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b'Attorney and author Dennis Hursh helps physicians navigate their employment contracts. He describes his shock early on in his career when he saw the lopsided language in the contracts offered to his highly trained physician clients. He points out that no hospital executive would ever agree to such contractual language for themselves.
A sampling of items Mr. Hursh considers \\u201cinsane\\u201d:

- 24 hour call shifts (and by the way, you will work the next day, too)
- The employer will decide if you\\u2019re disabled and has the right to terminate you if you can\\u2019t do the job
- No paycheck for you if you can\\u2019t navigate their complex credentialing process by your start date AND they reserve the right to terminate you if you aren\\u2019t fully credentialed by your start date
- Punitive non-compete clauses (a.k.a., restrictive covenants) that wreak professional and personal havoc rather than simply limit the loss of patients who might follow you when you leave
- \\u201cBrutal\\u201d provisions in the contract that the administration promises they won\\u2019t enforce (but nonetheless they won\\u2019t remove the language)
- Low starting pay with a promise (but no contractual language) of partnership to come
- \\u201cIntegration\\u201d documents that provide explanations and promises related to the formal contract (but alas, they are not enforceable unless they are in the formal contract)

In this episode, Mr. Hursh exposes the risks lurking in several areas typically included in physician employment contracts (beware if these points are not explicitly addressed!):

CREDENTIALING: Flexibility can be built into the contract to allow a physician to begin a narrower scope of work if certain hospital credentials or other privileges are still delayed at the start date.

RESTRICTIVE COVENANTS (noncompete clauses): This refers to contractual language that prohibits a departing physician from practicing within a specified distance of the former employer for some period of time. Mr. Hursh draws attention to several issues regarding the distance that is specified and what is being measured: Is it the distance between the physician\\u2019s previous office and the office with the future employer? From a specific hospital or the organizational headquarters? Or from any of the employer\\u2019s sites anywhere?

MALPRACTICE INSURANCE: He describes the critical difference between Occurrence vs. Claims-Made insurance policies. Red alert if the contract simply says \\u201cmalpractice insurance is provided.\\u201d If you don\\u2019t know the difference you could be saddled with expensive \\u201ctail insurance\\u201d when you hightail it out of there.

COMPENSATION, CALL, DUTY HOURS and LOCATION: Ambiguity is not the physician\\u2019s friend when it comes to an employment contract. Exquisite clarity about compensation and call is critical. If your future employer thinks full-time means 40 jam-packed patient-contact hours then, in reality, you could end up with a 60-hour workweek. Similarly, it\\u2019s critical to have clarity and security about your office and hospital location.

Mr. Hursh advises physicians to hire an attorney who has experience working with physician agreements and who has the needed resources (e.g., MGMA database, up-to-date Stark regulations). An advantage of hiring an attorney is that shelling out the money for an attorney signals that the physician is taking the offer seriously. Also, contractual challenges can be raised by the attorney so that the physician doesn\\u2019t have to directly challenge a potential employer.

Also in this episode:
\\u2022We discuss my guest\\u2019s article \\u201cAre Hospitals Evil? A Physician Contract Attorney Explains\\u201d
\\u2022How hospitals protect themselves while circumventing the bans on Corporate Practice of Medicine
\\u2022The Business School Mindset (BSM) and its many manifestations in healthcare systems
\\u2022How disdain for physicians leaks out in the language, action, and inaction of management
\\u2022Patient care and collegiality are harmed when competition is the primary motivator

Meet Dennis Hursh, Esq.
Dennis Hursh, a veteran physicians\\u2019 lawyer, with over 35 years of health-law experience is a frequent lecturer on physician contracts to residency and fellowship programs, and has spoken at events sponsored by the White Coat Investor, the Pennsylvania Medical Society, the Hershey Medical Center, UPMC, Geisinger Health System, the Pennsylvania Society of Cardiology, the WellSpan Health System, the Hospital of the University of Pennsylvania, and the American Podiatry Association. A former contributing editor to Physicians News Digest, Dennis has authored several published articles on physician contractual matters, and has literally \\u201cwritten the book\\u201d on physician employment agreement negotiation - \\u201cThe Final Hurdle - A Physicians\\u2019 Guide to Negotiating a Fair Employment Agreement\\u201d.
Dennis represents physicians in all 50 states in reviewing and negotiating employment agreements to protect physicians in one of the biggest transactions of their careers.

Dennis has also published information you may find useful in his Physician Contracts Blog, at: https://pahealthlaw.com/physician-contracts-blog/
Website: https://pahealthlaw.com/
Book: The Final Hurdle: A Physician\'s Guide to Negotiating a Fair Employment Agreement

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