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Lets negotiate
Soon I will be finishing my fellowship and as people around me started looking for jobs, I did the same. The interview process was somewhat scary but fun, and I landed the job I wanted. Now what? They sent me some documents and asked me what I thought about the offers. Hence began my quest of issues with contract negotiation.
I knew that my present institution had an attorney who could help me. I was advised that since state laws differ, someone in the state of employment should also look at the documents. The ability to negotiate varies in the employment setting as well: academic vs. community practice.
The work schedule should be clarified. Is moonlighting allowed? Typically it may not be, but it is good to know. How often are on-call weekends, months and nights? Is it based on seniority or on an equal-sharing basis?
Is there a specified probationary term? What are the criteria for regularization of the probationary term? How would one become eligible for partnership in the practice? What are the grounds for “cause” termination vs. notice for “without cause” termination?
Usually when a cause is given for termination, a “restrictive covenant” applies. In such cases noncompensation, nondisclosure, nonsolicitation of patients and enforceability should be discussed. The employer should not have provision to terminate a contract in case of “perceived economic hardship” as that is usually not well defined. Similarly, it is not appropriate for the employer to decide if the employee’s skill level is appropriate to continue or terminate the term; the community’s accepted standards might be a better yardstick. In case termination is provided for without a cause, restrictive covenant does not apply, at least not rigidly. The employee can negotiate for a minimum term from the beginning of the employment when a “no-cause termination” cannot be enforced by the employer.
There should be a clearly laid out annual base compensation and also an incentive compensation plan. It may also be appropriate to ask other members of the practice or faculty of the department to inquire what the average starting packages include. Vacation might not be the first thing on your mind when starting a job, but ask how much paid time off is provided for. Fringe benefits including annual CME reimbursement, relocation reimbursement at the beginning of the first term, retirement or pension plans and disability payment plans should also be discussed explicitly.
Insurance benefits should be discussed in detail. Usually the employer pays the malpractice insurance, but it is important to know what kind: occurrence based or claims made. Claims made coverage is more frequently offered and that requires a discussion about tail coverage. Tail coverage refers to claims that are made after an employee leaves the practice; often the employee pays for this. If private employers have provision for partnership in the practice, the modality and duration of payments should be mentioned.
All this information is limited but is meant to be a primer to at least get you started when the time comes.
Sikander Ailawadhi, MD, is a Second-year Medical Oncology Fellow at Roswell Park Cancer Institute and is a member of the HemOnc Today Editorial Board. Dr. Ailawadhi would like to acknowledge his mentor, Dr. Asher Chanan-Khan.