Things to ask in contract negotiations

[objleakT]

Hi guys,

About to receive my first LOI. What are some “musts” that I need to address when negotiating my first generalist contract?

thank you in advance

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[anonperson]

Hi guys,

About to receive my first LOI. What are some “musts” that I need to address when negotiating my first generalist contract?

thank you in advance

Malpractice tail coverage. Who pays it. Larger health systems will usually pay it. Smaller groups will stick you with the bill. To give you can idea, a tail can be $50k to $100k depending on how long you've been in practice. You don't want to be stuck paying your tail because it can handcuff you to a bad job.

What is the termination clause? Can you or your employer terminate the contract with or without cause with the appropriate notice. Notice can be 60 to 90 days typically. If the job sucks and you find a better opportunity, you want to be able to give notice and peace out.

Is there a non compete clause if you leave. In some states this is illegal but in others it is fair game. Try to avoid having this in your contract.

Typically first year or two is guaranteed. What is the pay set up after the guarantee? Is it dollars/rvu or based on collections etc.

Relating to the above. If you are paid on collections, how do new patients get distributed. Do the senior docs get the patients with well paying PPOs while you're stuck with medicaid patients?

Do you get admin time to catch up on paperwork, results etc.

Who schedules surgeries, c sections, inductions etc.

What is the call requirement? Can this change or is this set in stone barring any unusual circumstances?

What is the expected clinical volume expected? Some groups are happy with 20 to 25 in a full clinic day. Others want at least 50 in a day (yes, this is true).

CME?

PTO?

 

[objleakT]

Malpractice tail coverage. Who pays it. Larger health systems will usually pay it. Smaller groups will stick you with the bill. To give you can idea, a tail can be $50k to $100k depending on how long you've been in practice. You don't want to be stuck paying your tail because it can handcuff you to a bad job.

What is the termination clause? Can you or your employer terminate the contract with or without cause with the appropriate notice. Notice can be 60 to 90 days typically. If the job sucks and you find a better opportunity, you want to be able to give notice and peace out.

Is there a non compete clause if you leave. In some states this is illegal but in others it is fair game. Try to avoid having this in your contract.

Typically first year or two is guaranteed. What is the pay set up after the guarantee? Is it dollars/rvu or based on collections etc.

Relating to the above. If you are paid on collections, how do new patients get distributed. Do the senior docs get the patients with well paying PPOs while you're stuck with medicaid patients?

Do you get admin time to catch up on paperwork, results etc.

Who schedules surgeries, c sections, inductions etc.

What is the call requirement? Can this change or is this set in stone barring any unusual circumstances?

What is the expected clinical volume expected? Some groups are happy with 20 to 25 in a full clinic day. Others want at least 50 in a day (yes, this is true).

CME?

PTO?

Thank you so much! I really appreciate it

 

[Lost in Translation]

Malpractice tail coverage. Who pays it. Larger health systems will usually pay it. Smaller groups will stick you with the bill. To give you can idea, a tail can be $50k to $100k depending on how long you've been in practice. You don't want to be stuck paying your tail because it can handcuff you to a bad job.

What is the termination clause? Can you or your employer terminate the contract with or without cause with the appropriate notice. Notice can be 60 to 90 days typically. If the job sucks and you find a better opportunity, you want to be able to give notice and peace out.

Is there a non compete clause if you leave. In some states this is illegal but in others it is fair game. Try to avoid having this in your contract.

Typically first year or two is guaranteed. What is the pay set up after the guarantee? Is it dollars/rvu or based on collections etc.

Relating to the above. If you are paid on collections, how do new patients get distributed. Do the senior docs get the patients with well paying PPOs while you're stuck with medicaid patients?

Do you get admin time to catch up on paperwork, results etc.

Who schedules surgeries, c sections, inductions etc.

What is the call requirement? Can this change or is this set in stone barring any unusual circumstances?

What is the expected clinical volume expected? Some groups are happy with 20 to 25 in a full clinic day. Others want at least 50 in a day (yes, this is true).

CME?

PTO?

Thanks for this.

What are your thoughts on asking a [private] practice if they have received any interest in being bought out by XYZ conglomerate in the region (or nationally by private equity as seems to be becoming more and more common)? Would that be somewhat of a taboo topic? Would that information even be shared?

I'm a couple of years away from looking for attending jobs but I fear that by the time I get there, the economics and business model behind the field will have changed.

 

[bikelady]

Thanks for this.

What are your thoughts on asking a [private] practice if they have received any interest in being bought out by XYZ conglomerate in the region (or nationally by private equity as seems to be becoming more and more common)? Would that be somewhat of a taboo topic? Would that information even be shared?

I'm a couple of years away from looking for attending jobs but I fear that by the time I get there, the economics and business model behind the field will have changed.

Doesn't hurt to ask but it will very likely fall under a nondisclosure agreement while they are negotiating their terms, so they may not be able to tell you if they are.

 

[anonperson]

Thanks for this.

What are your thoughts on asking a [private] practice if they have received any interest in being bought out by XYZ conglomerate in the region (or nationally by private equity as seems to be becoming more and more common)? Would that be somewhat of a taboo topic? Would that information even be shared?

I'm a couple of years away from looking for attending jobs but I fear that by the time I get there, the economics and business model behind the field will have changed.

Feel free to ask.

As above, there could be a NDA. Also, they could flat out lie.