Patient Contact Hour
The first draft of many standard physician employment agreements is silent on patient contact hour requirements. Often, the first offer provides that the physician is expected to work “full-time”, without defining that term.
Larger physician practices and health systems are often willing to stipulate that you are expected to work 40 hours per week (exclusive of call coverage requirements). At first blush, many physicians might feel that is eminently reasonable. A standard work week is 40 hours, right?
However, it’s important to delve into how many patient contact hours are required each
week. Some employers specifically require 40 patient contact hours per week. If
you are scheduled to see patients for 40 hours each week, you may be working
significantly more than you initially anticipated.
In particular, if the employer does not utilize hospitalists,
you may be expected to “round” outside of the 40 patient contact hours. This
can be especially onerous if the employer admits patients to multiple
And regardless of expectations regarding rounding, you can be expected to spend significant time on charting and other administrative activities. One respected journal has estimated that physicians in four common specialties spend, on average, 785 hours per physician per year just dealing with reporting on quality measures!
Physician employment agreements with a private practice are likely to require much more flexibility in scheduling. Patient volumes do not decline when a physician is absent because he or she is sick, taking vacation, or attending CME. Good patient care may require extended office hours during these periods, so that the remaining physicians can see patients within a reasonable time of an appointment request.
A true 40-hour workweek may be attainable if the employer is willing to agree to about 32 patient contact hours each week. That should give you adequate time for rounding, charting, medical staff meetings, and other administrative duties – and still allow you to have a life outside the practice of medicine.
To learn more about the critical issues to be aware of when negotiating a physician employment agreement, you can see my podcast of the 4 most common traps in physician employment agreements, my physician employment agreement checklist or, for the most extensive discussion of the topic, my book on physician employment agreements. For specific information on topics you might be interested in, see my posts about physician productivity compensation, MGMA compensation analysis, medical record provisions in physician employment agreements, letters of intent in physician contracts, physician covenants not to compete, and call coverage requirements.