How are Pennsylvania Physician Contract Reviews Different?
Pennsylvania physician contract reviews are different from reviews in other states because of the (somewhat unusual based on my dealing with employers in many other states) balkanization of several large hospital systems.
I assume this balkanization is the result of the acquisition of various smaller health systems by the big gorillas in the state. For example, UPMC has various regions in the state, and each region has it’s own unique contracts, negotiated by it’s own unique in-house counsel. Jefferson also has different contracts for it’s mid-state “partner” than it uses at the mother ship in Philadelphia, and uses local in-house counsel to negotiate each. Lehigh Valley Health Network has slightly different contracts for the various hospitals, but until recently only used in-house counsel for those in Allentown.
Each of these in-house counsel have issues they typically will negotiate on, and some they generally won’t. I say “generally” because I have been occasionally surprised when a lawyer yields a point in negotiations that they typically don’t. I assume the different approach is the result of either a more lenient department chair, or a shortage of physicians in that specialty (or both).
Notwithstanding the different contracts and attorneys, most Pennsylvania health systems start with the “this is our standard physician employment contract” line. At least in that sense Pennsylvania physician contract reviews are like any other physician contract review.
What I've Learned about Pennsylvania Physician Contract Reviews
As I said before, there isn’t “one size fits all” even for hospitals in the same chain. Some attorneys for the local hospitals are very reasonable (and some require a slightly more aggressive approach). I can honestly say, however, that virtually every interaction with opposing counsel in Pennsylvania physician contract reviews is based on a mutual desire to get the deal done. That is generally the way things work in other states, but I have been subject to some real hardball negotiations in other states, and have actually been told that there were other candidates for the position if my client didn’t mend their ways and realize that they didn’t deserve a fair contract (paraphrasing here).
Pennsylvania hospitals seem to be more willing to stick with outside attorneys that serve them well. I have been dealing with an outside attorney for Tower Health for over 30 years (well before there was such a thing as Tower Health). I think that those years of working together has created mutual respect on both sides, that I truly believe leads to better contracts – for both parties.
As a member of the Pennsylvania bar since 1982, I know the law in Pennsylvania, and I know the players as well as anyone. Healthcare in Pennsylvania changes as much as in any other state, and so do the people. But I think practicing for that long does give me some credibility that helps in negotiating with the employer’s counsel – even in those relatively rare instances where we haven’t dealt with each other before.
Pittsburgh and Philadelphia are obviously major cities, but in many of the cities of Pennsylvania there is a distinctive small-town feel that belies the population figures. That feeling tends to make contract negotiations less adversarial, and even Philly and Pittsburgh counsel are frequently more reasonable that the legal counsel of large cities outside Pennsylvania.
Pennsylvania Physician Contract Reviews Require Expertise
Although there may be a small town feel to many Pennsylvania physician contract reviews, that doesn’t mean that physicians can throw caution to the wind and accept whatever the employer’s lawyer has drafted. Physicians still need to be aware of the worst traps in physician employment agreements. I already mentioned that Pennsylvania employers are as likely as anyone else to use the “this is our standard contract” line. Starting work under a physician employment agreement has the same potential traps in Pennsylvania as anywhere else, and Pennsylvania law recognizes physician covenants not to compete. And, like anywhere else, malpractice insurance in physician employment agreements, specifically, who pays for tail coverage, is always a concern.
As a physician’s attorney for over 40 years, I’d like to think that I have seen it all in Pennsylvania physician contract reviews. But I have learned that knowing opposing counsel can sometimes give my client an edge, however slight. Physician contract reviews are all I do, and it never ceases to amaze me when I see attorneys who practice in a multitude of areas, but try to claim expertise in all of them. Negotiating physician employment agreements is as much art as science, and dealing with an experienced (I prefer that term to ancient) attorney who is immersed in his craft seems like a no-brainer.
There are so many nuances to Pennsylvania physician contract reviews, from understanding physician productivity compensation to understanding and applying MGMA benchmarks. Physicians are brilliant and dedicated people, but they have been trained in medicine, not the law, and it is rarely worthwhile to invest in MGMA benchmarks just for your contract review – let alone trying to decide the significance of national versus local benchmarks.
I'm Here to Help with Pennsylvania Physician Contract Reviews
I’ve been practicing law in Pennsylvania for over 40 years, much of it spent in Pennsylvania physician contract reviews. I am passionate about protecting physicians in this negotiation that can have a major positive (or negative) effect on their careers and their lifestyle. I wrote my book on physician employment agreements in an effort to educate physicians on the major issues they need to master to obtain a fair employment agreement. I also perform Pennsylvania physician contract reviews on a daily basis.
If you would like me to help with your Pennsylvania physician contract review, you can start your review. If you’d like to speak to me about your specific circumstances to see if I can help, you can set an appointment with me.
