By Bradford E. Adatto, Partner, ByrdAdatto

The biggest concern that every young plastic surgeon typically has with their first employment agreement is compensation. Although this can drive whether you decide to enter into the arrangement, it should not be the only driving force. Most plastic surgeons don't understand that there are five other key details that they must consider before entering into any contract. This article covers what we call "The Big Five":

• A written contract;
• Before and after pictures;
• Covenants;
• Patients; and
• Benefits.

The Big Five should be addressed at some point, either in the written contract or in conversations between the medical practice and the physician.

1. A written contract: Most states allow parties to enter into oral contracts. However, we recommended all parties enter into written contracts. One of the biggest issues with any contract is the danger of unmet expectations. If terms and conditions are not in writing, it is impossible to figure out what was actually expected between the parties. Therefore, our recommendation is always to get something in writing between the parties to minimize unmet expectations.
2. Before and after pictures: As a plastic surgeon, your lifeblood is new patients. Additionally, most plastic surgeons' desire is to become board-certified. To accomplish both of these goals, you must be able to access and use before and after pictures. These pictures are used on social media, including Snapchat, Instagram and RealSelf, and are submitted to the board to demonstrate competency. Most plastic surgeons do not address the ownership and use of these pictures in their contract. This can cause massive disputes over time. Additionally, there are numerous privacy laws that must be discussed and understood while working through these issues.
3. Restrictive covenants: Restrictive covenants are terms and conditions that prohibit physicians from certain rights—the right to work in certain areas (non-competes), contact patients or employees (non-solicitations), and share information (non-disclosures). The vast majority of states do allow some form of restrictive covenants. Accordingly, it is important to understand how those restrictions will affect you down the road.
4. Patients: It is important for you to understand how you find your patients when you are joining a new practice. Will the practice market you? When a patient calls the practice, how will they be assigned if they do not have a relationship with any of the physicians at the practice? What is the process of keeping up with those patients once they walk through the door? Most of these questions are not addressed in the initial stages of a contract and are vital to the health of the practice and to a physician's success.
5. Benefits: When joining a practice, understand that, although the salary is an important benefit, you should take the time to understand what other benefits the practice will provide. Benefits can include paying for or subsidizing continuing education, licensing and subscriptions; providing health care insurance and 401K matching; and, of course, providing your malpractice insurance.

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Bradford E. Adatto is a partner at ByrdAdatto, a national business and health care boutique law firm with offices in Dallas and Chicago. His background is in regulatory, transactional and securities law. Having worked in health care law his entire career, he has an in-depth knowledge of the "dos and don'ts" of this heavily regulated industry. Brad has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions and contract terms, including Medicare fraud and abuse, antitrust, anti-kickback, anti-referral, and private securities laws.