ACFAS HUB Session Sheds Light on Contract Negotiations

Why do you feel contract negotiations remain such a challenge for physicians?
 
Bela Pandit, DPM, FACFAS, points out that a significant paradigm shift occurs when searching for one’s first practice job.
 
“A majority of physicians have never worked in a corporate-like setting and have spent most of their life in training,” she says. “We are not taught a class on negotiations, let alone standard expectations, benefits, and questions to ask when joining a work environment.”
 
Dr. Pandit adds that newly graduating residents may not be inclined to negotiate their employment contract, for fear of losing an opportunity. However, she notes that others may have inflated, unrealistic expectations of what a fair contract may look like.
 
Ellianne M. Nasser, DPM, CWS, FACFAS, DABPM, agrees that negotiation, regardless of the setting, is always challenging. Like Dr. Pandit, she feels confidence plays a role in how one approaches the process. From her observations, she says physicians early in their career may lack confidence or insights into their strengths and value to their potential employer.
 
Often, contracts are inherently designed to favor one party over the other, usually whichever party's attorney drafted the document, says Maryellen P. Brucato, DPM, FACFAS. As a result, she encourages physicians to enter the process with this challenge in mind.
 
“Furthermore, it takes a skilled attorney or a lot of experience with legal contracts to figure out what the contract is even saying,” she adds. “Some physicians think ‘I'm smart—I'm a doctor, after all! I'm going to save some money and I'll be my own contract lawyer,’ and unfortunately this usually results in an unfavorable situation. Contracts are complex, they're difficult to understand, and they're made to be that way. So, of course we need help with them!”
 
When do you think is a good time for physicians to learn about contract negotiations?
 
All of the panelists agree that early pursuit of knowledge about this topic is ideal, specifically during one’s residency training. However, furthering one’s experience in this area is always going to be a good idea.
 
“Ask about contracts, look at your colleagues’ contracts, look at the contracts your practice enters into with other entities,” shares Dr. Brucato. “The more you have seen, you will pick up tidbits of legalese that could help you in the future.” 
 
What resources are available to learn more about navigating this process?
 
ACFAS and the American College of Physicians have resources on this topic that physicians can peruse, say the panelists. The HUB session that the panelists led at the ACFAS ASC is one key example. (Look to the “Additional Resources” list at the end of this interview for more specifics, along with a few other editorially identified sources.)
 
Dr. Pandit, in practice in Evergreen Park, IL, adds that one may also choose to seek out a human resources professional or corporate recruiter that they know who may be able to provide valuable information.
 
“They treat every job equally in terms of negotiations no matter what environment,” she explains. “Seek out peers that have recently negotiated a job offer to compare.”
 
What key features of a contract do you feel are the most important for a physicians to explore/learn more about?
 
The panelists all mention different features of an employment agreement that they feel are important to evaluate. They also point out that each physician may have different priorities and terms that are vital to them. However, some examples of important points to consider include, but are not limited to:

• Compensation
• Benefits
• Access to medical records for use in board certification
• How can one exit the contract?
• If a party terminates the contract, what are the terms?
• When a contract term is fulfilled, could the agreement change? Is it renewable?
• Restrictive covenants
• Maternity/paternity leave
• Focusing on the “big picture,” not just the salary
• Is work-life balance addressed in the agreement? Including things like paid time off, manageable work hours and locations, time allotted for conferences, CME, etc.

Who can/should be part of the team that helps physicians successfully negotiate contracts?
 
Each of the panelists stress the importance of an employment attorney reviewing the contract. Consultants can also provide guidance, they share. And, as previously mentioned, friends or family in human resources may be able to assist in helping one to hone their negotiation skills. Lastly, Dr. Nasser, in practice in Scranton, PA, adds that asking a mentor or residency program director to review a contract may be an additional resource.
 
What else do you feel physicians should know?
 
Dr. Nasser encourages physicians to obtain documentation throughout the process.  
 
“Just like in patient care, if it is not documented it did not happen,” she says. “Do not rely on verbal agreements for any details of the agreement.”
 
“Contracts can cause a lot of anxiety for physicians,” explains Dr. Brucato, practicing in Clifton and Hackensack, NJ. “If you take our advice, break down the contract with a qualified attorney, and have a plan of what are the most important negotiating points for you, you can enter into these discussions cool, calm and collected.” She adds that the information from HUB lecture aims to inspire confidence in its attendees.
 
Drs. Pandit and Brucato provide contract consultation through the First Class Club.

Any views and opinions expressed are those of the author(s) and do not necessarily reflect the views, policy, or position of Podiatry Today or HMP Global, their employees, and affiliates. Information regarding contracts is provided as a service to our readers. Every effort has been made to ensure accuracy, however the above is informational only and is not official legal advice. HMP and the author do not represent, guarantee, or warranty that this information is error-free and/or will yield any particular result.
 
Additional Resources
1.    Hood C. Pertinent pearls in contract review. Podiatry Today. 2024; 37(2):24-25.
2.    Hood CR, Taubman R. The Art of Negotiation: From CVs and Interviews to Contracts. Presented at the ACFAS Annual Scientific Conference. February 8-12, 2023. Los Angeles.
3.    American College of Physicians. Physician Employment Contract Guide 2017. Accessed January 8, 2024.
4.    American College of Foot and Ankle Surgeons. Human Resources and Planning. Accessed January 8, 2024.
5.    ACFAS On-Demand Podcast. Contracts-Negotiations for Joining a Practice, Bringing on a New Physician. Published June 28, 2022. Accessed January 8, 2024.