Doctor Employment Lawyer Blog

Lately we have been seeing private practice employment contracts that are dependent on hospital support. These are typically physician employment contracts in areas where there is a shortage of doctors practicing in that particular specialty. These can be great arrangements, but they can also be strait jackets for doctors that end up in a bad employment situation.

Physicians considering these types of employment situations should do their due diligence before accepting a position. Be sure that the practice's culture and processes meet your expectations. Research the reputation of the practice and speak with the physicians and support staff about how the practice operates.

Of course, this sort of due diligence should be performed regardless of the type of physician employment you are considering. But, the reason it is especially key in these situations is because you could up having to pay huge sums if you decide it's not working out. These employment agreements typically have a repayment schedule that is based on how much of the contract term is fulfilled. The sooner you want to terminate, the more it could cost you.

In these cases, it literally pays to know what you are getting into before you sign the employment contract.

I used to think that the word "equitable" means equal or fair. Merriam Webster would certainly have us believe that to be true. Yet, when I see variations of the word in physician employment agreements, I'm a bit wary. Especially when the word is connected to a discussion regarding call coverage.

Physicians who are required to take call know that weekends, holidays and family time in general can be eaten up by the days and hours on call. What does it mean if your agreement says that "call will be determined on an equitable basis, as determined by employer"? Equitable may mean that each physician is given an equal number of days of coverage, but your days are all the major holidays. Or, equitable may mean that new physicians get the bulk of call coverage because senior physicians have paid their dues. Or, it may mean that you are excluded from call altogether.

"Equitable" may very well mean fair, but meaning and application are not always the same. In negotiating your employment contract, the question should not be "is equitable fair?" but rather "is equitable fair to me?"

Many physicians joining a practice want the opportunity to be an owner. And, many practice groups use future ownership as a potential benefit to physician employees. However, the terms of that future ownership interest are usually vague at best.

To some extent, an open ended, to be negotiated at a later date agreement may be beneficial to everyone. But, if your main objective in joining a practice is to be an owner, ambiguity means uncertainty. Including the minimal requirements for a buy-in will prevent you from being shocked by terms down the line.

For those of us that live in or around an urban area, getting from point A to point B on a daily basis means navigating down streets and around buildings. Hover cars have yet to be invented and evolution has yet to bring us wings. Nevertheless, when it comes to non-compete agreements, the distance is almost always as the crow flies.

Most non-compete provisions prohibit the physician from working within a specified mile radius of the place of employment. That single word "radius" can add a lot of area to the restriction.

This can be especially crucial if you signed an agreement with a 10 mile radius restriction and you accept a job that is 13 miles away by car. Many physicians are under the impression that the 13 mile driving distance puts the new job beyond the restricted area. The fact is that a 13 mile drive can easily be within a 10 mile radius depending on available roadways. That can be a very expensive mistake for a physician who is sued for violating a non-compete.

Congratulations to all of you who have just completed your residency. Most of you have already signed your employment contract and are preparing to take on your new role as an attending. I hope that you asked for everything you want in your employment arrangement and that your employer gave you what you want in a clear manner.

Just make sure you read your agreement and enjoy what you do.

I recently heard a story about a surgeon who accepted her first attending position without having a full understanding of her contract and the employer's expectations. It turned out that the employer expected her to take on all of the grunt work for the senior attendings. She was miserable and didn't have a lot of options given that she agreed to a non-compete and was not interested in moving.

In the excitement of finding your first job or a new job for that matter, there is often a rosy view of the future that prevents people from asking all of the questions that will affect whether the employment relationship is successful. And, while asking questions does not guarantee you will get honest answers or a realistic perspective, the answers usually provide some insight into the employer's culture.

Signing an agreement with the heading "Independent Contractor Agreement" does not make you an independent contractor. If you are terminated from a position that was labeled independent contractor but was an employment relationship in practice, you may actually be considered an employee under Illinois law (and federal law as well). Why is this this important? Because as an employee you have rights that are unavailable to independent contractors. For example, discrimination and wage laws do not apply to independent contractors. Furthermore, employees have access to unemployment benefits; independent contractors do not.

How do you know if you were really an employee? It depends. The Illinois Department of Labor, the Illinois Department of Employment Security and the IRS all have slightly different standards in determining whether you were an employee or independent contractor. The most basic question is whether you were free from direction and control of your employer.

Did you perform a job that was unrelated to the purpose of the company for which you worked? Did you make your own schedule? Did you use your own equipment and materials?

This is not an exhaustive list of the questions that the agencies will consider to determine your status, but it's a good place to start. If you were under the control of your employer and treated more like an employee than an independent business, you may be entitled to employment related benefits and your employer may be subjected to a number of penalties.