TeamHealth Contract Negotiations and Revisions

[deleted206819]

I’m having to transition from my current employment going to TeamHealth. In doing so, I have received their contract and have been reading through it.

I’d appreciate any guidance and advice regarding contract revisions or changes when it comes to TeamHealth specifically.

Is it a take or leave type of situation or is there wiggle room? If so, what should be changed?

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[AlmostAnMD]

A guy in our group (TH affiliate, not direct TH) spent 3k on a contract lawyer. Had a lot of suggestions/ changes. Boss told him to sign as is or walk away. Waste of money.

 

[Brigade4Radiant]

what are you trying to negotiate? Do you want a bonus? Do you want to hire hourly pay? Do you want to work less night shifts?

Just ask if you could get what you want. A lot of times if it’s a competitive area you really don’t have too much bargaining power because you’re just a cog in the wheel. You’re mostly just an independent contractor and standard in their contract. You get have to put in a 90 day notice and they can fire you at any time.

 

[bky3c]

I took a part time job at a rural TeamHealth site that was in an awful area, had one full-time EP (everyone else was part time or locums), and so was... obviously... rather desperate. (I did it because it was close(r) to home than all the locums stuff I was flying to, so there was a convenience factor for me. I lasted less than a year.) Even then, they refused to budge on the hourly rate. So although it's always worth asking for changes in the contract, unless things have changed with TH in the past few years, don't expect much.

 

[thegenius]

I’m having to transition from my current employment going to TeamHealth. In doing so, I have received their contract and have been reading through it.

I’d appreciate any guidance and advice regarding contract revisions or changes when it comes to TeamHealth specifically.

Is it a take or leave type of situation or is there wiggle room? If so, what should be changed?

You can try. Worst case scenario is they (TH) says no. I tend to think docs in these cases have little leverage

 

[bravotwozero]

You can try. Worst case scenario is they (TH) says no. I tend to think docs in these cases have little leverage

No the worst case scenario is dropping a couple grand on contract review by a lawyer and then be left standing with your appendage in your hand because you’ve got zero leverage and the employer won’t budge.

 

[Vandalia]

No the worst case scenario is dropping a couple grand on contract review by a lawyer and then be left standing with your appendage in your hand because you’ve got zero leverage and the employer won’t budge.

Well, the reason to have a lawyer review a contract is so you know what it actually says, not that you think it will help you negotiate something.

Remember a legal document does not mean what the words say, it means what the courts say the words mean.

Is it important or worth it? Depends.

 

[HemorrhagicShock]

A guy in our group (TH affiliate, not direct TH) spent 3k on a contract lawyer. Had a lot of suggestions/ changes. Boss told him to sign as is or walk away. Waste of money.

I can't tell you how many times I've heard some version of this exact same story.

The advice is good in general. A contract lawyer who specializes in medical contracting should review all contracts before you sign. But for the specific situation of an ER doc reviewing a contract from a CMG employer with the hopes you'll be able to line-item the various "gotcha" clauses within their standard contract is just not going to work.

A lot of it becomes "take it or leave it" with CMG contracts

 

[EctopicFetus]

Yep. Waste of time if the goal is to get something changed.

Worth it if you want to understand what is in there.

 

[Apollyon]

When Team Hell took over a site where I was, there was only one thing I could change in the contract: they had a 30 day out for them, 90 day for me. I don't recall exactly, but I got it changed to equal - don't remember if it was 60/60, or 30/30. But, I got it.

 

[NYEMMED]

Teamhealth will not negotiate a contract. You can negotiate a sign on bonus, that is about it…

 

[alphaholic06]

Teamhealth will not negotiate a contract. You can negotiate a sign on bonus, that is about it…

And that’s more money for more time.

 

[NYEMMED]

And that’s more money for more time.

Usually 15k per year that you add
15k/1 year
30k/ 2 year
Etc…

 

[Apollyon]

Teamhealth will not negotiate a contract. You can negotiate a sign on bonus, that is about it…

As I posted right above you, they negotiated on the leaving time with me.

 

[Rekt]

I’d be more concerned about updating your CV. A contract change to a CMG is not going to be anything in your favor.

 

[cyanide12345678]

I’m having to transition from my current employment going to TeamHealth. In doing so, I have received their contract and have been reading through it.

I’d appreciate any guidance and advice regarding contract revisions or changes when it comes to TeamHealth specifically.

Is it a take or leave type of situation or is there wiggle room? If so, what should be changed?

Definitely not a take it or leave it.

Ive negotiated about $30/hr more from them and put in a clause where i will only work ‘mutually agreed upon days’. So i literally could make my schedule 😂

Changed a dozen wordings of their contract after review with an attorney as well.

