to another state and isn't it obviously that not letting a qualified MD practice medicine and provide care to cancer patients would cause harm to the public?

I will get a hold of a professional but just curious if others have first hand knowledge or experience.

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[Gfunk6]

I can only speak for California. It is true that they are non-enforceable but some caveats:

1. Sometimes groups will put in non-competes anyway. Even though it is unenforceable, some physicians won't know this so will be scared away from joining a nearby, competing practice. In one case, a physician left to join a competing group and the practice sued him for the non-compete. Even though it was eventually thrown out in court it did cost time, money, and anguish as the physician who left still had to secure legal counsel even if the non-compete was frivolous.

2. If your practice sells for a "market rate," then the buyer can legally compel a non-compete if you accept the money. If you want to leave to join a competing practice after you take the money, then you either have to return the money ("clawback") or you can't leave.

 

[deleted1116990]

Widely state dependent. My former employer fought someone who quit and opened a clinic across the street, where it went to the state supreme court and they (the employer) eventually lost. It's helpful to live in a state where they are explicitly forbidden by law or unenforceability is so well established they don't bother with them.

This **** needs to be addressed at the federal level. The definition of what's constitutional or not have been stretched far more for other issues.

Legislative efforts to fix this seem to be focused on protecting low wage earners from them only. Optics are bad for high wage W2 earning doctors complaining about employment non-competes. Optics good on raising their taxes.

 

[jondunn]

Widely state dependent. My former employer fought someone who quit and opened a clinic across the street, where it went to the state supreme court and they eventually lost. It's helpful to live in a state where they are explicitly forbidden by law or unenforceability is so well established they don't bother with them.

This **** needs to be addressed at the federal level. The definition of what's constitutional or not have been stretched far more for other issues.

Legislative efforts to fix this seem to be focused on protecting low wage earners from them only. Optics are bad for high wage W2 earning doctors complaining about employment non-competes. Optics good on raising their taxes.

States rights etc etc etc

 

[temujim]

Enforceable in Florida. Even if the non-compete is ridiculous, judges known to "red line" to make it "reasonable". So if non-compete 100 mi, they will strike through and put 25 mi. Or take a 15 county non-compete and make it one county. When 21c ran aground there were some non-compete lawsuits. Docs lost, and had to go to other states/locales.

 

[SneakyBooger]

If I sign a contract with a noncompete then I will abide by that contract. Otherwise I should have not signed the contract in the first place.

If noncompete clauses are not legal in my state and I have unknowingly signed a contract with a noncompete clause, then I will have something to discuss with my attorney who did not advise me of this prior to my signing.

 

[OTN]

You can get around them in Texas, but it requires a court case. I know a few physicians who have sued to get out and won.

 

[JumpingShip]

If I sign a contract with a noncompete then I will abide by that contract. Otherwise I should have not signed the contract in the first place.

If noncompete clauses are not legal in my state and I have unknowingly signed a contract with a noncompete clause, then I will have something to discuss with my attorney who did not advise me of this prior to my signing.

Fair enough but I know of at least one MD (medical oncologist but doesn't really matter) who signed a non-compete for a job in North Carolina about 7-8 years ago and is actually abiding by the contract, or so he thought, and planning to move far outside of whatever mile radius of the place he works, but he is freaking out because since that time his employer has built or acquired satellite centers and one of them is within the radius of the city he is trying to move to. I don't know about the exact wording but I find it hard to believe that his original contract said within 50 miles of your place of employment as well as any centers we may buy or acquire at any point in the future, anywhere, forever?

It seems like a no brainer to me that if somebody signed a contract 7-8 years ago in city x with a 50 mile radius non compete then tries to move 150 miles away but is blocked by a non-compete because the employer subsequently built a center 100 miles away that any reasonable person or court would see that as unreasonable. Otherwise, if one gets a job with one of those huge private practices or academic centers with a dozen sites and the 50 miles applies to every single site then one cannot work anywhere within literally multiple states . . . even states you've potentially never set foot in?!? Then again nothing surprises me anymore and as others noted above even if the court throws it out I assume it's a very stressful and costly process.

 

[deleted1116990]

Alternatively, if you work for a big system and take a job staffing a rural satellite 60 miles from the main center in the city and get tired of commuting out there every day or want to move back to the city, your non-compete will also surround the main site. So your only option to work in the city is to get them to move you to the main site or quit and wait out the non-compete. Of course, contracts are non-negotiable because "we would have to change it for everybody if we changed it for you."

