Details that should be included in the contract

[shantster]

I am reviewing a contract for an academic position, and it is very general and lacking on specific details. A number of things refer to the hospital system's medical group policies (such as benefits, vacation and CME time), which I will ask for, but some things regarding work expectations and compensation structure are not detailed in the contract despite having talked and emailed about these details. I will follow-up Monday regarding the lack of details in certain areas and wanted to get a comprehensive list of things that should be included in the contract.

 

Thus my list includes:

*Expected RVUs to meet base salary after the guarantee

*Expectations in order to obtain yearly performance incentive

*Benefits - Retirement accounts with match, health insurance, group disability insurance

*Days off for holidays/vacation/CME

*CME funds

*Professional liability coverage, including tail coverage
What else should I make sure is in there?

 

I do plan on having a lawyer review prior to signing but want to wait until I have more specific points addressed before moving forward with a lawyer's review.

[redsand]

I would definitely like to hear what others have to say on this as I expect to be negotiating a contract within the next year.

- Call frequency, and is there compensation for taking call?

- Moving expenses/signing bonus, if there is any

- Is the job eligible for PSLF? (if that is important to you)

- Protected time for teaching, or what is your percent FTE for clinical work vs. teaching/research

- How many hours per week is 1.0 FTE? (I know of an academic department where it is 50 for people without administrative titles, and 60 for people who were in positions like program director/associate program director/medical student rotation director...and people worked more hours than that across the board due to clinical demand, though 50/60 was what was in the contract)

- You might want to ask/review what the institution's requirements for academic promotion are, which might not be specifically in the contract itself.  After a certain number of years, are you expected to have met certain publication/research requirements to be promoted to an associate professor level?  And if you don't meet them, do you just stay as an assistant professor or do they not want to employ people who aren't going to try to be promoted?

[pulmdoc]

Key points that need to be included in every contract (or have a solid legal reason for not including them)

1) Non-compete clause. Ideally you would not have one, however they are enforceable in most states and employers are unlikely to give them up. Instead, focus on trying to limit the radius so that you would not be forced to relocate for a new job if you wanted to leave. I would also try to negotiate that the noncompete radius is specialty specific; you don't want your plastic surgery practice blocked by a primary care office owned by your former employer. Now, if there is not a noncompete clause in the contract as given, I certainly would not bring it up!

2) If there is a signing bonus, under what circumstances does it have to be repaid-separation before 12 months in my contract.

3) If there are performance bonuses, what criteria are used to determine the bonus and the schedule for paying the bonus. A friend of mine lost a 75k bonus check because he didn't realize that the bonus was not pro-rated and he left for his new job 2 weeks before he would have been eligible for the bonus.

4) If working for a large employer, any requirements for outreach clinic, where outreach clinic is located, and any compensation for doing outreach clinic. One place I interviewed expected me to do weekly clinic 100 miles away from the main clinic-this was not brought up until I asked about it.

5) How call schedule is determined. If a large academic center, expect something generic like "in accordance with department policy." Make sure you ask your department head how it works.

[CM]

pulmdoc wrote:

Key points that need to be included in every contract (or have a solid legal reason for not including them)

1) Non-compete clause. Ideally you would not have one, however they are enforceable in most states and employers are unlikely to give them up. Instead, focus on trying to limit the radius so that you would not be forced to relocate for a new job if you wanted to leave. I would also try to negotiate that the noncompete radius is specialty specific; you don’t want your plastic surgery practice blocked by a primary care office owned by your former employer. Now, if there is not a noncompete clause in the contract as given, I certainly would not bring it up!

2) If there is a signing bonus, under what circumstances does it have to be repaid-separation before 12 months in my contract.

3) If there are performance bonuses, what criteria are used to determine the bonus and the schedule for paying the bonus. A friend of mine lost a 75k bonus check because he didn’t realize that the bonus was not pro-rated and he left for his new job 2 weeks before he would have been eligible for the bonus.

4) If working for a large employer, any requirements for outreach clinic, where outreach clinic is located, and any compensation for doing outreach clinic. One place I interviewed expected me to do weekly clinic 100 miles away from the main clinic-this was not brought up until I asked about it.

5) How call schedule is determined. If a large academic center, expect something generic like “in accordance with department policy.” Make sure you ask your department head how it works.

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[nachos31]

CM wrote:

Don’t assume anything. Get it in writing.

Click to expand...

Very true. I found that as I was receiving contracts with various offers (all employed primary care positions with large organizations) that their contracts were very vague and I was challenge them on that and was always told, "this is our generic contract and details are worked out at the clinic level," which was very frustrating. For the offer I ended up taking, I did stipulate some specific language but it was like pulling teeth.

Everyone acts like you're being a petty child when you ask for things in writing so it's nice to say that your lawyer said you had to have this is writing (heck, even if you don't have a contract lawyer). Alternatively, I assume telling them you got burned at your last job (I couldn't since I was coming out of residency--haha, talk about a super vague contract without hours or call stipulated...!) and thus are playing it safe.

