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4 Steps to Consider When Signing a Contract as a Doctor

Amanda B. Hill, JD teaches us to negotiate with power, but not sweat the small stuff.

November 20, 2023

There is not a day that goes by that a client doesn’t tell me they were sent a contract, after months and months of waiting, just to be told they have only days to sign it. Over the weekend.

And oh, by the way, it’s via Docu-sign so you can’t even make edits. When you say you want your lawyer to look at it, they say “it’s not negotiable.”

Sound familiar?

There is certainly a middle ground between chopping up a contract and having your attorney redline the thing to death and then just signing it as it passes through your email inbox. But what can you feasibly get away with negotiating, and what should you leave on? My overall advice is to pick your battles and fight for what’s really going to hurt you.

Sure, they claim you must follow all their policies, and you haven’t seen every policy. You’d like a little more “upon mutual consent” language thrown in. You think you need a little more CME reimbursement money.

Seriously, folks. Focus on the big stuff.

 

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First, always find the back door.

The first thing any doctor should do when negotiating a contract, whether it be a physician employment agreement or a subscription agreement, is to know how to get out.

I’ve said this many times – if there is no way out of a contract, this is a critical edit you simply must make.

It’s okay to agree to not terminate in the first year, but don’t lock yourself into a five year contract with no way out.

You never know what life will throw your way.

 

It's okay to agree to not terminate in the first year, but don't lock yourself into a five year contract with no way out. Share on X

 

Next, see what’s triggered upon your exit. 

Sit down, review your contract, and start to go over all the things that are going to be “triggered” by you leaving.

Sometimes there is a 90 day notice in employment agreements or even a year long notice in some partnership agreements, so you need to be aware of this in advance.

Look at your contract.

Is it a clear exit without cause provision for 90 days notice, for example, or does your agreement require you to show some sort of breach?

If you leave in the first year, for example, do you have to pay back the sign-on bonus?

 

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Are you required to pay tail?

Is the non-compete fair or reasonable?

These are things you can certainly negotiate BEFORE you sign so you aren’t facing a tremendous financial burden on the way out.

I have seen doctors leave a job and end up owing the practice $50K and more due to these “clawbacks” in their contract.

 

Third, negotiate your salary and bonus based on the market

The kicker to negotiating your salary and bonus is to be well educated on what the market values are.

Do your homework.

Find access to MGMA numbers so you aren’t going in hot with “my buddy in residency got X” or “I just feel I deserve Y” but you are basing it on real market factors.

The fact is, if they are offering you $250K and that falls at 40% of MGMA for your specialty in your region, you absolutely have room to push back.

 

"I have seen doctors leave a job and end up owing the practice $50K and more due to these "clawbacks" in their contract."

 

Lastly, push back on the dreaded non-compete

If you live in a state where non-competes are still legal, you simply must make them reasonable in time and scope.

If it’s for a year and five miles around your practice, fine, but be careful about non-competes wrapping around “all the practice locations” and all of a sudden there will be nowhere for you to go. Limit the range to the one location where you work over 75% of the time.

 

There may be strange provisions in your contract that you may still want to push back on, but these are the big ones.

Always remember that contract negotiation comes down to LEVERAGE. You must find it and use it.

What sets you apart from the other physicians interviewing for the same job? What can you use to show the Employer that you are the perfect fit, the perfect hire, the perfect person for the job? This gets you movement on your contract.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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