Very raw deal.

 

[RickyScott]

Does anybody have personal experiences with "non-competes" in medicine or obviously more specifically radiation oncology?

I've heard everything from they are not at all enforceable in some states (but then why would they even be in the contract?) to the hospital will sue your pants off and take your first born if you try to make a living within 50 miles (even from one of their satellite centers 100 miles from where you actually previously worked), and more seriously they are enforceable but the employer would only act upon it if you did something crazy like steal all the patient charts and call patients to come to your new place of employment.

After a quick google search of a few larger states it looks like in California they aren't enforceable, in North Carolina and Texas it would be very hard to prove, but in Florida and New York it wouldn't apply to an MD? At least not to a lowly staff radiation oncologist leaving one job to go to another?

North Carolina: https://www.smithlaw.com/media/alert/273_Non-compete Laws North Carolina _w-000-2726_.pdf

Florida: Statutes & Constitution :View Statutes : Online Sunshine

New York: https://ag.ny.gov/sites/default/files/non-competes.pdf

"A non-compete is only allowed and enforceable to the extent it (1) is necessary to protect the employer’s legitimate interests, (2) does not impose an undue hardship on the employee, (3) does not harm the public, and (4) is reasonable in time period and geographic scope."

#1 and #4 seem subjective to me but wouldn't it always be the case that a radiation oncologist who is unemployed and then takes a job in a busy clinic full of cancer patients who need care would but is blocked from doing so because of a non-compete could easily argue that #2 and #3 invalidate the non-compete? What could be more of hardship to the employee than being unemployed or moving to another state and isn't it obviously that not letting a qualified MD practice medicine and provide care to cancer patients would cause harm to the public?

I will get a hold of a professional but just curious if others have first hand knowledge or experience.

In some states like florida and Pennsylvania. they are widely used and very enforceable.

 

[medgator]

In some states like florida and Pennsylvania. they are widely used and very enforceable.

Correct. Entirely state dependent. Some places/groups will let you buy out of it as well

 

[dieABRdie]

Fair enough but I know of at least one MD (medical oncologist but doesn't really matter) who signed a non-compete for a job in North Carolina about 7-8 years ago and is actually abiding by the contract, or so he thought, and planning to move far outside of whatever mile radius of the place he works, but he is freaking out because since that time his employer has built or acquired satellite centers and one of them is within the radius of the city he is trying to move to. I don't know about the exact wording but I find it hard to believe that his original contract said within 50 miles of your place of employment as well as any centers we may buy or acquire at any point in the future, anywhere, forever?

It seems like a no brainer to me that if somebody signed a contract 7-8 years ago in city x with a 50 mile radius non compete then tries to move 150 miles away but is blocked by a non-compete because the employer subsequently built a center 100 miles away that any reasonable person or court would see that as unreasonable. Otherwise, if one gets a job with one of those huge private practices or academic centers with a dozen sites and the 50 miles applies to every single site then one cannot work anywhere within literally multiple states . . . even states you've potentially never set foot in?!? Then again nothing surprises me anymore and as others noted above even if the court throws it out I assume it's a very stressful and costly process.

Unreasonable? Certainly to a rational person. But a business will absolutely put that in the contract and enforce it.

That is how 21C contracts were worded. Your non-compete would cover every facility they own. So... like the entire US? A colleague of mine received an offer from 21C and it was written like this. He eventually got it changed to only the facility he worked in.... but he had to pay a lawyer to get 21C to respond.

I received a contract like that. They owned multiple facilities across the region. I said "No way in hell... it needs to say only those I practiced at." They agreed to that.

I dropped that offer fairly quickly... but I would have also had to be sure it specified those I practiced at for extended times.... not practiced at AT ALL. (Hey we are going to need you to cover these other facilities a day here... a day there....)

And like Moonbeams said, many say take it or leave it, especially when they have a stack of other applicants.

 

[deleted1116990]

Correct. Entirely state dependent. Some places/groups will let you buy out of it as well

I think in Florida they have to offer that option by law?

I know someone with a 300k or so option to buy out of it LOL

 

[medgator]

I think in Florida they have to offer that option by law?

I know someone with a 300k or so option to buy out of it LOL

Not sure if it is a requirement or not. I think some do, "liquidated damages" provision is the term iirc

 

[temujim]

I think in Florida they have to offer that option by law?

