Physicians are often handed employment agreements and told that a contract is non-negotiable, straightforward, or that all physicians in the group have signed the same contract. Because of this, they often see a job offer is non-negotiable, or think that only certain elements such as physician salaries or signing bonuses are negotiable. If they have access to physician salary data, they may think that there is no additional value in using a contract attorney if they can’t change the wording or terms. However, in our physician communities, whenever someone asks, “Should I have a contract lawyer review my contract?,” the consensus answer is a resounding yes. We see posts daily that reflect the importance of having your contract looked over by someone knowledgeable in legal terminology as well as the ways physicians run into issues with their contracts. Below, we’ll cover reasons why having your contract reviewed by a competent physician contract lawyer is not only prudent, but will pay itself off with dividends.
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What does it mean to be a physician contract attorney?
There are many lawyers who can review physician contracts, but for the purposes of this article, when we refer to physician contract attorneys, we are referring to those with a particular niche expertise in this space. We have several physician contract lawyers or physician contract review firms on our physician lawyer database. These attorneys review many contracts for doctors a year, and therefore are more familiar not just with physician compensation, but also with common red flags in physician employment agreements, things unique to physician contracts such as RVU structures and private practice partnerships, and understand what things are normal and need to be clarified in physician employment situations in particular. As we all know, our jobs are not typical 9-5 jobs, things like malpractice coverage and tail insurance and noncompete agreements aren’t part of all jobs, and patient care responsibilities are different than other realms. Therefore, having someone who doesn’t understand the job review the contract can result in important omissions or concessions that can be costly and/or stressful later.
PSG Resource: We have local and national physician contract attorneys that are sponsors who have been used and recommended by our members.
What is the cost to have a physician contract lawyer review your employment agreement?
Physician contract attorneys charge different amounts depending on their models. Most will either charge a flat review rate or charge a fixed hourly fee, but there are hybrid models and variations as well. Most of our physicians report paying between $500-$3500 depending on the complexity of an agreement, if the contract attorney is actively negotiating on your behalf as well, and what local market norms are.
Is it worth the cost to have a physician contract attorney review your employment agreement, and do I need one?
In our opinion and that of many in our communities, in one word: yes.
You don’t know what you don’t know. Even if you’ve done your research and read all the articles in our physician contract negotiations series, ultimately you are not a lawyer. Something that seems straightforward to you, like an indemnification agreement, may actually have huge consequences you couldn’t have foreseen.
It’s really important to keep contract review costs in perspective. At certain stages of your career, like when you’re still in training, these costs can seem very high and unaffordable. However, keep in mind how much has been spent on your education, interviews, etc. throughout this process. You didn’t do all of that to make a mistake at the finish line on the thing that matters the most - your actual job as a physician.
Finding even one thing that is changed in a contract will pay itself off in dividends. This thing can either earn you that money back with dividends by negotiating a better RVU rate or compensation package, make your life less stressful or complicated by negotiating in a non-monetary item that makes your life better, or prevent you from entering into unfavorable terms that will contribute to burnout or hold you in a job that you don’t like. The majority of the experienced physicians in the group pretty uniformly attest to this, but please feel free to search related discussions on our physician communities to see specific anecdotes for yourself.
If they do recommend changes and you’re not able to negotiate those changes with the employer, at least you’ll go in eyes wide open. Sometimes, employers will not concede to recommended changes, but even in those cases you want to understand the terms and weaknesses in your contract. Ask your lawyer to explain those in detail to you so you can decide whether you’ll be able to live with the implications or if they’re dealbreakers and you should walk away. Ultimately we’re not lawyers, so understanding the contract and the legalese has value even when changes aren’t made.
Even in the off chance that your attorney says everything looks good, you’ll sleep better at night knowing a second pair of eyes with legal expertise has looked for any red flags in your contract. In our experience, most contract attorneys that look through things carefully will find some areas for improvement to point out, but sometimes, you may luck out and just have a really good contract.
What if I’m told my physician contract is a standard agreement and can’t be changed?
