Physician Contract review services

[Nebulus2017]

Hi all,

Current fellow here. Interviews have begun and I anticipate several offers within the coming 1-3 weeks.

Does any one have any recommendations for a physician contract review attorney and/or service? What sort of prices have you guys paid for such services?

Also, when it comes time for negotiations, would you recommend that I perform the negotiations myself, or have the attorney be the intermediary? I've seen services that offer it, and I can see pros/cons for both.

Thanks a bunch!

[jfoxcpacfp]

We recommend Contract Diagnostics (a vetted advertiser on this site). I don't have a recommendation for who does the negotiations as I don't know how good you are at them  

[wally world]

Congratulations on nearing the end of training!

I would imagine that the "right" answer depends on your field & the types of groups/practices that you are considering. While it has been a while since I went through the process, I'd like to share some of my experiences that may have some relevance to you.

Re: contract review, I don't think it would ever hurt to have someone (Contract Diagnostics as mentioned by Johanna above, etc) review the contract so that you can fully understand what you are getting yourself into (especially in private practice land). Understanding things like buy in calculations, buy out calculations, non-compete clauses, revenue sharing, overhead splits, opportunity for ancillary revenue participation, etc can be tricky especially if you've never done it before. I would imagine that professional review can help compare contract to contract as well. You should definitely be aware of starting salaries in your field (which can vary widely based on geography and type of practice) & a group that reviews a large number of contracts will have insights not available to most of us.

What you can do with the information is another issue entirely. When going through my first job search during fellowship, I had 2 contracts in hand (both good sized single specialty private practice groups). The attorney helped me understand some of the above mentioned issues. He sent back suggested changes in the contract to the leading group. They said they wouldn't make any changes to the language in the contract (since it "wouldn't be fair" to the other docs). They were willing to change the numbers a bit (starting salary, bonus), but that was done via phone discussions between myself and the CEO directly (no lawyer involved). They also agreed to reimburse me for the lawyer fees (since they had been the ones to suggest lawyer review, without telling me that they wouldn't change the contract very much) & added the $ to my sign on bonus. The total I spent on contract review was between $3-5k (now well over a decade ago). I got the feeling that having the lawyer speak for me would have been frowned upon. One heard stories on the interview trail about how too much back and forth led to withdrawal of offers. Apocryphal or not, I don't know for certain, but I would be cautious. If you are in a small field, most people will know each other and word can spread pretty (both about jobs and applicants!)

My second job change involved joining a very large group of employed physicians out West. The contract was barely 2 pages long, IIRC. There were just 3 blanks: Name, department, salary. The  salary range was set each year for the region based on specialty and any additional training (which added a certain %). I was told there was no room for negotiation on any verbiage of the contract (other than a little wiggle room on the salary part of things & they ultimately agreed to pay for my tail insurance purchase from my previous gig as a bonus). Not a single comma would be altered. Given this, I saved my $ and didn't have a professional review my contract. I did spend a lot of time talking to other employed physicians to make sure I understood what I was signing up for. The money was fine and the boss seemed like a good, stand-up person. At some point, there is a "leap of faith" component to such things...

https://www.youtube.com/watch?v=xFntFdEGgws

Best of luck!

[The White Coat Investor]

I haven't had any complaints about Contract Diagnostics from anyone but someone who is a competitor to them. Health care contract attorneys would argue that "you need someone who also litigates these contracts to review your contract." Not sure how strong that argument is. I think I'd rather have someone who does this all day every day. But if you're really worried, you can always do both. It's only a few hundred bucks.

[squaredroot]

As someone who just went through the process with Contract Diagnostics, everything went very smooth and straightforward.

For most of us, this is our first physician contract, so it is a little overwhelming to go trough the contract alone, always help to have extra eyes available, especially if they are specifically dedicated to physician contracts.

PM me if you want any specifics! But overall must say it definitely helped!

[Craigy]

A real attorney should be reviewing a contract, preferably a local attorney who handles contracts for a living, and preferably one who has some experience with physician employment contracts.  You don't need a litigator, but it wouldn't hurt.  It might take you awhile to find the right person, but ask around with your colleagues, attendings, etc. and they should steer you in the right direction.

Many people have positive things to say about contract diagnostics, but based off of all of what I have read and heard about them, they do not do any aggressive negotiating, and you could get stuck with a big non compete, etc.  I have no personal experience with them, but from what I gather they are more of a "make you feel good about your contract" type of business than an attorney who is going to walk you through and help negotiate the hotspots of a contract, ask for large concessions, etc.  And then depending on exactly what you're getting advice on, it may be illegal unauthorized practice of law for a non-attorney to advise you for a fee on the legal impacts of a contract.

Find someone who comes highly recommended (hardest part), and then make sure you get a quote before work begins.  Any good attorney should be able to give you a few minutes of their time and a cost estimate before you commit to spending a dime.

What a good attorney charges could be anywhere from several hundred to a couple thousand dollars.  One friend of mine recently spend $700 with an attorney and it was worthwhile to get several meaningful areas of a contract tailored to protect his needs.  Most attorneys are going to be by-the-hour on this, so it really depends on how much back-and-forth you have, and it doesn't take more than an hour to review a contract, maybe an hour and a half or two for some 50+ page monstrosity.

Also it depends on the contract itself.  You might not even need a review depending on how simple it is.  And some employers don't even have a contract to sign, e.g. many governmental entities like the VA.

Doing the negotiations, that's up to you.  If you find a good attorney who likes to handle it, and can do so efficiently, by all means have an intermediary.  But no scrupulous employer should balk at your using an attorney to review your contract.