Want Help with Your Job Search?

Jane Jerrard

The Hospitalist. 2007;11(5):11-15. 

In This Article

Before You Sign

When you're presented with a contract, it's time to take a close look at what's being offered. "Before you sign anything, you need to come to an agreement with the other party in the contract that this is exactly what we agreed to. Otherwise, it's no deal," says Fred A. McCurdy, MD, PhD, MBA, FAAP, FACPE, professor and regional chairman of pediatrics, Texas Tech University Health Sciences Center at Amarillo. "Everything needs to be really specific in the offer letter or the contract–their duties, expectations– all clarified up front."

Examine the benefits, including retirement and insurance. Ideally, you want disability insurance– and malpractice insurance with tail coverage is essential. (Tail coverage, also called extended reporting coverage, covers you after you leave a group in case a patient files a lawsuit years after the fact.)

Make sure you understand what the contract says, and make sure your employer doesn't hold too much power. "Check to see if you can be assigned to areas of work that would be a dealbreaker– if you can be sent to another city or state to work, for example," says Dr. McCurdy.

As a new physician, you do have some leverage to negotiate for better compensation or schedule. Dr. McCurdy says of recent residents, "The two biggest benefits they bring to the table are their youth and the fact that they're current and up to date on what's going on in [internal medicine]. They have energy, and they'll bring energy to the program; and they've spent three years in intense study and have the most up-to-date knowledge of anyone you can hire."

Point out these advantages to the right interviewer, and you may be able to negotiate.

Dr. Badlani encourages new hires to negotiate their moving expenses, bonuses, and malpractice insurance.

But keep in mind that not all hospital medicine programs can or will negotiate. "It's quite variable," admits Dr. McCurdy.

Dr. Harris' program is a prime example. "In my experience, we don't have a tremendous amount of negotiating," she says. "Basically, we say, 'Here's the deal.'"

Dr. McCurdy advises having someone else read the contract for you. "When you're enthusiastic about a new job, you don't see everything," he explains. "And you need to have a lawyer read it to make sure it's a correctly constructed legal document."

Dr. Harris simply advises that you "read through the contract with a fine-tooth comb. Does it have a non-compete clause that prohibits you from practicing in the region after you leave? You can find a job [locally] without this clause."

Dr. McCurdy has allowed new hires to strike these clauses from their contracts, but it's a trade-off. "Noncompete clauses are hard to enforce," he acknowledges. "Our boilerplate contract has one, because we want to send the message that we don't want to spend two years training you and then have you leave and go to work for the competition. So if [a candidate] wants to strike that clause from the contract, I'll say that's fine, but on the basis of that I'll make it a binding three-year contract."

What if, after researching, interviewing, reviewing the contract, and taking every step possible to ensure you get the best job, you find you've made a mistake? "Remember, your contract is only for one year," Dr. Badlani points out. "You can always change next year if you don't like your [first choice]."


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