Hospitlalists must be aware of the 3 biggest traps in hospitalist employment agreements.
The First of the Biggest Traps in Hospitalist Employment Agreements
One of the biggest traps in hospitalist employment agreements relates to provisions concerning working hours.
Many hospitals have a “week on, week off” rotation.
However, many hospitalist employment agreements do not include specific provisions regarding schedules.
Instead, many hospitalist employment agreements provide that the hospital may assign the physician to shifts in its discretion.
When reviewing a hospitalist employment agreement, the physician should assure that there are basic parameters around the ability of the hospital to assign the hospitalist to shifts without the consent of the physician.
For example, the agreement should provide only daytime shifts or only nighttime shifts in a given week without the physician’s consent. The agreement should also provide for a maximum number of mandatory shifts in a given month (e.g., 20).
There should also be limits on the number of consecutive shifts the physician may be assigned to without consent (e.g., two). The agreement should also provide a reasonable limit on the number of consecutive days (or nights) you will be scheduled to work without time off (e.g., 10).
These assurances should not be a problem for most hospitals, especially if they have a long-established hospitalist program. However, many institutions use “hospitalsplaining” to assure physicians that, although that provision is in their “standard employment agreement”, but they would never actually use it. In my 40 years of dealing with hospitals, I have often been led to a basic question: are hospitals evil?
The Second of the Biggest Traps in Hospitalist Employment Agreements
The second of the biggest traps in hospitalist employment agreements relates to provisions regarding physician compensation.
Amazingly, the compensation formula is not always clear in hospitalist employment agreements.
Some hospitalist employment agreements provide a salary “assuming completion of X shifts.”, Obviously, there should also be provisions regarding compensation for shifts beyond X. Physicians should assure that there is some methodology in the contract for how the physician will be compensated for additional shifts.
The Third of the Biggest Traps in Hospitalist Employment Agreements
The third, and perhaps the most vexing of the biggest traps in hospitalist employment agreements is the insistence on a covenant not to compete.
Physician covenants not to compete may be appropriate in some contexts.
However, it seems obvious that it is not at all appropriate for a hospitalist to agree to a covenant not to compete.
The hospitalist may be the finest physician who has ever treated a given patient. Still, it is highly unlikely that the patient will change hospitals because a hospitalist has left employment with this hospital. Maybe the hospitalist’s mom will change hospitals, but even that isn’t a given.
Accordingly, the hospital should have no problem in removing covenant not to compete provisions from its “standard physician employment contract.”
Of course, hospitalist employment agreements are also subject to all the concerns found in other physician employment agreements: physician compensation, starting work under a physician employment agreement, the physician sign-on bonus and relocation allowance, physician benefits, and physician disability provisions in employment agreements (to name a few).
A more complete explanation of all the issues that can be found in hospitalist employment agreements (and every other type of physician employment agreement) can be found in our book on physician employment agreements “The Final Hurdle: a Physician’s Guide to Negotiating a Fair Employment Agreement.”
If you have a hospitalist employment agreement you would like us to review, you can start your review here. We can also provide a free consultation to talk about how we can help.
