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Contracting

Contracting

Words matter. In medicine, provisions in a contract between a physician and an insurer or an employer glossed over at the time of signing may spring to life in unexpected ways.

The WSMA offers education and information that can help you know what to expect, and to take the right steps to a fair contract that reflects your needs and goals.

Payer Contracts

Resources to help guide your review of all facets of a payer or network sponsor who is submitting a contract.

Payer contract evaluations

Physicians often overlook the need to carefully review all facets of the payer or network sponsor who is submitting a contract. Use the resources below to help guide your review of payer or sponsor contracts.

Model health insurance physician contract

Payer matrix provision descriptions and scoring guide

Payer contract evaluation

Employment Contracts

Increasingly, physicians are graduating from medical school and transitioning directly into employed positions.

Agreeing to the terms of an employment contract can have profound and long lasting effects on your life.

Contract terms can dictate where you'll be able to practice, how you'll be compensated, and what obligations you'll owe your employer-even after you stop working there. You should never sign a contract without carefully reading its terms, and should consider consulting an experienced attorney to aid you in this review. The WSMA can provide members with referrals to attorneys experienced in employment matters. Email us at wsma@wsma.org.

After consulting a lawyer, however, many physicians decide to negotiate the terms of their contracts on their own. The resources below can help you as you review and prepare to negotiate the terms of your employment contracts.

WSMA Principles for Physician Employment
Modeled on the AMA Principles for Physician Employment, the WSMA Principles for Physician Employment can help physicians, those who employ physicians, and their respective advisors identify and address some of the unique challenges to professionalism and the practice of medicine arising in the face of physician employment. The principles are not intended to serve as a comprehensive listing of the professional and ethical obligations of employed physicians; such obligations, which are the same for all physicians, regardless of employment status, are more fully delineated in the AMA Code of Medical Ethics (which have been adopted by the WSMA).

Frequently Asked Questions: Noncompete clauses
Employment contracts frequently include noncompete and non-solicitation clauses. While a physician seeking employment will want to avoid signing an unduly restrictive provision, a physician employing other people will want to protect legitimate business interests and the good will of the practice. This concise WSMA FAQ will explain when these clauses are legal and what to consider when you evaluate them.

Contracts and physicians: The good, the bad & the things to never ignore
Noncompete clauses are frequently part of employment contracts in Washington state. This WSMA Reports (January 2015) article explains important considerations for any physician considering an employment contract, with a particular focus on noncompete clauses.

Red flags in physician employment contracting
Physicians need to be prepared when they negotiate with an employer regarding a job. In particular, physicians must be able, and willing, to identify potential "red flags" during negotiations that might provide insight into the future employment relationship. Read the WSMA's helpful explanation of the red flags you should be aware of anytime you consider signing an employment contract.

Employment contract checklist
A checklist of terms and conditions that are commonly found in employment contracts so that all parties know what terms need to be clarified and agreed to before the agreement is executed. WSMA does not advocate how provisions ought to be written nor espouse a policy position on employment issues.

AMA annotated model physician-hospital employment contract
The American Medical Association has published a valuable resource for physicians who wish to evaluate an employment contract with a hospital. This publication provides a wealth of background information regarding issues which physicians need to consider before even reviewing a proposed hospital employment contract. The document then walks through the terms included in a typical hospital employment contract and provides analysis of important sections and examples of sample language. This is a detailed and comprehensive look at what a physician may expect to see in a hospital employment agreement and should be a "must read" for those entering into employment with a hospital.

Books targeting negotiation tactics

"Getting to Yes: Negotiating Agreement Without Giving In," by Roger Fisher and William L. Ury. This oft-cited book has become well known in the 30 years since its initial publication as a go-to book for learning how to negotiate, resolve conflicts, and come to mutually acceptable agreements with others.

"The Final Hurdle: A Physician's Guide to Negotiating a Fair Employment Agreement," by Dennis Hursh. This textbook-like primer is intended to inform residents so that they can prioritize the kinds of benefits and bonuses they might want to have in their contract, avoid commonly encountered problems, and negotiate a advantageous contract.

"Physician's Guide: Evaluating Employment Opportunities & Avoiding Contractual Pitfalls," by Thomas C. Crawford. In this book, the author helps physicians assess potential employers and avoid common contractual pitfalls.

"Physician's First Employment Contract (Second Edition): A Guide to Understanding and Negotiating a Physician Employment Contract...from the Employee Physician's Perspective," by Michael L. Kreager. This guide is intended to equip physicians with the insights and practical information necessary to successfully review and negotiate their first employment contract.

Online resources

The American Medical Association website has a wide selection of tools and resources to aid physicians during contract review and negotiation.

AMA's Annotated Model Physician-Group Practice Employment Agreement , which AMA members can download for free in the AMA's online store, describes basic contract terms physicians can expect to find in their employment agreements, alongside more comprehensive explanations of why these terms matter. Also included are model contract provisions for comparison purposes.

For those preparing to review and negotiate an employment contract offered by a hospital (or similarly situated entity), the AMA's Annotated Model Physician-Hospital Employment Agreement will be especially helpful. This resource addresses the specific needs of physicians considering employment with a larger institution, and the considerations and consequences unique to those kinds of contracts.

For those looking for a lengthier, comprehensive resource, the American College of Physicians has published an online resource entitled Physician Employment contracts.

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