Doctor Employment Lawyer Blog

Before there is even a physician employment contract to review, doctors should investigate whether a hospital or practice group is truly going to be a good fit. Too many times we have seen physicians get into bad employment situations just because the pay was good. It does not take long for them to realize that no amount of compensation can justify staying in an uncomfortable working situation for the long term.

The following tips will help you conduct a little due diligence before accepting an offer of employment:

1. Culture. Speak with as many team members as possible. Don't just contact the physicians. Try to speak with the nurses, PTs, assistants and support staff. They will likely have a different perspective to share.

2. Reputation. Use the internet to find out what people are saying about the practice/group. Search each individual physician as well as the practice itself.

3. Volume. Ask the following questions: How many patients does the practice have? What is the breakdown of private pay versus public pay patients? How many patients does each doctor see per clinic? What were the previous year's total collections for the practice/group?

4. Vision. Ask about the practice/group's future plans. Are there plans for growth? What opportunities exist for you and what opportunities have your potential colleagues been able to conquer?

5. Attrition. How many employees have left the practice/group over the last 3 years? If a high number of people in any position have left, that might be an indication of how your potential colleagues interact with others.

Instead of providing a sign-on bonus, many physician employers now use forgivable loans as means of compensating a new employee. This allows the employer to pay a sign-on bonus without the risk of losing that money if the physician leaves before the required time period. Typically this type of compensation is structured as a loan that the physician can elect to take when she/he starts the position with the employer. The loan will accrue interest over a specified time frame, such as two to five years. If the physician stays with the employer for the required period of time, the loan will be forgiven. If the physician leaves or is terminated for any reason whatsoever, the loan and all accrued interest will be immediately due and owing.

Because the loan is option that the physician can elect to take or decline, the terms of the loan are usually difficult to negotiate. The risk to the physician lies in the fact that she/he can would for the employer without ever intending to leave and then be fired right before the loan is forgiven. In such situations, the employer has the right to demand immediate payment of the principal and interest due on the loan.

This is why understanding the culture of your new employer is so valuable. While you can't possibly know everything about an employer before you start, there are a number of ways you can get insight into an employer's culture. And, even if you are not receiving a sizable forgivable loan, knowing your employer before you start working is invaluable.

It may seem like selecting your area of specialty is the largest career defining decision as a physician, but the choices do not end there. You may go into private practice, academics, hospital practice, a partnership or a solo practice. And, once you decide on the type of practice you want to have or be involved with, there are a number of different factors that can affect your job satisfaction.

Many physicians believe that, other than your specialty and the type of practice, all you need to worry about is the contract. While a contract can address many areas of concern, it can't address everything. Just like any other profession, a physician's office is made up of people. There are hierarchies, cliques, processes, and policies. Knowing the office that you are planning to enter and understanding the practice's culture are key determinants of job satisfaction.

Always research prospective employers. Ask to meet with each of the practice's physicians and a member or two of the staff. Ask specific questions about expectations for new physicians and the support that the practice will provide you to meet those expectations. The more you know about the employer, the better you can negotiate your contract. If you know that the practice shifts the heaviest on-call duties to new physicians, you can try to negotiate an equal call distribution. Similarly, if you know that the practice only provides the marketing support it is contractually required to provide, you can try to negotiate a specific marketing budget or specific initiatives.