March 14, 2025

Negotiating Contracts: Ask the Right Questions

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Evaluating a potential job and employer is all about asking the right questions. The more answers you can find, the better equipped you will be to negotiate a contract and make the final decision to sign or not. You obviously want to know your salary, benefits package, or paid time off. However, there are other inconspicuous terms of employment that you'll want to know about sooner rather than later. Here are a few questions to ask your future employer.

What are the other physicians like, and how do you fit in?

Getting to know who you would be working alongside will absolutely give you a better idea of how the practice functions. If you're able to speak with physicians and other current employees directly, you could also gain some insight into what they do or don't like about their workplace.

Most importantly, you want to understand where you fit with the other physicians from a scheduling standpoint. The way they are scheduled will affect when you work, and vice versa. Find out how many other physicians are working and how you share call time with them. Ideally, call time should be equal and rotating between all physicians involved. Whether or not this is the case, also investigate capping your call time to avoid taking an unnecessary amount.

Finally, know what happens when another physician must be absent. Will there be a backup, or will you have to pick up the slack? Similarly, what happens if someone leaves the practice entirely? Find out how the employer plans to handle these situations, and ensure your contract protects you from taking on any excess workload.

What patient volumes can be expected?

Production bonuses are great, but only if you can meet the threshold. When your earnings are dependent on the number of patients you see, you must either see more patients or lower the expectations defined by your employer. While the former is mostly out of your control, the latter can be changed in your employment contract.

Inquire about patient volumes early in your talks with an employer. If you get the chance, ask other employees as well, so you get a more neutral view of the situation. Once you receive a contract, if you know what volumes to expect, you can determine whether the proposed bonus rate and threshold are reasonable. You don't want to sign a contract with a bonus threshold you will never realistically reach.

What happens in the event of a buyout?

Questioning these more unassuming contract details helps you prepare for the "what-ifs," and a buyout is a big what-if to plan for. Even if it seems unlikely, do not write off the possibility of a buyout or acquisition taking place.

Your contract should include specific language designed to protect you in such situations. For example, if your contract includes a non-compete, that clause should be written in a way that it is waived in the event of a buyout. When you sign the contract, you agree to non-compete terms relative to your employer's current location(s). You don't want the clause applied to additional locations owned by an acquiring company, and you may want to leave the practice altogether if you don't like the new direction. Being unrestricted by a non-compete allows you the freedom to change jobs without changing location.

Malpractice tail coverage also becomes a topic of concern when ownership changes. It's ideal that your employer is responsible for 100% of your tail coverage costs if a buyout happens, provided they aren't already. Like waiving the non-compete, this gives you additional flexibility if you decide to leave the practice, since you won't have to worry about paying for tail coverage.

Additionally, ensure your path to partnership is uninterrupted, and preferably accelerated as well. You don't want to put a lot of time into a practice, get close to obtaining partnership, and then have a buyout postpone or even negate everything. The effects of a buyout on your partnership should also be specified in your contract.

It's all in the details

When searching for a new job, you can save a lot of time and avoid trouble down the road by ironing out the small details early. Don't be afraid to ask questions, even if they regard situations that seem insignificant or unlikely to happen. Some employers may downplay the possibility of a buyout or staffing changes. Even so, after you've found sufficient answers to your questions, ensure that you have protection written into your contract. Although you may be able to renegotiate later, it's always best to fully understand your employment terms and negotiate them before you sign.

--This article is brought to you by WSMA's preferred partner, Resolve, providing WSMA members discounts on employment contract review services and salary data.

You may also find WSMA's Career Center of interest in your job search. Find out more here.

March 14, 2025

Scope of Practice Bills Among Legislation No Longer Advancing in the Legislature

Several cutoff deadlines have passed in the 2025 legislative session, narrowing the field of bills eligible for further consideration this year. Over1,800 bills have been introduced on a wide variety of issues, including the practice of medicine, housing reform, and redesigning the state flag. Only those bills that have passed the deadlines will continue on in the legislative process (though bills that are considered necessary to implement the budget are not subject to the Legislature's cutoff deadlines).

Nothing is truly "dead" in Olympia until session adjourns, but at this time a number of WSMA-opposed bills related to scope of practice and the business of medicine are not expected to receive further consideration this year including:

• HB 1888: Would have granted naturopaths prescriptive authority for Schedules III-V drugs, and stimulant medications contained in Schedule II, without detailing specific education and training requirements.
• HB 1520/SB 5513: Would have directed the Pharmacy Commission to promulgate rules for independent diagnostic and prescriptive authority for pharmacists by 2030, among other provisions. There is an ongoing sunrise review examining pharmacist scope of practice in progress at the Department of Health and recommendations are expected prior to the 2026 legislative session.
• SB 5185/HB 1306: Would have allowed international medical graduates who have not completed a residency to obtain a full and unrestricted physician license.
• HB 1507: Would have generally prohibited physicians and practitioners from entering into non-disclosure and non-disparagement agreements with patients, adversely impacting the ability of physicians to enter into voluntary settlements of medical malpractice actions.
• HB 1881/SB 5704: Would have established numerous restrictions under which health care entities may enter into partnerships such as mergers and sales.

March 14, 2025

Webinar on Immigration Law Enforcement, Clinic Rights, and Patient Rights

April 9 from noon-1 p.m. CME available.

Join us on Wednesday, April 9, for a lunchtime webinar about how Community Health Plan of Washington and the Washington State Health Care Authority have responded to the federal administration's executive orders regarding immigration.

On Jan. 20, 2025, the Department of Homeland Security rescinded a 2021 memorandum instructing immigration and border patrol officers to refrain from taking enforcement actions at or near protected areas, including medical and mental health facilities. That same day, the administration issued an order that targets "sanctuary" jurisdictions and vows to prioritize identifying and detaining undocumented immigrants.

During the first Trump administration, Community Health Plan of Washington, Community Health Network of Washington, and the Washington Association for Community Health, under the purview of the Health Care Authority, developed the Immigration and Refugee Alliance, which serves as a key resource for informing community-based organizations and patients of their rights when interacting with immigration law enforcement. Community Health Plan of Washington continues to support patients with information and resources, helping patients receive needed care safely.

Join us for discussion and learning about what your rights are in the workplace and how you can support your patients. Stay tuned as we add sessions to a series about immigration law enforcement and health care. This activity is approved for AMA PRA Category 1 Creditâ„¢. For additional resources and guidance regarding how to prepare for immigration enforcement in practice settings, visit our new Immigrant Welfare webpage.

Register online.