HCA Physician Employment Agreements are not Carved in Stone

HCA physician employment agreements

Negotiating HCA physician employment agreements is often seen by physicians as impossible, partly because the contract has an impressive form number in the upper left hand corner – which is often seen by physicians as a sign that the agreement cannot be changed.  In fact, we have a great deal of experience in  negotiating HCA physician employment agreements, and have been successful getting changes.

Giving HCA Physician Employment Agreements a Form Number Doesn't Make Them Sacred Texts

HCA is a huge organization, so it makes sense to try to standardize everything as much as possible.  However, HCA physician employment agreements, although they  may have been given a form number, are very much open to negotiation. This is not to say that HCA recruiters are above using the form number as “proof” that the first draft is “our standard contract.”

However, I have reviewed and/or negotiated dozens of HCA physician employment agreements, and I don’t recall ever having an HCA affiliate refuse to change the standard form. That isn’t to say, of course, that every change we ask for will be accepted (in 40 years of physician contract negotiations involving thousands of  medical contracts, that has happened a grand total of one time). However, I have found HCA affiliates to be reasonable when it comes to clarifying covenants not to compete, adjusting repayment obligations of bonuses, and in requiring the physician’s consent to changing practice location (this is far from an exhaustive list).

Do HCA Physician Employment Agreements Provide Reasonable Compensation?

I hate to give the lawyers’ standard answer of “it depends,” but, unfortunately, that is the case. I have been able on several occasions to obtain an increase in compensation or bonuses based on an MGMA compensation analysis. However, as with any employer, there tends to be issues where there isn’t much flexibility.  For example, if the whole department has a physician productivity compensation bonus structure based on $X per wRVU, pointing out that the wRVU to compensation ratio is below median isn’t likely to result in a new deparment productivity plan. 

Although we might not get changes to the productivity compensation plan, I have used unfavorable comparisons to MGMA  benchmarks in productivity plans to get an increased signing bonus, increased salary, and/or more time for a compensation guarantee. As always, much of the negotiation will depend on outside factors like how badly the hospital needs a given physician or that physician’s  specialty.  Some hospitals will be more flexible addressing issues for subspecialist physicians than they will be in negotiating hospitalist contracts. However, the specialty probably doesn’t matter as much as the hospitals’ unique circumstances.

Is it Worthwhile Attempting to Negotiate HCA Physician Employment Agreements?

This is a question that doesn’t need any weasel language. In my experience it definitely pays to negotiate an HCA physician employment agreement. I have never seen a negative HCA employer reaction to legal review of physician employment agreements. As a big employer, HCA expects it’s physicians to be savvy enough to negotiate, and has inhouse lawyers who are ready to work with the physician’s counsel.

HCA physician employment agreements have all the issues that any other physician employment agreement has, from patient contact hour requirements to call coverage requirements to physician disability provisions in employment agreements. I have found that HCA affiliates (perhaps because of their size) do not tend to “nickel and dime” issues like a reasonable physician sign-on bonus

If you would like me to review your HCA physician employment agreement (or any other physician employment agreement for that matter), you can start your review here. If you would like a complementary consultation with me to discuss your particular concerns, you can set an appointment.

If you are a “do it yourself” type, you may want to read my book on physician employment agreements

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Dennis Hursh

Dennis Hursh

Dennis Hursh has been providing healthcare legal services in Pennsylvania since 1982. Since 1992, he has been a physician's lawyer serving as Managing Partner of Physician Agreements Health Law, the first law firm in the country to focus exclusively on physician employment agreements. Dennis has devoted his life to serving physicians and medical practices. He is the author of the definitive book on physician contracts "The Final Hurdle - a Physician's Guide to Negotiating a Fair Employment Agreement, and a frequent lecturer on physician employment agreements.

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Physician Prosperity Program


How It Works

After purchasing the physician contract review, you will receive an email asking you to transmit the agreement and any concerns you have to me. Many physicians do this by email, but I will be available by phone, too. In three business days from the time you purchase the Physician Prosperity Program® and transmit the draft physician employment agreement along with any concerns you have about the agreement and the information I will need to perform the MGMA analysis, you will receive a detailed physician contract review letter from me.

After you receive my physician contract review letter, you will have the opportunity to discuss it with me, to make sure all of your concerns were met, and to correct any factual inaccuracies, or to point out things that were verbally promised but didn’t make it into the physician employment agreement. These discussions, and revisions of the letter following these discussions, are included in the initial fixed fee.

Once you are completely comfortable with the physician contract review letter, you transmit the letter to your potential employer.