I know someone with a 300k or so option to buy out of it LOL

Some Florida contracts will have a buy out clause. But often there is a separate non-solicitation agreement. Meaning if you leave you cannot solicit your former patients, referrings, etc. Former employer can still come after you for that even if you buy out.

However, all of that (non-compete, non-solicitation) doesn't apply if there is only one employer for the specialty in the county.

 

[medgator]

However, all of that (non-compete, non-solicitation) doesn't apply if there is only one employer for the specialty in the county.

Key point.

Old 21C folks made sure that was good for thee was not good for me when they decided to leave their old group

Non-Compete Opinion In 21st Century Oncology Inc. Vs. Ashley Moody (House Bill 843)

Call The Law Offices Of Tache, Bronis, Christianson and Descalzo, P. A. At (305) 537-9565 If You Need Legal Representation To Do With Non-Compete Agreements.

tachebronis.com

Former 21st Century Oncology docs suing over contracts win Florida lawmakers' backing

Cancer doctors suing 21st Century Oncology to get out of their non-compete contracts may have found a quicker path to win: the Florida Legislature.

www.news-press.com

 

[Neuronix]

In my opinion, non-competes are used entirely to control the radiation oncologist. They should be considered an illegal restriction of free trade. I am passionate about this issue, and I only support medical interest groups that fight non-competes. As ASTRO, AMA, and many others have never spoken out against non-competes, they have no support from me.

I think in Florida they have to offer that option by law?

I know someone with a 300k or so option to buy out of it LOL

I've never seen a buyout option in a Florida contract, and I've seen several.

If I sign a contract with a noncompete then I will abide by that contract. Otherwise I should have not signed the contract in the first place.

If noncompete clauses are not legal in my state and I have unknowingly signed a contract with a noncompete clause, then I will have something to discuss with my attorney who did not advise me of this prior to my signing.

Disliked this because it was impossible for me to find a job without a non-compete. It is a non-negotiable condition of employment in many states.

 

[DrZap]

In my opinion, non-competes are used entirely to control the radiation oncologist. They should be considered an illegal restriction of free trade. I am passionate about this issue, and I only support medical interest groups that fight non-competes. As ASTRO, AMA, and many others have never spoken out against non-competes, they have no support from me.



I've never seen a buyout option in a Florida contract, and I've seen several.



Disliked this because it was impossible for me to find a job without a non-compete. It is a non-negotiable condition of employment in many states.

Completely agree. I tried to negotiate my non compete and it was a take it or leave it situation

 

[medgator]

Completely agree. I tried to negotiate my non compete and it was a take it or leave it situation

Was like that even when job market was better, now i think it would be pretty much hopeless to get one out unless you are looking at a fairly hard to recruit kind of place.

If everyone else at a group or practice signed one before you did, it ain't gonna change when you get hired (at least that's how it was explained to me when i interviewed around and was eventually hired).

 

[temujim]

Completely agree. I tried to negotiate my non compete and it was a take it or leave it situation

Aware of situations where offer withdrawn bc pushed too hard on non-compete clause.

 

[RadRadRad]

Sorry if this has already been discussed
But as it applies to the original poster / jumping ship

If you have a noncompete but then get offered a contract wildly inconsistent with you prior contracts, is the non compete valid?

That’s kind of like being fired without cause which often voids non compete

 

[Burt Radnolds]

Noncompetes can offer some stability for private groups. I'm in a big multi-specialty group. The hospital has been sniffing around us looking for weak links for awhile. Pretty sure a few of us (not me) would like to plug into the Borg. Running a private group is hard and losing a contingent of doctors could sink us. We are doing pretty well so it's not like these people are being held hostage in a crappy situation. I think some just don't have the intestinal fortitude to continue to rebuff the hospitals aggressive posturing. Luckily the non compete keeps everyone in line. We all have the same contract and I would not take out the non compete even if I could.

 

[medgator]

Noncompetes can offer some stability for private groups. I'm in a big multi-specialty group. The hospital has been sniffing around us looking for weak links for awhile. Pretty sure a few of us (not me) would like to plug into the Borg. Running a private group is hard and losing a contingent of doctors could sink us. We are doing pretty well so it's not like these people are being held hostage in a crappy situation. I think some just don't have the intestinal fortitude to continue to rebuff the hospitals aggressive posturing. Luckily the non compete keeps everyone in line. We all have the same contract and I would not take out the non compete even if I could.

