I was looking over the budget for one of my department heads when my phone rang. I hit the microphone button.
A familiar voice asked “Hey John, got a minute?” It was my longtime friend and former co-worker Ruth.
“Sure, what’s up,” I said.
“Well, my son will be finishing his cardiology fellowship in May, and he has been interviewing for jobs, mostly with large cardiology groups. He has an offer in hand, and a contract, and he’s wondering if you could take a look at it. You’ve seen a few employment contracts haven’t you?”
“A few,” I said sarcastically. With recent turnover in the leadership of our hospital-based medical group, I was spending up to 50% of my time on a daily basis interviewing new physician prospects, preparing contracts to be sent out, and negotiating with physician recruits and their attorneys. I was also regularly reviewing salary surveys, discussing legal concerns with our attorneys, and developing new financial models with our chief financial officer.
I was flattered by the request. Ruth’s husband is a very successful attorney, albeit not an expert in physician employment agreements, but I was sure between him and his colleagues he could have addressed any legal questions. But it became clear that what they really wanted was to make sure that all of the potential financial incentives, from salary to benefits and perquisites, were being considered.
I obtained a copy of the proposed employment agreement, looked it over and made a few suggestions. There were possible sign-on incentives that had not been offered and details about potential duties and salary considerations that had not been addressed. Ruth’s son liked the team he would be joining, and the town suited his wife. Most of the requested contract changes that I recommended were adopted by the employer and Ruth’s son ultimately accepted the position. As a result, in addition to successfully securing employment with one of his top choice of employers, he received a significant lump sum prior to starting his new career, and an enhanced salary that would benefit him for years to come.
Fast forward a couple of years.
I left my position as Chief Medical Officer in order to start a new venture. I still had many friends at the health system, including the Administrative Director of the residency and fellowship programs. She mentioned that some of her residents and fellows were preparing to search for permanent positions following graduation from the program. We discussed how I might help them understand proposed agreements and avoid common contracting mistakes. That’s when it occurred to me that most residents and fellows receive very little instruction in these issues, although their lives may be governed by the terms of such agreements for years or decades to come.
Maybe I Can Help You
That’s when I decided to create this blog, where I can post information and answer questions about negotiating employment agreements for newly graduating residents and fellows. My plan is to post written content like this, as well as videos and other resources. In time, I hope to post some interviews that you will find helpful and instructive. My goal is to help young physicians to understand and successfully negotiate outstanding employment agreements, with a focus on the financial and psychosocial aspects.
( NOTE: I am not an attorney and I do not give legal advice. In fact, I insist that every physician engage a competent, local attorney with experience in employment contracting to help identify and eliminate any legal land mines. My focus will be on optimizing the financial aspects of agreements, and identifying and minimizing future hassles, costs or other unforeseen consequences of a bad agreement. I will also provide some insight into the process of interviewing and negotiating.)
All of the resources on this blog will be FREE – my way of giving back to the profession.
I obtained my medical degree at the University of Illinois at Urbana/Champaign and completed my Family Medicine residency in Rockford, Illinois. I am board certified in Family Medicine. I completed a Master’s Degree in Public Health at the Medical College of Wisconsin. I worked as a physician executive for 15 years, first as Vice President for Medical Affairs, then as Chief Medical Officer and Senior Vice President. I obtained designation as a Certified Physician Executive through the Certifying Commission in Medical Management in 2012. In addition to physician group management, my primary roles as CMO included quality improvement, utilization management and inpatient pharmacy services. I now serve as medical director at an urgent care center near Chicago, Illinois.
My other interests include assisting my wife with her Home Services Agency, competing in masters (meaning over age 50) track meets in the 100- and 200-meter dash, playing bluegrass guitar, and learning new languages (currently working on Spanish).