 

[cyanide12345678]

Teamhealth will not negotiate a contract. You can negotiate a sign on bonus, that is about it…

False. Depends on degree of desperation and their need.

My team health site had the locums guy making $280/hr. I was making $260/hr. A couple per diem guys making $250/hr, and their initial offer always was $230/hr.

I don’t know how many suckers took the initial offer and made $230/hr

 

[cyanide12345678]

I’m having to transition from my current employment going to TeamHealth. In doing so, I have received their contract and have been reading through it.

I’d appreciate any guidance and advice regarding contract revisions or changes when it comes to TeamHealth specifically.

Is it a take or leave type of situation or is there wiggle room? If so, what should be changed?

For another one of their sites, once i told them I’ll think about it, didn’t respond for 3 weeks because i wasn’t interested because they were paying $185/hr, and they had said that everyone made that, it was standard. Which was actually true because that 185/hr was what the SDG that was bought out had paid. Guess what happened after 3 weeks of not bothering to respond to them?

Medical director called and said ‘hey don’t tell anyone but we are going to offer you $215/hr plus 150k sign on over 3 years. But just don’t tell anyone because we have people working there for 15-20 years and you’ll be getting more than them’

They play ball when they are desperate - and the best negotiation is when you walk away which is when they actually show you what they’re willing to pay. Easier to walk away with multiple competing offers. But truly comes down to the site and degree of need and the local EM market. The mid west market was amazing in 2019 when i graduated from residency. That may not be the case now

 

[GonnaBeADoc2222]

Definitely not a take it or leave it.

Ive negotiated about $30/hr more from them and put in a clause where i will only work ‘mutually agreed upon days’. So i literally could make my schedule 😂

Changed a dozen wordings of their contract after review with an attorney as well.

This. When I worked for Team Health about 5 years ago, my lawyer changed/added/deleted a ton of language...and they accepted 97% of it.

 

[NYEMMED]

Definitely not a take it or leave it.

Ive negotiated about $30/hr more from them and put in a clause where i will only work ‘mutually agreed upon days’. So i literally could make my schedule 😂

Changed a dozen wordings of their contract after review with an attorney as well.

That’s good.

Could it be region dependent, since each region runs somewhat independently?

I was in the southeast division. They would not negotiate a single item “sign it as is, or we will find another candidate for the position” were the exact words.

 

[JacobMcCandles]

Medical director called and said ‘hey don’t tell anyone but we are going to offer you $215/hr plus 150k sign on over 3 years. But just don’t tell anyone because we have people working there for 15-20 years and you’ll be getting more than them’

They play ball when they are desperate - and the best negotiation is when you walk away which is when they actually show you what they’re willing to pay. Easier to walk away with multiple competing offers. But truly comes down to the site and degree of need and the local EM market. The mid west market was amazing in 2019 when i graduated from residency. That may not be the case now

The amount of people that get told this and then think they are the only ones that get told this never ceases to amaze me. The number of people that were told this for that job was certainly greater than 1.

We've all seen this happen similarly in practice every day. How often do you get a patient that says "Dr. So-and-So said I had the worst case of X they'd ever seen"? CMGs do the same thing. We're nothing special to them and, honestly, it's tough to really ascertain whether someone is a good physician or not from an interview. There's nothing wrong with feeling special but just be cognizant that some people get worse deals than you and some people get better deals. But, any time someone from a CMG says "hey, don't tell anyone", you're not the only person that is being given that line.

 

[cyanide12345678]

That’s good.

Could it be region dependent, since each region runs somewhat independently?

I was in the southeast division. They would not negotiate a single item “sign it as is, or we will find another candidate for the position” were the exact words.

Probably not just region dependent, probably site dependent. If a site is hard to staff where they have locums, different story.

 

[cyanide12345678]

The amount of people that get told this and then think they are the only ones that get told this never ceases to amaze me. The number of people that were told this for that job was certainly greater than 1.

We've all seen this happen similarly in practice every day. How often do you get a patient that says "Dr. So-and-So said I had the worst case of X they'd ever seen"? CMGs do the same thing. We're nothing special to them and, honestly, it's tough to really ascertain whether someone is a good physician or not from an interview. There's nothing wrong with feeling special but just be cognizant that some people get worse deals than you and some people get better deals. But, any time someone from a CMG says "hey, don't tell anyone", you're not the only person that is being given that line.

I’m not thinking i was the only one, but team health definitely negotiates when they have to is my point.