Totally agree.. hospitals are notorious for this

 

[elementaryschooleconomics]

This is very state-by-state, as others have noted.

There are so many interesting wrinkles to these covenants. First, everyone talks about them as if they're "only" about geography/radius. They can be so much more!

Fair enough but I know of at least one MD (medical oncologist but doesn't really matter) who signed a non-compete for a job in North Carolina about 7-8 years ago and is actually abiding by the contract, or so he thought, and planning to move far outside of whatever mile radius of the place he works, but he is freaking out because since that time his employer has built or acquired satellite centers and one of them is within the radius of the city he is trying to move to. I don't know about the exact wording but I find it hard to believe that his original contract said within 50 miles of your place of employment as well as any centers we may buy or acquire at any point in the future, anywhere, forever?

Most of the covenants I've seen do include this "future facility" language. This is becoming increasingly murky, as telehealth becomes widely adopted. For your colleague: one argument could be that the spirit of the non-compete is to protect the business interests of his employer. If he was hired, and has only ever practiced, at a facility far away from his planned move, that he does not pose a threat in this new area. The concern, as usually argued, is patients are attached to the physician, not the business, and so a beloved physician becoming employed elsewhere or opening his own practice has the potential to take the bulk of his patients with him, and seriously "harm" the original employer.

This could be argued in circles forever. I would absolutely tell your friend to get an attorney. Get an attorney before signing anything with anyone. Your friend will find no answers on the internet or with his colleagues, because each scenario is unique.

New York is a great example. People have this notion that New York is very likely to enforce non-competes, which isn't true. What makes NY "unique" is that the merits of a healthcare non-compete is judged like any other industry, which (as far as I recall) no other state does (most states which still "allow" physician non-competes give them a special category).

What that means is that just like a tech startup can't write something to the effect of "can't work within 500 miles of any current or future facility, as well as [insert 15 surrounding counties], for 15 years after terminating the contract", a hospital can't do that to a doctor, either. You'll see this sometimes called "The Janitor Rule".

What makes New York "seem" more non-compete friendly is that it historically allowed "blue penciling", meaning if a court found a non-compete unenforceable because it was too broad in scope, an employer could narrow the restrictions until it was enforceable. So in the above example, if the tech startup (or hospital) changed 500 miles to 5 miles, or 15 years into 15 months, then it could be enforced. Other states have blue penciling, but not a lot. There were some precedent changes in some more recent years where it's unclear if this is still going to be a trick employers can use.

There's so many other things, like "unclean hands" or non-solicitation clauses.

While it doesn't sound like it would apply to your colleague, if you get out of your contract through claiming material breach it would render the restrictive covenant void, but doing something like that isn't an easy (or cheap) play to make.

Anyway, the point is, your colleague needs to get an attorney. I would suspect the non-compete isn't enforceable here, but what I would do is get an attorney, send them my current contract to review and explain the situation, they would likely advise me to go to my employer and ask for an amicable/mutual agreement (in writing, of course) that going to work in this new city is not a violation of the restrictive covenant. If my employer won't agree to some amicable arrangement, there are other steps to take...but all of which need an attorney.

Attorney!

 

[elementaryschooleconomics]

Was like that even when job market was better, now i think it would be pretty much hopeless to get one out unless you are looking at a fairly hard to recruit kind of place.

If everyone else at a group or practice signed one before you did, it ain't gonna change when you get hired (at least that's how it was explained to me when i interviewed around and was eventually hired).

This is what I usually tell people as well, just as a starting point.

However, I also throw out the caveat "within reason", in terms of "fitting in with the group". I've heard/seen/experienced situations where the offer that is extended by a small group/practice is "the same one we all get".

Except...the group last hired someone in 2015, and 2011 before that.

Inflation alone makes whatever offer was "good" in 2015 or 2011 "not good" in 2022 or 2023. My favorite being contracts that offer like $2,000 in moving costs. If anyone has done any sort of moving recently, you know that just the boxes cost $2,000 now.

But if it's an offer for a job you really want (or, RadOnc style: your only offer), it's not worth pushing before starting if it risks the offer being rescinded. Take the offer, start the job, be an absolute beloved rockstar, then sit back down with the bosses a year or two later and say "hey, here are my numbers, here's what I bring to the table, here's what the rest of my peers are getting paid for doing X amount of work, can we talk about maybe bringing me closer to average than where I am now"?

