Northstar losing YET ANOTHER contract? AMC's in death throes?

[hypnosMD]

This time reportedly right here in Tejas (Corpus Christi to be exact), which is their home field. No doubt the hospital likely grew tired of paying millions more than projected. The doctors (and the CRNA's as well) are now trying what to do next due to no-competes, etc (sell the house?? move the kids??).

Cautionary tale for anyone entertaining an AMC job
1. Treat it like a locums gig and do it for (transparent) locums pay.
2. Always keep a foot in (day a week, etc) with another group so that when (not if) you are pressured by them to take an understaffed full time gig, you have options (and they know it). Speaking on that one from experience

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[ambiturner]

So the non-compete in the AMC contract prevents the MDs/CRNAs from working at the same hospital either as employees or part of a new group, even if the contract is lost? Seems like if they already worked at the facility, and the AMC is leaving the immediate area, they would no longer be in the non-compete radius unless they operate somewhere else in town.

 

[norwood]

So the non-compete in the AMC contract prevents the MDs/CRNAs from working at the same hospital either as employees or part of a new group, even if the contract is lost?

It happens. Worse is when they demand that you not work anywhere in that entire region, which I've also seen and which would be a major red flag about a job. That's designed to make you choose between doing whatever is demanded of you and *moving your family out of that entire geographic area*.

 

[chocomorsel]

Death to the DeathStar!!

 

[hypnosMD]

So the non-compete in the AMC contract prevents the MDs/CRNAs from working at the same hospital either as employees or part of a new group, even if the contract is lost? Seems like if they already worked at the facility, and the AMC is leaving the immediate area, they would no longer be in the non-compete radius unless they operate somewhere else in town.

AMC's such as Northstar absolutely can and will enforce their non-competes. Physicians, CRNA's, and hospital administrators all need to realize that no-compete language is their one and only asset and it is their leverage. Period. It allows AMC's to use leverage against the hospitals by essentially "owning" the providers (usually even up to 1-2 years after loss of a contract). It also allows them leverage against providers that can be used to quell discontent. Classic example that happens in every one of these AMC's: they find themselves understaffed and increase your hours/call but not your pay. Meanwhile, they are "working on it" (yeah right) while they keep the extra profit. Don't like it? Look back at your contract.

Will it hold up in court? That question is always posed by someone with no experience in court. AMC's such as Northstar are billion dollar companies with team of attorneys already bought and paid for. They could bankrupt you in court just fighting the case. They could even bankrupt you just to be punitive (and I have heard some stories). Look up strategic lawsuit against public participation (SLAPP).

Buyer beware, and you should enter into any AMC relationship with your eyes wide open (shut?). Only allow them locums at a premium hourly rate with everything outlined (call pay, overtime, etc) while having eggs in other baskets. Their whole endgame is to get you on a salary and then crank up your hours like a frog in a boiling pot.

 

[Beach bum]

May have mentioned this earlier but looked at one of their contracts a few years back and was totally dumbfounded why anyone would sign anything close to what they were offering....

 

[Beach bum]

May have mentioned this earlier but looked at one of their contracts a few years back and was totally dumbfounded why anyone would sign anything close to what they were offering....

So I am thinking before I would want to accept one of these positions the bread lines would have to be pretty long?!

 

[Man o War]

May have mentioned this earlier but looked at one of their contracts a few years back and was totally dumbfounded why anyone would sign anything close to what they were offering....

I have a buddy who successfully got his moonlighting contract altered with an AMC. He demanded they add in clauses for additional call on top of what he agreed to, and a set amount for any hour worked past 6 pm I think it was.
And wouldn’t you know, they ran short and he had extra call and longer days. Fortunately he was smart enough to get it all in writing and does well as far as AMC jobs go.

 

[jwk]

It happens. Worse is when they demand that you not work anywhere in that entire region, which I've also seen and which would be a major red flag about a job. That's designed to make you choose between doing whatever is demanded of you and *moving your family out of that entire geographic area*.

As I recall, non-competes that are overly broad can and have been ruled invalid in some cases. Can't work in an "entire region"? That "region" has to be defined. It can't be ambiguous. Does that mean a metropolitan area, the state, a 50 mile radius? What? And even then, courts can rule that a non-compete is overly broad and unenforceable. Obviously the best thing is not to agree to that sort of arrangement in the first place, if that's possible.

 

[hypnosMD]

I have a buddy who successfully got his moonlighting contract altered with an AMC. He demanded they add in clauses for additional call on top of what he agreed to, and a set amount for any hour worked past 6 pm I think it was.
And wouldn’t you know, they ran short and he had extra call and longer days. Fortunately he was smart enough to get it all in writing and does well as far as AMC jobs go.

THIS x 1000. New grads must recognize that contracts aren't rocket science and you don't have to spend boatloads on attorney fees. Anything not spelled out can and will be interpreted at your expense. If an AMC tells you call will be X amount, then they should have absolutely no problem standing behind that statement by adding language to compensate you for overage. If they won't stand by their word or even seem slightly reluctant, then they fully intend to work you more. When you "trust" them, you become the patsy. That is why they say physicians are bad at business. We assume others will operate by the same moral compass that we operate by.

 

[Mad Jack]

So the non-compete in the AMC contract prevents the MDs/CRNAs from working at the same hospital either as employees or part of a new group, even if the contract is lost? Seems like if they already worked at the facility, and the AMC is leaving the immediate area, they would no longer be in the non-compete radius unless they operate somewhere else in town.

This is why people should be smart enough to have a loss of contract rider that covers cases of AMC contract loss. Bad contract negotiations can literally ruin your life.