 

[Arcan57]

I’m not thinking i was the only one, but team health definitely negotiates when they have to is my point.

TeamHealth mandate #1: make profit

TeamHealth mandate #2: keep the contract

TeamHealth mandate #3: turn EM providers into widgets

If they're offering a differential base rate without throwing in some make-work admin title, that's an indication that their contract is in significant trouble.

 

[bravotwozero]

I’m not thinking i was the only one, but team health definitely negotiates when they have to is my point.

How long after did TH keep that contract? Do they still have it?

 

[cyanide12345678]

How long after did TH keep that contract? Do they still have it?

I don’t work there anymore. They probably still do since they staffed the entire multi hospital system in the area.

 

[MechEDoc]

Team Health probably won't negotiate at all on your contract, but they will willfully violate it. Double check your pay and that they are following the terms of your contract.

 

[RustedFox]

I was one of those docs that just got paid a lot of money in the class action lawsuit settlement because Teamhealth was straight stealing money every paycheck.

Eff Teamhealth. For ever. And ever.

 

[thegenius]

I was one of those docs that just got paid a lot of money in the class action lawsuit settlement because Teamhealth was straight stealing money every paycheck.

Eff Teamhealth. For ever. And ever.

Me too. Couldn't believe the size of the check

 

[dchristismi]

Me three, actually. I was shocked anything came of it.

 

[BoardingDoc]

I was one of those docs that just got paid a lot of money in the class action lawsuit settlement because Teamhealth was straight stealing money every paycheck.

Eff Teamhealth. For ever. And ever.

Can one of you 3 elaborate? I somehow completely missed this. I also have never heard of a class action lawsuit where anyone except the lawyers got a decent size paycheck. Y'all's posts seem to indicate otherwise.

 

[NYEMMED]

I was one of those docs that just got paid a lot of money in the class action lawsuit settlement because Teamhealth was straight stealing money every paycheck.

Eff Teamhealth. For ever. And ever.

Whoa whoa whoa

Tell me more about this class action and how I get a piece of Teamhealth ?

 

[RustedFox]

Can one of you 3 elaborate? I somehow completely missed this. I also have never heard of a class action lawsuit where anyone except the lawyers got a decent size paycheck. Y'all's posts seem to indicate otherwise.

Whoa whoa whoa

Tell me more about this class action and how I get a piece of Teamhealth ?

You had to work at one of their qualifying facilities in certain states. Maybe you worked at one of the "good ones" (there aren't many).

Anyways, they were underpaying the RVU component of the contract and got caught. I didn't expect to get much, but I got enough to pay for my new jeep and then some and then some.

 

[Backpack234]

You had to work at one of their qualifying facilities in certain states. Maybe you worked at one of the "good ones" (there aren't many).

Anyways, they were underpaying the RVU component of the contract and got caught. I didn't expect to get much, but I got enough to pay for my new jeep and then some and then some.

Is there a link to this? Also what counts as too low for the rvu component?? Asking for a friend

 

[Backpack234]

Just read a story about the suit. So before 2018-2019, docs should have gotten paid for supervisory rvu. Afterward their contract says they get 0. Wow.

 

[BoardingDoc]

Just read a story about the suit. So before 2018-2019, docs should have gotten paid for supervisory rvu. Afterward their contract says they get 0. Wow.

So TH literally pays their docs 0 for the midlevel patients they take on the liability for?

 

[MechEDoc]

You had to work at one of their qualifying facilities in certain states. Maybe you worked at one of the "good ones" (there aren't many).

Anyways, they were underpaying the RVU component of the contract and got caught. I didn't expect to get much, but I got enough to pay for my new jeep and then some and then some.

I had a feeling that they were doing that I. I was straight hourly at a site where they were pulling shenanigans with the RVU docs. I don't think TeamHealth ever got in trouble (California) for those stunts.

And they cheated lots of the hourly people too.

 

[NYEMMED]

So TH literally pays their docs 0 for the midlevel patients they take on the liability for?

I’ll caveat with I stopped working for team a few years ago. But it was switched so that if you saw a patient with a MLP and wrote a brief atteststion note/MDM then you go the RVUs. No RVUs for signing a chart….

 

[thegenius]

I had a feeling that they were doing that I. I was straight hourly at a site where they were pulling shenanigans with the RVU docs. I don't think TeamHealth ever got in trouble (California) for those stunts.

And they cheated lots of the hourly people too.

I live in CA and participated in that suit. paid very hansomly

 

[MechEDoc]

I live in CA and participated in that suit. paid very hansomly

Any idea if you were actually made whole?