If you get the sense that they're going to say "no" or not even talk with you about it, consider having a "aight, I'm out, see you later" plan in place if you can (not a common RadOnc play, unless you're ready and willing to move).

 

[JumpingShip]

This is very state-by-state, as others have noted.

There are so many interesting wrinkles to these covenants. First, everyone talks about them as if they're "only" about geography/radius. They can be so much more!



Most of the covenants I've seen do include this "future facility" language. This is becoming increasingly murky, as telehealth becomes widely adopted. For your colleague: one argument could be that the spirit of the non-compete is to protect the business interests of his employer. If he was hired, and has only ever practiced, at a facility far away from his planned move, that he does not pose a threat in this new area. The concern, as usually argued, is patients are attached to the physician, not the business, and so a beloved physician becoming employed elsewhere or opening his own practice has the potential to take the bulk of his patients with him, and seriously "harm" the original employer.

This could be argued in circles forever. I would absolutely tell your friend to get an attorney. Get an attorney before signing anything with anyone. Your friend will find no answers on the internet or with his colleagues, because each scenario is unique.

New York is a great example. People have this notion that New York is very likely to enforce non-competes, which isn't true. What makes NY "unique" is that the merits of a healthcare non-compete is judged like any other industry, which (as far as I recall) no other state does (most states which still "allow" physician non-competes give them a special category).

What that means is that just like a tech startup can't write something to the effect of "can't work within 500 miles of any current or future facility, as well as [insert 15 surrounding counties], for 15 years after terminating the contract", a hospital can't do that to a doctor, either. You'll see this sometimes called "The Janitor Rule".

What makes New York "seem" more non-compete friendly is that it historically allowed "blue penciling", meaning if a court found a non-compete unenforceable because it was too broad in scope, an employer could narrow the restrictions until it was enforceable. So in the above example, if the tech startup (or hospital) changed 500 miles to 5 miles, or 15 years into 15 months, then it could be enforced. Other states have blue penciling, but not a lot. There were some precedent changes in some more recent years where it's unclear if this is still going to be a trick employers can use.

There's so many other things, like "unclean hands" or non-solicitation clauses.

While it doesn't sound like it would apply to your colleague, if you get out of your contract through claiming material breach it would render the restrictive covenant void, but doing something like that isn't an easy (or cheap) play to make.

Anyway, the point is, your colleague needs to get an attorney. I would suspect the non-compete isn't enforceable here, but what I would do is get an attorney, send them my current contract to review and explain the situation, they would likely advise me to go to my employer and ask for an amicable/mutual agreement (in writing, of course) that going to work in this new city is not a violation of the restrictive covenant. If my employer won't agree to some amicable arrangement, there are other steps to take...but all of which need an attorney.

Attorney!

It seriously seems like everybody should get an attorney, one who specializes in employment, preferably for MD's and it seems like state specific as well! It's been a very long time since I attended ASTRO as a resident but I clearly recall that gentleman (I believe he was a practicing attorney and radiation oncologist?) whose name I don't remember saying over and over again that it's the best money you'll ever spend but quoting some alarming statistic that showed that most people don't do so (and that was when the job market was in the employees favor)!

 

[elementaryschooleconomics]

It seriously seems like everybody should get an attorney, one who specializes in employment, preferably for MD's and it seems like state specific as well! It's been a very long time since I attended ASTRO as a resident but I clearly recall that gentleman (I believe he was a practicing attorney and radiation oncologist?) whose name I don't remember saying over and over again that it's the best money you'll ever spend but quoting some alarming statistic that showed that most people don't do so (and that was when the job market was in the employees favor)!

Can confirm.

Sometimes I'm more of a "do as I say, not as I do" kind of doctor, but I definitely have spent more money on attorneys than on floss...despite all those times I told my dentist I'm flossing.

 

[medgator]

It seriously seems like everybody should get an attorney, one who specializes in employment, preferably for MD's and it seems like state specific as well! It's been a very long time since I attended ASTRO as a resident but I clearly recall that gentleman (I believe he was a practicing attorney and radiation oncologist?) whose name I don't remember saying over and over again that it's the best money you'll ever spend but quoting some alarming statistic that showed that most people don't do so (and that was when the job market was in the employees favor)!

Terry Wall. And yes he's absolutely correct

 

[madchemist89]

The purpose of a contract and attorney are to protect you if things go south. If everything is always hunky dory with your employer, then you wouldn't need a contract. You want to make sure that the contract provides you protections and not just your employer. I guarantee the contract you are initially offered is for the benefit of the employer and not the employee.

