When you’ve decided on your first physician job out of residency or fellowship training and are getting your first look at the employment contract being offered, these phrases might come up as it’s sent over:
“This is our standard contract.”
“We can’t change it.”
“The terms are pretty much set in stone.”
What they’re telling you, in short, is that the contract is non-negotiable. But for physicians, that shouldn’t be the end of the conversation, according to experts at Resolve, a contract review and negotiation firm specializing in physician employment. Even, they advise, if it’s true that much of the contract cannot be altered, there are more opportunities inside than you might expect.
Physicians are “likely going to hear that your organization has a standard contract that they do not want to change and that they never change,” said Kyle Claussen, CEO of Resolve, during an AMA webinar on physician employment contracts. “That’s usually not true.”
That’s why it is crucial for physicians to understand where they can get movement in areas such as relocation reimbursement, signing bonuses and professional duties so they can focus their efforts where they are most likely to yield results.
“Roughly 85% of the contracts that we see have some type of change to them,” Claussen said. “Whether that’s numbers or language, make sure you're pushing on things that are important to you.”
The AMA has teamed up with Resolve to provide AMA members an exclusive discount on services that include custom contract review. Resolve offers personalized legal expertise to help physicians secure the best employment contract terms, no matter where they are in their careers. Ready to access your AMA-member Resolve discount? Learn more now.
Physician contract changes can typically be made
Claussen said that healthcare employers are not being deceptive when they say that the contract they offer is largely the same from physician to physician within their organization.
“It’s very true that they [employers] don’t want to change it [a standard contract]. It’s very true that they likely have a standard template,” he acknowledged. But, “from where we sit, for physicians who are informed, physicians who are going through the negotiation process the right way, it’s very likely that you're going to get some adjustments made.”
A report on physician salary data (email registration required) released this year by Resolve draws from more than 4,000 physician contracts that their experts reviewed, coming from all 50 states and in 116 specialties and subspecialties. Physicians at any stage of their careers can leverage the data in the report to guide their job searches and determine what the trends are for their geographic area and specialty.
“This information is out there. You’ve got to go find it, get access to it. That’s what we do for clients at Resolve: Making sure you’re aware,” Claussen said. “So, as you’re looking at contracts, you just know if they’re fair or not.”
And physician job seekers also should explore the JAMA Career Center®, which presents physician career opportunities, news and information relevant to the full spectrum of medical practice. Search for physician jobs by specialty and location or browse all of the physician jobs by specialty.
Where the contract alterations are
Healthcare employers, particularly larger ones, may want to standardize their physician-employment contracts for a variety of understandable reasons—among others, that it removes the perception of inconsistency or bias and that it lowers their legal and compliance risks.
Therefore, physicians need to look for areas where the contract may naturally be more flexible.
Claussen said those can depend on a physician’s specific situation, “but we often see wiggle room on any recruitment incentive as a starting point. Things like signing bonuses and relocation allowances, those tend to be very negotiable.”
Additionally, there may be language in the contract that is specific to your physician role. Because those aspects of a contract will naturally be different from physician to physician depending on specialty and other factors, the terms may be less set within large healthcare organizations that use standardized employment contracts.
“When we talk about duties, responsibilities, things that are unique to your specialty as opposed to a different specialty or a different location—those things matter,” he said. “Most of the time, you can get some movement on that if you’re willing to push.”
Physicians might also want to seek an opportunity to reassess their contract should circumstances change.
“A lot of physicians think that there’s going to be a renegotiation that happens no matter what at the end of the term” of their contract, Claussen said. “Most contracts that we’re seeing now automatically renew. What that means is that if you don’t raise your hand or if you don’t say, ‘Hey, I need to renegotiate my rates,’ the contract rolls forward and there’s never really a meeting that’s going to be set unless the organization decides to just have one.”
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The limits of physician contract negotiation
Physicians also should know when they are unlikely to see as much movement from a potential employer on a job contract.
“There are some things that are going to be less negotiable, let’s say, malpractice insurance or health insurance,” Claussen said. “Something that they’re buying for the entire organization may be harder to get them to change terms on that for you, specifically.”
It is possible, however, that the employer has built in a range on even those types of terms.
“Items like dollars per RVU [relative value unit] and base salary, some of those are set at an organizational level,” he noted, while adding that “we do find that there’s a lot of flexibility, though, still, within those categories.”
Either way, it is important to have information about the industry standard for your contract, and to secure expert review to see how your contract will play out in the future.
“It’s not necessarily that we’re telling you anything’s bad or that you have to negotiate and push, but you need to know that if your conversion factor, let’s say in urology, is offered at 55 and the current market is 70, that’s a pretty big delta,” Claussen said. “It’s a pretty big gap, and you’re going to have to understand why, maybe based on other contract terms, why that’s being set where it is.”
With so much of a physician’s compensation and earning potential tied up in factors that require careful negotiation, it’s more important than ever to have experienced professionals review any employment contract before you sign.
AMA members receive a 20% discount on all Resolve services. With Resolve, you get:
- Custom contract review for any type of employment contract.
- Access to experienced attorneys who can negotiate on your behalf.
- Real-time, comprehensive compensation data and benchmarks to help you understand your worth.
- An instant contract-review option, powered by Resolve’s attorney-trained AI model.
- Free tools such as a contract scorecard to give a quick overview of where your contract stands.
Ready to access your AMA-member Resolve discount? Learn more now.
And if you’re seeking your first physician job after residency, get your cheat sheet now from the AMA.