The former approach was very helpful for my wife's contract as we were more worried about contract "abuse" given the known rigidity of her employer and their very vague language. We did use have a contract group review it and they helped us work in lots of little language modifiers to make decisions a mutual process so the employer couldn't just dictate that she was now going to go work at a different clinic, etc. This gave us a lot of piece of mind. Not to mention we got rid of her absolutely absurd non-compete clause in its entirety and got her a signing bonus which they were not originally offering.

[redsand]

Oh, the outreach clinic is important too.  I had a job before where I had to occasionally fly and then rent a car--the employer would pay for the plane ticket, the car rental, and would reimburse me for gas.  But any sort of car damage/insurance was not paid for!  I could have either purchased car insurance from the company (which would not be reimbursed) or just use my own, or that is how it was presented to me at the time.  Currently in a different job where there is an occasional outreach clinic, and we drive, and in this job I am never required to be the driver.  But it does raise the question, if a person is driving other coworkers to a clinic site as part of his/her job, would a person need to get some sort of car insurance that would cover work-related costs (and therefore in the contract, who pays for the costs associated with the outreach clinic)?

[Craigy]

Generally speaking anything that is vague you really want to be spelled out.  Certain items like rvus etc might not need to be included if you are getting a guaranteed salary and have no performance incentives.  It's also good to have a clear term and clearly stated methods for terminating.

No only days off but what what your days on might look like too.  5 days a week could theoretically be 120 hour shifts

Specifying who pays for the insurance rider on a car rental might be a little overkill, you don't want to scare them off from hiring, but if you're going to be driving a rental a lot, it very well might be important.

There are several good books out there.  I read one recently that WCI reviewed, The Final Hurdle, which had a lot of good tips.  https://www.whitecoatinvestor.com/the-final-hurdle-a-review/

You should definitely hire an attorney (preferably in your state) to help you review the contract.  If someone approached you with any other multi-year, multimillion dollar contract you'd probably want an attorney to look it over before you signed, and an employment contract is no different!

[redsand]

Yes, I agree, it's not so much about the absolute cost of the insurance on the car rental.  It's more related to a situation where a physician is going to occasional outreach clinics to fulfill his/her job duties, and he/she is expected to drive a staff member or two from the hospital to the outreach clinic site (and back to the hospital at the end of the day); if the person gets into an accident, and if there were any damages that cost money, would the individual's personal car insurance (+ umbrella?) even cover it, or would the insurance company deny it based on the person having individual coverage but not business-related car insurance?  Would the institution cover the damages if there was a car accident that occurred during the course of performing his/her job duties?  If not, that's a huge cost that is shifted to the employee.

As someone who has only ever been a W-2 employee, I just have car insurance for my own personal use, and fortunately I don't have to use my car for work in my current job.  I honestly never thought about commercial vs. individual insurance until recently.  I hadn't yet heard of WCI when I was asked to use my personal car insurance for car rentals during outreach clinics at my previous job.

I don't know if there might be a way to phrase in a contract that if there are any work-related transportation needs, they will be covered by the employer.  It's less about the cost of a single-day price of rental car insurance coverage.

[childay]

I expect like at your facility many places have common benefits packages for physicians ie: CME, vacation, retirement matching that may not be negotiable. But IMO here are the most important things to focus on.  This would be for a non-academic contract as I have no experience with that.  These should be crystal clear in the contract:

1. noncompete, if any

2. how you are compensated, and any limitation

3. malpractice tail, if any

4. termination with cause, or without

5. call requirements

 

[pulmdoc]

Always, always get it in writing. If it's not in writing, assume it doesn't exist.

[resident_1]

1. Ask for specifics about moving expenses. How much toward flights, coming out to look at homes/rentals, how much for movers. Do you need to pay back relocation expense if you leave early. For example I was offered $9k relocation money, but could only use $5k for movers/shipping cars. Basically movers is the largest expense (at least $10k for cross country move).

2. Remember bonuses are taxed differently.  Can you ask them to include the "bonus" in your regular pay.
3. inquire about retirement plan offered (and vesting schedule). If you are in a pension plan, what % is being taken from your pay (my training institution was 14% of pay mandatory contribution with employer contributing another 6%).

--definitely non-compete details (I didn't think before of inquiring whether its specialty specific). One of the most ridiculous non-competes is for pediatricians hired by Nationwide Children's Hospital in Columbus, OH.  Its 100 miles (you will have to leave the state with this one). http://www.dispatch.com/content/stories/local/2016/02/07/nationwide-childrens-hospitals-non-compete-clause-for-doctors-stretches-100-miles.html

 

 

 

[pulmdoc]

I have seen and heard of many many ridiculous non-compete clauses it's a topic near to my heart to try and help other folks avoid getting screwed by them. My "favorite" was a hospital income guarantee position in which the physician group demanded a non-compete radius larger than the geographic radius the hospital would force me to stay in. When I pointed out that non-competes were illegal under Stark in this situation and that I would have worked for negative money (having to pay back all guarantee money plus taxes) if I left, their reply was "well, our lawyer says it's fine." Needless to say I didn't take the job.

My second "favorite" was a doc who joined a solo practitioner who had a (unknown to him) bad habit of running associates away. When he left a few months later, he ended up commuting 90 miles each way for 2 years. Non-compete clauses are illegal in his state.

[shantster]

Thanks for all the feedback. This has been a good discussion with additional items to think about.