First off, this is rarely true. There’s usually some room for negotiation, even if it’s not salary or the noncompete clause. If you don’t ask for anything, you’ll never get it, and your physician contract attorney likely has experience with employers that say this and know where they may have some wiggle room. They can help you navigate.
And as we said above, even if they truly can’t change anything, at least you’ll have an opportunity to review the contract with someone who is paid to be on your side and think about things with your best interest in mind, not the employers. They can point out those red flags and explain them to you so that you go in eyes wide open about what you’ve agreed to.
What kinds of things can contract attorneys help with in physician contracts?
There are several roles your physician contract attorney can play, depending on your arrangement. The major ones are usually:
Read the contract and suggest changes based on legal issues or terms that are unfavorable.
Review your job offer and compare it against compensation data to tell you how competitive your compensation package is.
Negotiate on your behalf.
How do I pick a physician contract attorney?
Reputation and experience. You’ll want to ask other physicians for their experiences. You can do this by asking your colleagues, or by asking on our online physician communities. The attorneys on our recommended contract lawyers list have been used by and recommended by many of our members. You want someone who regularly reviews physician contracts and who has a track record of getting favorable terms. Ideally they have been doing this long enough to know what goes wrong in physician contracts and how to address those in the contract from the getgo.
Style and comfort. Some of this is about spidey sense. Who do you instinctively trust will advocate for you and take the time to review your contract carefully and explain it to you? Do they seem like someone that the other side will take seriously? Do they sound like they understand physician contracts?
Availability. We’ve learned after years of watching members of the groups talking about their experiences that availability is very important. You can have a great attorney but they may have too many clients or something going on in their life that precludes them from dropping everything for time sensitive matters. While we all understand work life balance, if they take 2 weeks to get back to you in the middle of a physician contract negotiation, it can be a big problem. See how quickly they got back to your response and how soon they could schedule a call. Ask them about how quickly you can expect to hear from them and make sure you ask your colleagues who gave you the recommendation what the experience was.
Price. While we don’t want anybody to be penny wise and pound foolish, we understand this is a practicality for many physicians, particularly those searching for their first job. Get a few quotes if you need to, so you can feel comfortable that you picked the best combination of an advocate and what you can afford.
Should I use a local contract attorney or a national company?
This all comes down to preference, pricing, and the availability of trusted sources. Physicians on our communities do both and we have resources for both on our recommended list of physician contract attorneys. If you are moving to a new market, you may not have a trusted agent in that area. You may ask around for contacts, but the attorney’s name who you are given locally may only do 2-3 physician contracts a year.
Therefore, our recommendation is that whichever way you go, you use someone who has niche expertise in physician contracts. You want someone who understands the nuances of physician employment agreements, including physician salary data, letters of intent, signing bonuses, bonus structures, noncompetes, tail insurance, termination clauses, common red flags in physician contracts, indemnification clauses, and more.
Should I have a contract lawyer negotiate on my behalf?
This will come down to your personal preference and your budget as well. Some people are very comfortable navigating contact negotiations and have the emotional intelligence and business savviness to advocate for themselves well. They may think they have a better chance of getting what they want by being their own advocate. Others may prefer to just stick to friendly talks and not introduce an element of discomfort when negotiating with the people they are going to work with in the future. Still others may feel that the lawyer comes across as more professional and/or more of an equal adversary at the negotiating table. Regardless, read up on physician contract negotiations so you can be your best advocate. Whether you’re doing the negotiations or understanding what your attorney is telling you, you’ll be glad that you did.
Conclusion
Physician contracts are getting increasingly more complex as our healthcare landscape becomes more corporate. Contracts can either be your enemy or your best friend. A well worded contract can protect you, prevent burnout, and get you paid fairly. Conversely, a poorly worded contract can handcuff you to a job or conditions that you didn’t mean to sign up for. Working closely with a physician contract attorney to identify and navigate any issues in the contract itself or the contract negotiations process is a valuable tool, and in our opinion, one that most physicians should use.