Doctor Employment Lawyer Blog

No matter how thoroughly you investigate a practice group, hospital or other employer, as a doctor you may someday be faced with an ethical dilemma regarding patient care, resident hours, billing, referral arrangements or other practices. Knowing how to make a report and to whom can affect the legal protections available to you as well as the ramifications on your future career.

A physician's first step should be to investigate and determine whether the issue is a legal issue, a safety issue or a personal ethics issue. All three are extremely important, but there are whistleblower laws in place to protect you when the issue affects public funds and public safety. Personal ethics issues may or may not have such protections, depending on the specifics of the concern.

Next, you should think about the ramifications that a report will have. Will it promote the change you believe is necessary or will it cause further damage to yourself or others?

Most importantly, you need to determine where to turn. Some issues are best addressed directly with your employer. But, there are issues that need to be reported to authorities. Regardless, you should approach an attorney or other professional whom you trust and fully explore all available avenues.

I have seen a number of Physician Employment Agreements recently that determine compensation based on productivity. This can be very lucrative for a physician who is able to market his/her services or has already developed a large patient base. However, a doctor who joins a practice directly out of residency will face a number of difficulties in building a practice. This is especially true if the Employment Agreement does not identify marketing and promotion tools and support that will be provided by the practice.

What makes these compensation terms especially treacherous for new physicians is that the practice groups that most often use this form of compensation are also the practice groups that do not pay for the physicians' tail coverage.

If you end up taking a position and patient volume is low or collectibles are low and you need to leave because you are not making any money, you could also be required to pay large amounts of money to obtain tail coverage.

Taking your first job out of residency should not dig you into a deeper hole of debt, but if you are not careful it can. This is why I always try to remind physicians that, regardless of whether they hire an attorney, they must make sure they understand the terms of an Agreement before their signature goes on the page.