Fear and Loathing – 8 Rules of Hospital Negotiations

A rant about hospital negotiations, from a physician's lawyer who has been in the trenches with these David and Goliath battles.
hospital negotiations

When you have been a physicians’ lawyer for as long as I have (since 1992), you tend to develop a certain frustration with hospitals, especially in hospital negotiations.

In 2009 I set forth a carefully considered speculation on what rules hospitals follow when they negotiate physician employment agreements and medical practice sales agreements with physicians.  (OK, it was actually a rant about hospital negotiations).  I would love to say that things are completely different now.  Or even much different now.  Or, maybe a little different now.

Unfortunately, I think the rules I discovered as I have represented physicians over the years in hospital employment agreements and medical practice sales are still very much enforced by your friendly neighborhood health conglomerate. These rules are as follows:

Hospital Negotiations -Rules for Negotiating With Physicians’ Lawyers

  1.  We are in a great hurry. There is a deadline of _________.
  2. It is unreasonable for the physician’s lawyer to change anything – that will slow the deal down.
  3. Every time the physician’s lawyer does change something, we must take a week or two to get it through legal.
  4. When it comes out of our legal, the physicians’ lawyer must respond immediately. See #1.
  5. The fraud and abuse laws prevent us from _______ (fill in the blank).
  6. If you had a real attorney, s/he would know that the deal must be 100% the way we want it. See #5. If the physicians’ lawyer disputes that simple fact, it is proof the poor fool does not know Stark.
  7. We are a not-for-profit. Therefore, everything we do is for the community benefit. If the physician’s lawyer tries to get something for the physician out of the deal, it is because the physician’s lawyer and the physician are greedy.
  8. MGMA benchmarks don’t apply to us, because _______.

What have I missed?

You may also be interested in my posts about hospitalist contracts, wRVU compensation traps for physiciansMGMA compensation analysis, and  MGMA benchmarks.

If you have a hospital contract you would like us to review, you can start your review here, or get a free consult.

Image Courtesy of PathDoc/Shutterstock

Share on Facebook
Share on Twitter
Share on Linkedin
Picture of 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.

Leave a Comment

Your email address will not be published. Required fields are marked *

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.