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.
