Comprehensive 15 Point Checklist when Negotiating Florida Physician Employment Contracts 

How do you negotiate a physician's job? 

Experienced physicians know that the first job will not be their last, first contracts need to be looked at very carefully to plan ahead for how their future employment opportunities will be impacted. It is an awakening when a physician resident comes out of school and lose the immunity and cocooning that they had during residency. In reality, physicians in the working world are susceptible to lawsuits, licensure complaints, employers who are negligent in carrying out their processes, and often find themselves handcuffed into non-compete agreements that impact their future employment prospects.  

There are many things to negotiate in a Physician Employment Contract.  The terms include:  

1. Important - Compensation Calculation: Is compensation based on a set salary or net revenues? Is performance based on wRVUs or profitability of the business? After-hours services compensation? Earning a bonus based on performance and attracting new patient business?  If it is important, then it needs to be specified in the physician employment contract. In the case of net collection of revenues it will be important to know and have access to exact and precise revenue reports.  If your compensation is based on salary, it will be important to see salary surveys for physicians.  Ask our firm for the salary surveys we have, and we will forward them to you.  Similarly if your compensation is based on a performance metric, it will be important to have transparency to the measurement metric by obtaining operational reports that track it. Whatever your performance metric, before you sign the contract, ask your future employer of what kind of reports you can expect to see in the future.  Also make sure that the payment is made at regular stated intervals.
   Doximity Physician Compensation Salary Survey 2023

   Doximity Physician Compensation - Salary Survey for year 2023
2. Important - Malpractice insurance: Will the employer provide it? Does it include tail coverage, nose-in coverage, and differences between claims made and occurrence based coverage. If it is important, then it needs to be specified in the physician employment contract. Typically the insurance is claims made insurance, occurrence based coverage is more expensive.  
3. Minimum Obligations of the Employee: What is the physician obligated to perform: based on number of days worked or number of patients seen, wRVU's performed, or revenues collected. If it is important, then it needs to be specified in the physician employment contract. 
4. Important - Minimum Obligations for the Employer: Maintaining a support staff, a reliable Electronic Medical Record (EMR) system, scheduling, training, relaying patient messages, prescription refills (controlled and non-controlled), position on patient abuse of the professional.  If it is important, then it needs to be specified in the physician employment contract. 
5. Location: Will all the locations that the employer owns or is affiliated with apply to the non-compete? Which location is your primary location? Typically you want to ask for a single location to apply, wherever you did majority of your work and that was your regular place of work in the last 12 months.
6. Hours: What days and times will the physician work? Is the call schedule fair? Is it in-house call or home call? Call compensation? If it is important, then it needs to be specified in the physician employment contract. If you are going to be on call, it is important to get in writing that the call will be administered equitably among all the physicians in the practice.  
7. Paid time off (PTO):  How many vacation days, sick days, CME days, family medical leave, holidays set and calculated. If it is important, then it needs to be specified in the physician employment contract. Many times the CME days are not specified, and it is important to know if you have 2 or 5 days of paid for CMEs.  
8. Professional Expenses: Continuing Medical Education (CME), Annual Dues of various associations and licenses, obtaining certifications, related travel and lodging for annual meetings, journals, books, personal professional equipment (i.e. stethoscope, uniforms)? If it is important, then it needs to be specified in the physician employment contract.  THis reimbursement can be subject to the employer's reimbursement policies, so it is important to know it upfront.  
9. Non-solicitation: Can a physician take other employees? Contact vendors, consultants or pharmaceutical reps?  If it is important, then it needs to be specified in the physician employment contract. 
10. Confidentiality of business processes: What is the unique process the employer uses? If it is important, then it needs to be specified in the physician employment contract. 
11. Patient records: PHI - who is the custodian of records? And will the physician get access to them post-employment if there is a complaint against the license? If it is important, then it needs to be specified in the physician employment contract. 
12. Hospital Privileges: is the employment contract coterminous with hospital privileges? What happens to privileges if the physician leaves the employer? If it is important, then it needs to be specified in the physician employment contract. 
13. **Right of Termination: who can terminate with cause and without cause? How many days notice? If it is important, then it needs to be specified in the physician employment contract. 
14. Very Important - What happens post termination: earned paid time off, return of records and equipment, access to patient records if a question comes up later. If it is important, then it needs to be specified in the physician employment contract. 
15. Very Important - Non-Compete: who or what entity is defined as a competitor? How many miles from what location? What area of medicine/specialty? Is the non-compete nullified if terminated without cause? If it is important, then it needs to be specified in the physician employment contract.  Florida does allow non-competes, although there is new proposed legislation to do away with it.  

What does it cost to Have an Attorney Review a Physician Employment Contract? 

Our firm reviews physician employment contracts: 

- Option 1 - for $875 fixed fee, and we will give you insights on what and how to negotiate, and conduct a background check on the employer. Our services include:

• Answering all your questions, 
• Coaching you on what you can and should negotiate, and what you should stay away from negotiating, 
• Conducting a background check on your prospective employer, and you if you want us to.
• Proposing language of what to change and how it can be tweaked to your advantage.  

- Option 2 - for $3,450 fixed fee, some physicians prefer for us to negotiate their contracts, because they do not want to strike a bad chord with their prospective employer.  It makes their life easier once they begin employment, to minimize any hard negotiations that may impact people's feelings.  Hence, Physicians retain our firm to do the negotiations on their behalf.  

- Option 3 - If you just wish to get some substantive legal input and are not ready to retain a law firm, you may consider making a 1 hour appointment  to discuss the specifics of your situation, for a prepaid legal fee of $475 legal, click here: 

Here is an informative webinar on How Experienced Physicians Negotiate Employment Agreements.

Hosted by the South Florida Hospital News and Reporter.

 Reasons to retain an attorney: 

Most physicians do not understand the intricacies and ramifications of physician employment agreements. To review and negotiate a contract that does not limit the future of a young physician, it is best to get legal help earlier in the process to navigating the 5 most important things. 

• Long lasting consequences of Non-compete  
• Compensation is not clear or fair market value  
• CME (Continuing Medical Education) benefits are not clearly listed – (association dues, license dues, course registration, and travel expenses) 
• You may be restricted from serving on certain insurance panels 
• You may have to relocate out of the area. 

Ben Mirza is not only an attorney but was formerly a CPA, with a masters of public health.  There are over 100,000 attorneys in Florida, less than 500 of whom were ever Certified Public Accountants, and even less have the trifecta combination of law/finance/strategic healthcare background.   The benefit of this combined and layered skillset works well for clients who want an advocate to approach the issues holistically.