 

[dchristismi]

Fox and I were at the same hospital at least part of the time. There were only a handful (as best I could tell) of groups who actually qualified. The exception list of hospitals and groups was over 4 pages long in small font and deliberately excluded a LOT. We are in Florida. "Made whole" is debatable. I had one foot out the door and was already part time. What price is mental health, "burnout" and moral injury? Because that is the bigger question and I don't have an answer to that.

 

[thegenius]

Any idea if you were actually made whole?

No clue, and probably not. It was remuneration over 2014-2019 I think.

 

[deleted206819]

Team Health probably won't negotiate at all on your contract, but they will willfully violate it. Double check your pay and that they are following the terms of your contract.

When you say double check your pay, what do you exactly mean?

Keep track of the number of patients seen per shift / month and double check with what they have billed?

 

[NYEMMED]

With Teamhealth be sure if you get metric bonuses that they actually pay it.

Also they tend to switch the metrics last minute, when they see too many people are meeting the metric

Finally they will frequently update the way they calculate your RVU pay. It usually always benefits Teamhealth when they do…

 

[Arcan57]

When you say double check your pay, what do you exactly mean?

Keep track of the number of patients seen per shift / month and double check with what they have billed?

TH tends to do really well with bog standard base rate or RVU pay. If you have extra incentives, there's a higher risk of them messing up. It's not so much that they're going to steal RVUs from you (although that can happen) but they may misapply or not apply one of the parts of your pay and it's up to you to realize it. It usually gets taken care of without escalating to lawsuits so you don't hear about it a lot unless you're at Team shop.

 

[Old_Mil]

When Team Hell took over a site where I was, there was only one thing I could change in the contract: they had a 30 day out for them, 90 day for me. I don't recall exactly, but I got it changed to equal - don't remember if it was 60/60, or 30/30. But, I got it.

I'd recommend this. 90 days is a long time if the environment of a department goes bad. If you can get 30/30, that is ideal.

Others may disagree, but I prefer a straight hourly rate to RVU based compensation for three reasons: (1) It eliminates the need for me to spend uncompensated hours checking their work. (2) It cuts the link between my compensation and decisions made at the corporate level that I have no control over. (3) Even during slow periods, I'm still getting paid.

 

[MechEDoc]

I'd recommend this. 90 days is a long time if the environment of a department goes bad. If you can get 30/30, that is ideal.

Others may disagree, but I prefer a straight hourly rate to RVU based compensation for three reasons: (1) It eliminates the need for me to spend uncompensated hours checking their work. (2) It cuts the link between my compensation and decisions made at the corporate level that I have no control over. (3) Even during slow periods, I'm still getting paid.

Hourly is better with opaque organizations such as team health, Envision, USACS, etc.

1099 can be better when it comes time to quit. Note that they are no longer meeting minimum requirements for appropriate provision of your services as an independent contractor. It is not unreasonable to have minimum expectations such as providing appropriate support (timely and professional consultations, necessary supplies, and appropriate nursing staffing). Nearly every one of these CMG sites will be failing in one or more of these areas. You can give notice that you expect something to be fixed and then quit when it isn't - however you will burn bridges.

 

[NYEMMED]

I'd recommend this. 90 days is a long time if the environment of a department goes bad. If you can get 30/30, that is ideal.

Others may disagree, but I prefer a straight hourly rate to RVU based compensation for three reasons: (1) It eliminates the need for me to spend uncompensated hours checking their work. (2) It cuts the link between my compensation and decisions made at the corporate level that I have no control over. (3) Even during slow periods, I'm still getting paid.

The most ideal is 30/90

You give them 30, they give you 90

No company would ever ok that, I would assume.

That way you have 90 days to find a new place and credential, most would take 180 for that process

 

[goodoldalky]

My advice is the following. Get together with your group. None of you sign the contract as-is. All of you begin working on part-time/PRN credentialing elsewhere. Split the cost of a good contract lawyer. After review, you all submit the contract back to your employer with your recommended changes, with the intention to work elsewhere if they do not concede.

This is the only way to get them to make changes. It is very effective, but the most difficult part is getting your group on the same page.

 

[ScepticSkeksis]

I'd recommend this. 90 days is a long time if the environment of a department goes bad. If you can get 30/30, that is ideal.

Others may disagree, but I prefer a straight hourly rate to RVU based compensation for three reasons: (1) It eliminates the need for me to spend uncompensated hours checking their work. (2) It cuts the link between my compensation and decisions made at the corporate level that I have no control over. (3) Even during slow periods, I'm still getting paid.

I haven't worked in an hourly position yet. Don't you find it challenging to work with other lazy docs who won't see their fair share?