Navigating Contract Negotiations: What Surgeons Should Know

This is an excellent discussion. It is indeed, unfortunately, 30 years after I finished training, we still ignore teaching this important topic. I always recommend to our medical students and residents:

a. Always get an experienced surgeon to read your contract. A lawyer is, simply, not familiar with medicine, "how" we are paid, call-schedule/sharing, etc. An experienced surgeon will be able to look at your contract and readily point out areas of concern.

b. Interesting the FTC chose to "carve out" non-competes and allow them for physicians. If this doesn't tell you, immediately, how low we rank on the social support structure of reimbursement, it should. Simply, my rule is easy: I will not, and tell residents/students, do not sign any agreement that has a non-compete. If they are not willing to remove it or significantly change it, and you sign, you will be held to that covenant. If, as the employer, you are advertising your group or hospital needs surgical help, but not enough to the point of removing your restrictive covenant, you are not worthy of the talented help for which you are advertising. If you are afraid of "competition", then your community does not have enough volume to support your surgical group--whether it is hospital-based or private-based.

c. Salary is not the most important part of the agreement.

d. You must understand the structure of your claims-made or occurrence med-mal policy. Did you really sign an agreement that did not provide for how the tail was to be paid?

e. Remember, as the video states, "your employer is not your friend." Whether this is another surgeon, or a corporation, regardless of how nice the restaurant is where your contract is discussed, your employer has the upper hand. They are NOT your friend. The biggest enemy of the physician/surgeon is another physician/surgeon. Remember, too, SOMEBODY had to write that contract. And, if it is evil in nature, so will your employment be, too.

f. I once was offered a contract for a salaried position--first offer after residency--on the day I showed up for work. I'd obtained hospital privileges, moved, rented an apartment, and simply was under the impression I was to be an employee--no different than any other STAFF employed individual. The contract was 36 pages in length, a HUGE restrictive covenant, no tail coverage. It was the worst contract I have ever seen (and remains so to this day). How could this corporate giant have done this to me? How could they hand me my pager without a signed contract in hand? Simple: They were not my friend. They waited until I had moved, signed a 6-month apartment lease, had my privileges at the local hospital granted, and by then I was "hooked." As I stood there, holding the 36 page contract, that should have been signed MONTHS prior, I knew I'd been had. I was stupid. Best lesson, but hardest lesson, I ever learned in medicine. I walked that day. They refused to return my phone calls or even negotiate. I have seen nearly every tactic in my years. I've known surgeons who were suicidal over their agreements. This is business and you're not trained. A lawyer's review of your agreement should ONLY come after a seasoned surgeon/physician has read the agreement and, if a CPA is needed, that's a red-flag for the salary structure. It should be easy to understand. Mentorship goes beyond the operating room.

Very good video. Thank you GSN for posting this.