Forming a long-term relationship with a primary-care physician is the most important thing a patient can do to obtain better medical care. That’s according to 76 percent of doctors surveyed in a Consumer Reports poll a few years back.
While that poll was taken as President Obama’s health-reform law was being put into place, the importance of a long-term relationship with a patient is something most doctors emphasize on a consistent basis, says Dennis Hursh, an attorney who has provided legal services to physicians for more than three decades and is the author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement.” (www.TheFinalHurdle.com).
“But that long-term relationship may be in jeopardy if your doc feels tied to an unfair contract,” he says. “Let’s put it this way: Are you a better employee when you’re happy or at least content with your work circumstances, or when you’re consistently dissatisfied? I think we’d all prefer our health in the hands of a happy doctor.”
Doctors are brilliant people who have had to cram plenty of information into their professional skillset. But one thing they’re not taught is contract negotiations, and those right out of medical school are particularly vulnerable to bad contracts, he says.
As a doctor’s advocate, Hursh offers four considerations physicians should keep in mind when negotiating a contract.
• The “Standard Physician Employment Agreement” is a mythical creature. Most likely, few other physicians have signed the exact “standard physician employment agreement” that the recruiter/office manager/department head puts in front of doctors. Every employer is willing to tweak your agreement.
“I have negotiated literally hundreds of physician employment agreements, and I have never, in over 20 years of practice, had an employer refuse to change something,” he says.
• Demonstrating a spine is not a negative character trait for a physician. Many physicians seem to want to impress their new employer with their willingness to be a team player. While you needn’t pound the table during negotiations, you don’t want to be the victim of a one-sided deal. Recruiting a physician is expensive and time-consuming. It’s best for both the employer and the physician to arrange a deal that is tolerable in the long-term.
• Consider an attorney. There are a few problems with doing it yourself. The biggest is that you don’t know what you don’t know, Hursh says. Sure, you can learn more on your own, but you may not catch the legal significance of some of the language in the agreement. In addition, having an attorney be the bad guy helps smooth future relations with the employer. A good attorney will always present your case as if the attorney is asking for the concessions, not you. In addition, getting the employer’s attorney involved is often the quickest way to getting substantive changes to the agreement.
• After working so hard in medical school, why sell yourself short now? Every year, Medical Group Management Association (MGMA) lists the various percentiles of physician compensation and productivity. Coming out of training, it isn’t reasonable to expect to hit the 90th percentile of compensation. But, you also shouldn’t be stuck at the 10th percentile. Knowing what physicians in your specialty earn, and the productivity expected of them, is the first step in getting a fair physician employment agreement.
About Dennis Hursh
Dennis Hursh, author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement,” has been providing health-care legal services for more than three decades. Since 1992, he has been managing partner of Hursh & Hursh, P.C., http://www.PaHealthLaw.com, a Pennsylvania law firm that serves the needs of physicians and medical practices. He is a member of the American Health Lawyers Association, where he is involved in the Physician Organizations Practice Group.