It would be a better world if everyone kept their word, played fair, and shared the wealth. In reality, employers turn out to be different than you thought, practices are sold, and office managers become major obstacles. And of course, money changes everything.

Employment conflicts are easier to avoid when expectations are put down on paper. Unfortunately school does very little to prepare clinicians for the business end of medicine. This includes explaining what an employment contract should cover and how to negotiate this. There are three contract principles essential for success:

1) Get it in writing

  • There are very few disadvantages to working under an employment contract. The clinicians I know with the most harrowing workplace stories are the ones who were working without a written contract. If you have a contact that your employer does not honor, you need to decide whether to pursue legal action in small claims court or take on the expense of an attorney to represent you. Even if you consider your employer honest and reliable, a written contract can help avoid potential conflicts.

2) Establish a timeframe

  • Contracts that automatically renew put the clinician at a significant disadvantage. A contract with a built-in expiration date will force you to the negotiating table when the time comes. Even the most fair and kind employer will hesitate to bring up a topic that requires them to spend more money.
  • Any contract regarding a new-employment situation should cover only one year. Once you become comfortable in the job, three- or five-year term contracts are reasonable, especially if the contract has a set escalation of compensation and benefits.
  • To make time for the necessary back and forth, start negotiations no fewer than 60 days before your current contract is set to expire. Make sure you give yourself enough time to allow for a legal review by an attorney. Getting started even 90 days ahead of time is reasonable if you expect prolonged deliberations or work for an employer with whom it is difficult to schedule meetings.

3) Leave the legal talk to the experts

  • If there is any part of your contract you cannot understand, do not sign it. Ask your employer for an explanation. If they cannot explain the situation to your satisfaction, ask to either remove the item in questions or reword it so that it is clear to all parties involved.
  • Always have a lawyer review any contract you intend to sign. Make sure your lawyer is familiar with health-care contracts, the NP/PA profession, and the applicable regulations of the state in which you practice. Ask colleagues for a recommendation, or check with your local state professional association. Legal advice can be expensive, but it will help avoid a more costly and stressful situation in the long run.

Next month, we’ll discuss how to get what you want out of employment negotiations.


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