Physician Employment Questions? The AAFP Has You Covered
Know Your Goals and Do Your Research, Says Legal Expert
October 5, 2021, 3:25 p.m. Cindy Borgmeyer ― As a family physician, few decisions you’ll make in your professional career ― or your personal life, for that matter ― are as momentous as determining where and how you’ll practice your craft.
The prospect of signing your first employment contract, or even your second or third, can be daunting. You want to be sure you’re asking potential employers and others involved in the process the right questions to get the information you need to make a well-informed decision. Not just about salary, work hours and benefits, but the less tangible variables, too. Because you want ― no, you need ― to find a good fit.
Relax. The AAFP’s got your back.
Whether you’re a newly minted resident or a physician who’s been in practice a while, you’ll find a wealth of resources you can turn to for help on the Academy’s Employment Contracting webpage.
Some of the offerings, such as Making Sense of MACRA: A Guide For The Employed Physician, have been around for a while. Others are brand-new, such as the employed physician compensation letter template created earlier this year to assist physicians who choose to advocate for fair compensation with employers who have failed to implement the evaluation and management increases in the 2021 Medicare physician fee schedule. One tried-and-true resource, the Resident Employment Preparation checklist, recently received an update.
Story Highlights
Practice Hack Video
Want to get tips on preparing to negotiate an employment agreement? The latest Family Medicine Practice Hack video, Negotiating Your Employment Agreement, features Kansas AFP President Jennifer Bacani McKenney, M.D., of Fredonia. In the video, she outlines four steps to ensure you’re well-informed and equipped to negotiate your employment contract.
- Obtain good advisers to guide you. Working with a health care attorney and financial adviser who have relevant experience and can explain contract terms and tax implications is essential to help set you on the right career path and avoid employment missteps.
- Create a pro/con list to prepare for negotiations. Before signing a contract, talk with your attorney and financial adviser to understand the advantages and disadvantages. List red flags, questions and concerns to discuss; understand how physician compensation is determined so you can negotiate based on evidence; and ensure the organizational culture matches your values.
- Ask practical questions and respect the process. Identify and work with a primary contact when negotiating, and focus on asking questions rather than making demands. What is the organization’s vision? Is it reflected in the duties and terms of the contract? If it’s not, ask about it ― you can learn a lot about the employer from these discussions.
- Understand the contract’s termination provisions. Develop an exit strategy before you ever sign the agreement to protect your career options, and be certain you understand and are comfortable with all provisions before signing.
FPM Journal
The September/October issue of FPM is another go-to resource for AAFP members seeking information on career and employment topics. Whether you’re a resident searching for that first practice opportunity or an established FP wanting to explore new career options, you’ll find articles that can answer your needs.
“Life After Residency: Exploring Practice Options in Family Medicine,” for example, outlines some of the many career pathways open to family physicians, including traditional family medicine practice and positions that offer more flexibility in scope or work-life balance, as well as nonclinical positions.
For physicians who aren’t looking to ditch their full-time job but simply want to tap into another area of interest or take on a new challenge, there are plenty of possibilities to explore. “Find Your Side Gig: Extra Income Opportunities for Family Physicians” looks at the usual suspects ― serving as an expert witness, covering extra clinical shifts, or completing case reviews or utilization assessments ― as well as newer opportunities, such as conducting telemedicine consults or podcasting.
Moving from the exam room to the board room is another career route some physicians choose to take. FPs ― thanks to their breadth of knowledge and experience, ability to form lasting patient relationships, and skill at working with people from diverse backgrounds ― are particularly well suited to lead health care organizations. “The View From the Top: Leadership Lessons From Family Physician Executives” presents insights from three physician executive leaders, each of whom followed a different career trajectory.
Physician Employment Contracting
The supplement that accompanies that FPM issue, “Navigating Physician Employment Contracts,” gives a high-level view of the contracting process, defining terms commonly used in physician employment agreements, offering advice about specific provisions, and laying out key steps that should be completed before finalizing a contract.
The supplement’s author, Ericka Adler, J.D., L.L.M., also served as consultant on a second AAFP publication that takes a much deeper dive into the physician employment contract process. A Family Physician Guide to Employment Contracts details a long list of provisions and other elements of physician employment agreements, calling out red flags to watch for, giving expert tips for navigating the process, and listing questions to ask during employment interviews and negotiations.
A shareholder and health law practice group leader with Chicago-based law firm Roetzel & Andress, Adler recently spoke with AAFP News and offered insights on key aspects of employment agreements. The following Q&A covers some of that conversation.
Q: What key issues should physicians keep in mind as they interview with a prospective employer about a job opportunity?
A: I think physicians have to keep in mind their personal goals. For physicians who have families that they’ve just started or those looking for work-life balance, they need to keep that in mind when they’re looking at a job. When they’re interviewing, they need to ask questions that will give them the answers they’re looking for so they’re not unpleasantly surprised.
For doctors who just want to earn a lot of money to pay down loans, they may be looking for something different: How much money can I make? They may not care where they end up working or the hours they work.
Knowing what your goals are, what’s important to you and how the contract dips into that is really important.
Q: What are the most important steps physicians can take to prepare themselves to enter into contract negotiations?
A: It’s important to have a good team so you have someone helping to review that contract. Obviously, I think having a lawyer is always going to be important, but just having someone who can play devil’s advocate and talk through those issues with you is key.
I also think it’s important to compare contracts to see what the differences are and understand what those differences mean. And if you can, talk to someone who works for the potential employer, because contracts and the interview paint the picture the employer wants you to see. But you want to talk to somebody who’s there. Do they have a lot of turnover? Do they feel they were misled? Are they treated fairly? That tells a more important story sometimes than the contract itself.
That’s part of your research, too. Why does the place need you? Are they replacing somebody? Do people come and go? Is somebody retiring? Is there really enough work? Are they hiring several people at once and will there be enough volume? That’s really important if you want to succeed under a compensation formula.
Q: What are the chief pitfalls physicians should take pains to avoid?
A: One of the biggest pitfalls is just assuming you can trust the employer about everything. They’re selling themselves to you; they want you to come work for them and they’re making all kinds of promises. But at the end of the day, the person you are interviewing or negotiating with may not be there a year later; all you have is that written contract. So, a big pitfall is relying too heavily on verbal statements and email communications.
People always want to believe the best of their future employer. But things can change. You choose to go work somewhere and suddenly one doctor leaves and another retires and you’re the only one left and handling call all on your own. Or you were told the employer wasn’t planning on opening any new locations so you didn’t worry about specifying location, but guess what? They were acquired and the buyer has a new location at which you are now being required to work.
It comes down to understanding and talking through the risks before you make a decision based on anything that’s not spelled out in the contract.