1 The first tip is if you do not ask, then you will not get. Too many physicians accept the “standard” contract, sign it without a careful review, do not ask nor negotiate more favorable terms, and do not pay the $500-$1000 to have an attorney review it.
2 It is harder to get major changes in subsequent contracts then it is in the first one. But even in subsequent contracts, it is easy to ask for things like pay raises, more paid time off, more paid CME, and if on salary-to ask for fewer shifts per year. You will be surprised to find that the human resource people, or whoever reviews your contract, frequently will grant you these increases, BUT ONLY IF YOU ASK!
3 If your hospitalist group all have their contracts renew at once, it is worthwhile getting together to try and negotiate a better deal for all of you. You can share the cost of the attorney to review for you (and possibly negotiate for the group).
4 Compensation: Read the salary survey results in www.societyofobgynhospitalists.org . Have a good idea what other OB/GYN hospitalists are being paid in the geographical area. Just call them up and ask. Most colleagues will give you a general idea. After all, you would do the same for a newcomer, correct?
Most OB/GYN hospitalists get either hourly pay or salary for so many shifts per year with only the exceptional position also having productivity factored in. Beware “bonus” additions to salary—be sure they are easily obtainable (ask currently employed hospitalists if they have received their “bonuses”).
5 Watch out for restrictive covenants—how long and how large a geographical area (footprint)? Are they restricted to OB/GYN hospitalists versus general OB/GYN in private practice? Will you have to leave the area if this hospitalist job does not work out for you?
6 Malpractice insurance: Do not sign unless employer provides occurrence malpractice insurance or claims made with employer paying “tail coverage.” If you are working part-time and pay for your own malpractice insurance, ask for an increased hourly wage because the hospital (or employer) does not have that expense in your particular case.
7 Especially with your first contract, engage an attorney who concentrates his or her practice on physician employment agreements. Let them negotiate the deal for you without you alienating your future employers. You can let the attorney be the “bad guy.” You can just say, “I don’t understand this legal stuff,” or “My attorney is making me ask for…”
8 Ask for a sign-on bonus and/or ask for moving expenses (why not? They can just say no).
9 Negotiable costs: Employer paid CME, medical staff dues, DEA fees, transportation costs, and medical Society dues are all negotiable, while disability, health insurance, and retirement packages are generally less negotiable.
10 Other negotiable expenses: Payment of previous malpractice tail insurance, debt, and/or loans can sometimes be negotiated over years of service (generally at least three years).
11 Not-for-cause termination: 90 days is common; try for 120 days—the duration should be the same for both you and the hospital (employer).
12 If you are working for a staffing company, will there be “ownership” opportunities in the future-stock options, etc.?
As an independent contractor, I have been negotiating my own contracts for over eight years (using my accountant as an advisor) I have taken some of these ideas from a recent book I reviewed: The Final Hurdle: a Physician’s Guide to Negotiating the Fair Employment Agreement by Dennis Hursh, published 2012.
Information for Hospitalists on Legal Issues, Contracts, and Negotiation:
A sample hospitalist contract:
I, of course, am not an attorney and I am not offering legal advice here or anywhere, but I have spoken to a lot of different OB/GYN hospitalists about their contracts and would be glad to share my experience if you would like to contact me.
Good luck in negotiating your own contracts!
Rob Olson, MD, FACOG