 

[DokterMom]

As I recall, non-competes that are overly broad can and have been ruled invalid in some cases. Can't work in an "entire region"? That "region" has to be defined. It can't be ambiguous. Does that mean a metropolitan area, the state, a 50 mile radius? What? And even then, courts can rule that a non-compete is overly broad and unenforceable. Obviously the best thing is not to agree to that sort of arrangement in the first place, if that's possible.

Very true. If you're emotionally invested in the geographic area, it might be worth bringing your non-compete to a good lawyer for interpretation. As a rule, they're designed to protect trade secrets and relationships, but are not allowed to prevent you from making a living in your profession in your area. Many are written to be unenforceabally broad (intentionally so) just so they can bluff you into backing down. As has been noted though, the team with the bigger legal budget has a significant advantage.

 

[GravelRider]

THIS x 1000. New grads must recognize that contracts aren't rocket science and you don't have to spend boatloads on attorney fees. Anything not spelled out can and will be interpreted at your expense. If an AMC tells you call will be X amount, then they should have absolutely no problem standing behind that statement by adding language to compensate you for overage. If they won't stand by their word or even seem slightly reluctant, then they fully intend to work you more. When you "trust" them, you become the patsy. That is why they say physicians are bad at business. We assume others will operate by the same moral compass that we operate by.

Easier said than done. These employers will play the guilt card of saying "you're a doctor, not a clock puncher." New grads want to come out of the gates with a reputation as a hard worker. These AMCs and practices employing docs feast on that mindset.

 

[GravelRider]

The worst contract I've seen was not an AMC contract, but rather a hospital employed contract. It made these AMC contracts seem benign. Not only did it lay out a radius using specific GPS coordinates (very wide), but it listed practices and companies that you could not work for if you left. It also had very restrictive clauses about staying in the same state. The restrictive covenant section was about 2 pages long and the section describing compensation and workload was about 2 sentences long. This is a fairly notorious hospital system in the northeast. Why on earth anyone would sign a contract like that absolutely baffles me.

 

[skypilot]

Very true. If you're emotionally invested in the geographic area, it might be worth bringing your non-compete to a good lawyer for interpretation. As a rule, they're designed to protect trade secrets and relationships, but are not allowed to prevent you from making a living in your profession in your area. Many are written to be unenforceabally broad (intentionally so) just so they can bluff you into backing down. As has been noted though, the team with the bigger legal budget has a significant advantage.

Does the ASA have any suggestions on language we can add to the contract to protect us from frivolous legal action by the AMC? It sounds like EVERY non compete should have an additional paragraph explicitly stating that the agreement is not intended to limit the Physicians ability to practice and the agreement should be voided in the event that the AMC loses the contract.

 

[Beach bum]

Does the ASA have any suggestions on language we can add to the contract to protect us from frivolous legal action by the AMC? It sounds like EVERY non compete should have an additional paragraph explicitly stating that the agreement is not intended to limit the Physicians ability to practice and the agreement should be voided in the event that the AMC loses the contract.

Lol that is the specific reason for that language, I.e. to inhibit the hospital from cutting them loose!

 

[skypilot]

Lol that is the specific reason for that language, I.e. to inhibit the hospital from cutting them loose!

Yes, but the group of doctors providing the Anesthesia has a the most power as a group before the contracts are signed. That is when they can review the contract boilerplate and make sure they are satisfied as a group with the language. Once they individually start signing contracts they are sunk.

As much as possible, they should review the contract as a group before the AMC comes in and limit the non compete as much as possible to ensure they are not ensnared by a legal battle in the future. The AMC would have a tough time replacing the entire group all at the same time if they stick together at least when it comes to the contract.

Maybe I am living in a fantasy land, because I have forgotten about the big payouts (ie bribes) the former partners are receiving to sign anything that comes along.

 

[Beach bum]

Yes, but the group of doctors providing the Anesthesia has a the most power as a group before the contracts are signed. That is when they can review the contract boilerplate and make sure they are satisfied as a group with the language. Once they individually start signing contracts they are sunk.

As much as possible, they should review the contract as a group before the AMC comes in and limit the non compete as much as possible to ensure they are not ensnared by a legal battle in the future. The AMC would have a tough time replacing the entire group all at the same time if they stick together at least when it comes to the contract.

Maybe I am living in a fantasy land, because I have forgotten about the big payouts (ie bribes) the former partners are receiving to sign anything that comes along.

Fantasy land it is.

 

[Beach bum]

Fantasy land it is.

What I suspect would typically happen is they “pick off” several providers and then use that as leverage to get others to sign. Typically physicians/medical providers are extremely unknowlegable in these matters.
The example above of someone making sure they would get paid for hours provided as a locum after 6 pm, that seems to have been provided as such a genius move, really? If someone presented me with a contract that didn’t have that in it and I had to ask for it “in writing”? I would avoid that job like the plague!!

 

[Beach bum]

What I suspect would typically happen is they “pick off” several providers and then use that as leverage to get others to sign. Typically physicians/medical providers are extremely unknowlegable in these matters.
The example above of someone making sure they would get paid for hours provided as a locum after 6 pm, that seems to have been provided as such a genius move, really? If someone presented me with a contract that didn’t have that in it and I had to ask for it “in writing”? I would avoid that job like the plague!!

If there is anyone here who has successfully had a non compete clause removed please come forward.
More significantly any groups that had it removed as a few in the group with that accomplishment would be inconsequential in the overall scheme.

 

[skypilot]

If there is anyone here who has successfully had a non compete clause removed please come forward.
More significantly any groups that had it removed as a few in the group with that accomplishment would be inconsequential in the overall scheme.

How about any group which has modified their non-compete to make it less onerous?