Doctor Employment Lawyer Blog

You can be the greatest doctor in the world, but it means nothing if patients don't know who you are or where to find you. Medical school and residency programs provide the training necessary to treat patients, but there is very little access to the business and marketing aspects of developing a medical practice.

Many private practices are moving away from guaranteed salary structures and implementing productivity based pay plans. This means that, in addition to treating patients, doctors are expected to market and grow their practice.

Employment agreements often reflect this type of pay plan, but have little information about how the practice will assist you in attracting patients. These types of employment contracts will typically provide a short period of guaranteed pay (anywhere from 6 months to 2 years). After that period, your pay will be solely based on collections resulting from your medical services.

As with any business, it takes time for a doctor to build a reputation and patient base within the practice. Make sure you know how the practice will support you in attracting new patients. And, more importantly, make sure you understand how collections are processed within the practice. It's no longer enough to be a great physician. You have to have great support. The only way to ensure that, is to have an employment contract that provides for that support.

The contract to contract is like the meeting before the meeting. It's the initial offer whereby the big terms are agreed upon before the nitty gritty details are discussed.

Many practice groups use an initial offer letter to lock down key terms before sending a physician a proposed Employment Agreement. This allows the practice to lock in salary and certain benefits before going down the road of negotiations. However, when reviewing an offer letter, doctors should be cautious not to bind themselves to terms about which they have not really agreed.

While compensation is not always the most important item in an Employment Agreement, it is the most important item in the offer letter. This is because, by signing the offer letter, the practice typically will take the position that compensation has been determined.

Of course, your signature on an offer letter does not prohibit you from revisiting issues. Just because you signed the agreement to agree, does not mean you really have to agree. However, signing the offer letter should be the first step in a long term employment relationship. And, it's never good to start by reneging on an initial agreement.

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.

Many physicians are asked to sign non-compete and non-solicitation agreements by their employers. When you are staring a new job, this sort of thing may seem typical or unimportant, but when you leave to pursue a new opportunity, you may realize that such an agreement can effectively keep you out of the marketplace.

If you have signed a non-solicitation agreement and are moving to a new practice, you likely want to send out an announcement to all of your past patients inviting them to come see you at your new place of business. This may seem like a great idea, but there is a lot of potential liability if you violate the terms of a non-solicitation agreement.

Some of these agreements are narrow and specific in that they only prevent you from actually soliciting patients, meaning you cannot ask your patients to switch to your practice, but you may be able to send out announcements advising them of your new location or offering to assist them in continuing their care at your former practice.

At the same time, many employers are going to greater lengths to protect their investment in practice developments. These agreements are drafted in broad terms and specifically prohibit you from even sending announcements to your patient list. Some such agreements even go so far as to attempt to prohibit you from initiating any communications whatsoever with patients. Whether or not a court would uphold such a broad provision depends on the language, and the court.

Make sure that you understand to what you are obligating yourself before you sign a non-solicitation agreement. And, at the very least, try to negotiate an exception for patients that you bring with you to your new employer.