New Year New You New Contract!

We set so many goals for ourselves in the new year: join a gym, dry January, start meditating, etc etc etc. But what about your job? Your contract? This is often the bulk of your life and waking hours…so let’s make it count! On that note, what do I think your 2023 #1 intention should be? Know your values and your non-negotiables.

I am often asked by fellow physicians, “Is there any point in having my contract reviewed? The employer told me it’s non-negotiable.” Here are 4 reasons why my answer is always a resounding YES, you should absolutely have your contract reviewed. These tips also apply to physicians who are already established in a practice who would like to renegotiate the terms of the current contract and/or compensation.

1. If if they won’t change the verbiage, it’s important to understand the content. Contracts can be anywhere from 2 to 75 pages and there is a lot of language your employer can include in that volume. No surprises, please! You cannot assume that the employer has your best interest in mind and that this non-negotiable contract is “fair” or even “standard”. These contracts are written by the employer’s legal team and are meant to protect the interests of the hospital much more heavily than the interests of the physicians. I cannot stress the importance of reviewing the contract thoroughly with a professional so you are aware of what you are signing, agreeing to, and legally bound by. Some of the sneaky language we’ve seen in contracts:
   • Your without-cause termination clause does not take effect until you have completed 2 years with your employer. Why does that matter? Life changes often and sometimes without notice. Let’s say you start your new position and 6 months later your significant other accepts a job three states away – most likely you would be interested in moving with him or her, however this clause would not allow that flexibility. You may be obligated to spend another year and a half with your employer, bearing the stress of long-distance with your partner, before you can even submit your without-cause termination notice.
   • Malpractice does not include tail insurance. Contracts generally outline your malpractice insurance policy details, including whether it is a claims-made policy (with or without tail covered by the employer) versus an occurrence based policy. For those whose employers provide a claims-made policy without tail, providers are required to purchase their own tail insurance when the position terminates. Depending on how long you have been with the practice and your field, for some providers (ahem, OB/GYN’s beware!) this may be upwards of six figures, which is a knot in the stomach when you are not expecting that bill.
   • Your position expectations and compensation can change without notice by the employer due to a “Force Majeure”. This one seemed to come about during the COVID pandemic, when employers furloughed employees and dropped salaries abruptly (physicians included). This clause provides minimal protection to the physician in these circumstances and for anyone with hefty mortgages, student loans, or mouths to feed, an unexpected decrease in salary is a life-changing blow.
2. Everything is negotiable. A lot of the larger organizations or big state employees may have contracts that are expected to be signed by every employee, and anyone who has chosen to work with that employer has signed that exact same contract. It is not uncommon that that language cannot and will not change. However, that does not mean that your contract cannot be personalized to your position, needs, expectations, and values. Generally those personalizations are found in addendums or even under formal letterhead attachments. Your special requests can be included as supplemental legal documents attached to your “non-negotiable” contract language. This may include protected time for your research, global health work, or vacation, and often the compensation and bonuses fall under that category of negotiable. So maybe the text in the Section on compensation will not change, but that number could be adjusted from “$285,000 per year” to “$305,000 per year” without fuss!
3. You have non-negotiable points too. This goes back to our #1 intention for 2023! It is important to recognize which contractual points are most important to you and where you draw the line. Ideally you want to find an employer who is willing to acknowledge your values and share them. As physicians we go out of our way consistently to meet our employers’ needs and values, and this should be a two way street. Knowing your values and when to walk is, I feel, one of the most important intentions as a physician. Having said that, please put yourself in a position to be able to walk! Have a back-up plan, whether it’s savings, another job, or a vacation for example, otherwise you find yourself compromising on your values to meet those of the employer, which breeds resentment, dissatisfaction, and burnout. Every physician is unique and this list can go on for miles. While you’re working on those meditation and journaling goals you already set for 2023, mull over this question in that time. Some examples of physician values and when they walk:
   • Schedule: Is a 4 day work week rather than 5 day your primary goal to achieve work-life balance? If the employer digs their heals in on a 5 day work week despite negotiations, you can walk.
   • Compensation: Is a compensation below $300,000 absolutely out of the question for you due to budgeting needs? If the employer offers anything less and you cannot successfully negotiate up or agree on bonuses to make up the difference, you can walk.
   • Benefits: Do you need a contract that offers a minimum allotment of vacation time? If the employer will not include that, you can walk.
4. It doesn’t hurt to ask. Although negotiating can make your palms sweat, and asking for more compensation for example might make you feel “greedy”, “anxious”, “insert adjective here”, it can only help, not hurt. Worst case scenario is they say no and you have the same number they initially offered. Best case scenario, they agree to what you have requested and you are ahead of where you started! Asking questions and negotiating is expected, so take the time to do your due diligence, and ask for what you need. Although we have seen physicians walk from contracts that do not serve them, we have never seen a contract retracted by the hospital for a physician making a request.