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    COVID-19: Impacts to Physician Employment

    Decreased patient volumes are causing practices, hospitals, and health care systems to review staffing levels and compensation due to lost revenue.

    For the employed physician, a signed contract establishes the terms of your employment. Given the financial realities of COVID-19, your employer may wish to modify your contract. Locate your contract to review policies, procedures, and any amendments (i.e., force majeure clauses or other references to events that cannot be reasonably anticipated or controlled). If you do not understand the language in your employment agreement, contact a health care attorney. Be proactive by reviewing the situations below and related questions to assist you in navigating your employment issues.

    Questions to ask about a reduction in salary or hours

    Your employer has asked you sign an amendment agreement to defer a specified amount (i.e., 10%) of your salary.

    • How long will this remain in place?
    • What are the repayment terms?
    • Is repayment over the course of several months or in one lump sum?
    • How will this income affect your taxes?

    Your employer has asked you to sign an amendment agreement for a salary reduction (not deferred).

    • How long will the reduced salary remain in place?
    • After the COVID-19 public health emergency ends, will you need to renegotiate your salary? Consider whether you have reached important metrics (e.g., productivity, quality, cost) set by your employer that demonstrate your value. Use these metrics in your contract negotiations.

    Your employer has stopped contributions to your 401(k) or 403(b) account.

    • Has your employer communicated when contributions will be resumed?

    Your work hours have been reduced.

    • How long does your employer expect the reduction in hours to last?
    • After the COVID-19 emergency ends, will you need to renegotiate your hours?
    • How will a reduction in hours affect your salary?
    • Will your paid time off or vacation balance be used to make up for lost hours?
    • Will a reduction in hours affect your benefits (i.e., health or life insurance)?
    • Is redeployment to another setting (such as an inpatient facility) an option to maintain your standard work hours?
    • Is redeployment to another city or state an option? If you are redeployed, will your employer cover expenses for travel, food, and housing?


    You have been furloughed or been put on temporary unpaid leave.

    • Can you use paid time off or vacation hours to receive pay during leave?
    • How does this affect insurance and benefits during the furlough?
    • How long will the furlough last?


    Your employment has been terminated.

    • Does your employment agreement have stipulations regarding termination?
    • What are the provisions in your employment agreement about termination, with or without cause?
    • Does your employment agreement provide length-of-notice requirements for termination without cause?
    • Does your employment agreement require your employer to give you written notice of the cause for termination and an opportunity to address alleged breaches or deficiencies within a reasonable period (typically, five to 30 days)?

    Next steps if you have been terminated:

    • Review termination documents provided by your employer, including benefits termination, COBRA options, repayment of bonuses, and malpractice tail insurance;
    • Review your contract for restrictive covenants;
    • Review AAFP member resources on careers here;
    • Contact your state unemployment insurance office to apply for benefits.

    The CARES Act

    The CARES Act expands unemployment insurance (UI) eligibility and compensation. These changes are effective January 27 through December 31, 2020.

    • Several groups of workers typically not covered by UI are now eligible, including:
      • the self-employed,
      • independent contractors,
      • gig workers,
      • part-time employment seekers,
      • those who lack sufficient work history, and
      • those who have exhausted their unemployment benefits under existing regulations.
    • These groups must certify that their unemployment is due to COVID-19. Unemployment reasons can include:
      • diagnosed with COVID-19 (self or member of household),
      • providing care for family member diagnosed with COVID-19,
      • caregiver unable to work due to school or childcare closure,
      • COVID-19 quarantine,
      • scheduled to start a job but cannot due to COVID-19,
      • household breadwinner has died due to COVID-19 and another adult becomes primary financial support for household, or
      • quit a job due to COVID-19.
    • UI compensation is increased by $600 per week through July 26, 2020.
    • UI compensation is extended an additional 13 weeks for those who have exhausted their UI benefits.

    This information is intended to assist you in this rapidly evolving financial and practice environment, but it does not constitute legal or business advice and cannot take the place of seeking such advice from your own trusted professionals that is tailored to your own circumstances.