Special Issues in Hospitalist Physician job Contracts

Hospitalist employment agreements present several special issues that are not frequently encountered in other physician employment agreements.

This post will attempt to alert you to some of the most common problems you might encounter.

One of the first issues unique to hospitalist agreements is treatment of working hours.

Many hospitals have a “week on, week off” rotation.

However, many hospitalist employment agreements do not include assurances on schedules.

Instead, these agreements frequently provide that the hospital may assign you to shifts in its discretion.

When I review a hospitalist employment agreement, I always try to assure that there are basic parameters around the ability of the hospital to assign you to shifts without your consent (e.g., only daytime shifts or only nighttime shifts in a given week without your agreement, no more than 25 shifts in a given month, etc.).

There should also be limits on the amount of consecutive shifts you may be assigned to (e.g., two), and a reasonable limit on the number of consecutive days (or nights) you will be scheduled to work without time off (e.g., 12).

These assurances should not be a problem for most hospitals, especially if they have a long-established hospitalist program.

However, obtaining these assurances will protect you if things go horribly wrong.

Amazingly, sometimes the compensation formula is not clear in hospitalist employment agreements.

I have seen some agreements that provide a salary “assuming completion of X shifts”, with no discussion of payment for shifts beyond X.

There obviously should be some methodology in the contract for how you will be compensated for additional shifts.

Perhaps the most vexing issue 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, I do not believe it is at all appropriate for a hospitalist to agree to a covenant not to compete.

You may be the finest physician who has ever treated a given patient, but it is highly unlikely that the patient will change hospitals in order to see you again if you leave employment with this hospital.

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).

~Dennis Hursh is a physicians’ lawyer who focuses his practice on review and negotiation of physician employment agreements. He is located and licensed in Pennsylvania, but provides review and negotiation services in all 50 states. Dennis provides free consultations by appointment.

Copyright 2020, Dennis Hursh.  All rights reserved.

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