There are many issues surrounding the practice of medicine today. In this heavily regulated field, one of the key factors for a young physician seeking employment with a practice or group, or even a physician who is more experienced, is to consider how their arrangement with their employer could affect the development of their career over the next couple of years and how and what they will be able to practice in the future.
Of particular concern are many of the following:
Restrictions on Competition (Non-compete Provisions)
Non-compete provisions in a contract could, after the contract ends, prevent a physician from practicing as an employee, or opening their own practice, within a certain radius of their employer’s business.
Continued Insurance Malpractice Coverage
It is important for a physician to assess their malpractice coverage and who pays for any “nose” and/or “tail” coverage; in other words, to ensure that the physician is not exposed from any prior employment or that there will be coverage after the employee leaves this position.
Compensation and Incentive Bonuses
It is important for a physician to have the ability to audit their own records for what they have billed as well as have a clear understanding of how their incentive bonus is calculated. Usually, the physician employee receives a base salary. Once a certain amount of money has been recovered from the insurance carriers by the employer, the physician receives a small percentage of whatever comes in for their billings, over and above their base salary.
This number is calculated either as a net or a gross amount. It is usually in the employee’s best interest to have a number based upon the gross, even if it is a lesser overall percentage since the employee has no control over what deductions or expenses are taken on a net calculation. An unscrupulous employer could easily cheat a physician employee.
Billing Issues Concerning Insurance Companies
It is very commonplace these days to have a clause in a contract where an employer, in certain cases, can demand monies from an employee physician for bills which an insurance company has demanded back due to fraud and abuse. In a normal climate, this might not be a cause for concern but in most audit settings, insurance companies almost always claim fraud and abuse in an attempt to gain an upper hand on the provider. If the employer doesn’t properly settle a claim, through no fault of the physician employee, the settlement of the employer could very well affect the employee depending upon their employment agreement.
Investigations and Professional Misconduct Regulations
There are additional concerns an employee might face if the employer’s practice is being investigated or if the employee becomes the subject of allegations or investigations for professional misconduct or otherwise. Various clauses or terms of the contract can affect the employee if investigations by an oversight body or professional misconduct allegations arise. The employee also needs to consider how investigations of the employer’s practice will affect them.