 

[fiji128]

Last time I did this, it was like $800 for a state specific MD employment attorney to go through the contract. Hard to believe someone would sign a contract w/o playing that relatively small fee to get a professional opinion.

 

[JumpingShip]

Last time I did this, it was like $800 for a state specific MD employment attorney to go through the contract. Hard to believe someone would sign a contract w/o playing that relatively small fee to get a professional opinion.

I totally agree but at the same time understand if one was a resident (likely with a spouse and baby … maybe another on the way) and definitely if hired where he trained and being told by his chair and mentors “don’t worry we would never …”

While we are on the topic, anybody know how one would find an experienced, state specific attorney with experience with MD contracts (of course even better at least some experience of ones specific field). Seems like if such a person existed he’d be worth his weight in gold and definitely the best $800 one ever spent!

 

[medgator]

Last time I did this, it was like $800 for a state specific MD employment attorney to go through the contract. Hard to believe someone would sign a contract w/o playing that relatively small fee to get a professional opinion.

Bingo. Good to review state case law on things like non competes and termination as well

 

[medgator]

While we are on the topic, anybody know how one would find an experienced, state specific attorney with experience with MD contracts (of course even better at least some experience of ones specific field). Seems like if such a person existed he’d be worth his weight in gold and definitely the best $800 one ever spent!

Great resource and list of questions regardless of where you live, these guys are very good but obviously only good for FL and CO i believe

Physician Employment Contract Review

For all physicians who are employees and potential employees: The Health Law Firm reviews, prepares, negotiates,

www.thehealthlawfirm.com

 

[seper]

I've used these $600 lawyers to look at my "contracts". No luck changing any provisions, hospitals had "take it or leave it" attitude. So may as well save your money.

 

[medgator]

I've used these $600 lawyers to look at my "contracts". No luck changing any provisions, hospitals had "take it or leave it" attitude. So may as well save your money.

I think it's less useful for large system contracts, maybe more helpful for private groups when you're looking at their employment offer/contract

 

[Neuronix]

I've used these $600 lawyers to look at my "contracts". No luck changing any provisions, hospitals had "take it or leave it" attitude. So may as well save your money.

It helps me to understand the reasonableness of the contract and what the provisions mean.

Regarding the last contract I was offered, my lawyer with decades of experience in employment law in my state said it was one of the worst physician contracts she had ever seen. It had some provisions that were "truly bizzare". Sure most of the contract was non-negotiable, but it was also a huge red flag that helped me to turn it down and sleep well at night.

Physicians are trusting/gullible enough and rad oncs desperate enough that I'm sure someone signed it.

 

[elementaryschooleconomics]

I've used these $600 lawyers to look at my "contracts". No luck changing any provisions, hospitals had "take it or leave it" attitude. So may as well save your money.

Yeah, it's hard to get much changed before you're hired.

For me, I like having them as a "Plan B" sort of thing. If you're concerned about something, or are changing jobs (there are a lot of scenarios like OP's colleague), I think it's a good idea to run things by them, but that's just me. I've definitely spent money on attorneys preparing for issues that didn't happen, but who knows what the future holds. At worst, I have a paper trail if stuff goes south in 10 years.

 

[DrZap]

I've used these $600 lawyers to look at my "contracts". No luck changing any provisions, hospitals had "take it or leave it" attitude. So may as well save your money.

Exactly. And they didn’t catch something regarding retirement benefits that I felt they should have (which would not have been able to be changed anyway). I don’t regret doing it but didn’t change anything about my contract

 

[nexus73]

As mentioned above, depends on state law. In Washington state, a local multispecialty clinic has successfully enforced their non-compete several times to the point they're sort of known for it among the local doctors. Their non-compete is "reasonable", something like a 15-20 radius for 1 year. It's not 100 miles for 10 years.

And what happens is not a lawsuit against the doctor only, they will also sue the next employer if you're trying to get hired on somewhere, and the new employer typically just rescinds the job offer because they're not interested in a court battle or buying out your non-compete.

Unless I knew state law specifically exempted me, I'd be very sure I could tolerate the contract stipulations before signing a non-compete. Don't think the non-compete is too broad so it won't be enforceable down the road...better to get it pared down or removed before signing.

 

[RickyScott]

As mentioned above, depends on state law. In Washington state, a local multispecialty clinic has successfully enforced their non-compete several times to the point they're sort of known for it among the local doctors. Their non-compete is "reasonable", something like a 15-20 radius for 1 year. It's not 100 miles for 10 years.

And what happens is not a lawsuit against the doctor only, they will also sue the next employer if you're trying to get hired on somewhere, and the new employer typically just rescinds the job offer because they're not interested in a court battle or buying out your non-compete.

Unless I knew state law specifically exempted me, I'd be very sure I could tolerate the contract stipulations before signing a non-compete. Don't think the non-compete is too broad so it won't be enforceable down the road...better to get it pared down or removed before signing.

Suing the new employer for tortuous interference is a typical means of enforcement of non competes in medicine. Even if a noncompete is legally dubious, hospital or clinic won’t hire you until the issue is settled.

 

[radoncftw]

the thing that sucks is this seems to be a big deal in Rad Onc. At the academic institution i trained, I have talked to a few attendings who have contemplated leaving but that would require moving to BFE for 2 years. I have seen surgeons and radiologists join the community hospital 10 min away.

 

[elementaryschooleconomics]

the thing that sucks is this seems to be a big deal in Rad Onc. At the academic institution i trained, I have talked to a few attendings who have contemplated leaving but that would require moving to BFE for 2 years. I have seen surgeons and radiologists join the community hospital 10 min away.

Yeah, I've seen the same.

I mean, everything is related. The workforce issues come from the same place as the non-competes: while radiotherapy is integral to modern medicine, a single RadOnc/linac can serve 100,000-200,000 people (reference: I've started asking everyone what their catchment area size is).

Zoomed out, certificate of needs and restrictive covenants make sense (eh, maybe) at a societal level, but it sure is rough at the individual doctor level, with a life and a family and hopes and dreams.

 

[RickyScott]

Yeah, I've seen the same.

I mean, everything is related. The workforce issues come from the same place as the non-competes: while radiotherapy is integral to modern medicine, a single RadOnc/linac can serve 100,000-200,000 people (reference: I've started asking everyone what their catchment area size is).

Zoomed out, certificate of needs and restrictive covenants make sense (eh, maybe) at a societal level, but it sure is rough at the individual doctor level, with a life and a family and hopes and dreams.

I don’t think restrictive covenants are good for society at all. They are banned for lawyers nationwide, and docs in many states . Purportedly they exist to stop stealjng business from an employer, but radoncs in large systems ,can’t really do this. Non competes are exploitated to lower salaries and have become much more commonplace in last 10 years. They often still hold if the employer doesn’t renew your contract or decides to lower your salary by 50%!


I have also been asking around and posting abt catchement area for many years. In the era of conventional frac, varian claimed one linac per 100k (and they are selling linacs!). By this metric the usa has around 2x as many linacs and radoncs as it needs and there is no metro under 100k that lacks a linac.

 

[fiji128]

I don’t think restrictive covenants are good for society at all. They are banned for lawyers nationwide, and docs in many states . Purportedly they exist to stop stealjng business from an employer, but radoncs in large systems ,can’t really do this. Non competes are exploitated to lower salaries and have become much more commonplace in last 10 years. They often still hold if the employer doesn’t renew your contract or decides to lower your salary by 50%!


I have also been asking around and posting abt catchement area for many years. In the era of conventional frac, varian claimed one linac per 100k (and they are selling linacs!). By this metric the usa has around 2x as many linacs and radoncs as it needs and there is no metro under 100k that lacks a linac.

Non competes only exist to limit the free market/enterprise in regards to labor.

Jimmy John's drops noncompete clauses following settlement

Jimmy John's agreed to stop including noncompete agreements in its hiring documents sent to franchisees.

www.cnbc.com

 

[medgator]

Non competes only exist to limit the free market/enterprise in regards to labor.

Jimmy John's drops noncompete clauses following settlement

Jimmy John's agreed to stop including noncompete agreements in its hiring documents sent to franchisees.

www.cnbc.com

It's unreal to make entry level workers sign one. Could argue that it protects practices from hospital encroachment but definitely not applicable to the fast food business at all.

Then again, iirc, the CEO at JJs is kinda a d-bag

 

[Mandelin Rain]

Then again, iirc, the CEO at JJs is kinda a d-bag

Would a D-Bag take great pleasure in killing beautiful, endangered animals for no particular reason?