The Ins and Outs of Physician Contracts

Posted By Mike Meyer, Wednesday, April 17, 2019


By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

An effective employment contract between a medical practice and a physician should be a win-win for the employer and employee. If one or both sides don't approach the negotiation in a thoughtful manner, they could find themselves disappointed with the outcome. Here are a few features that should be included in a mutually beneficial contract.

(For more information on medical spa employment contracts, view AmSpa's webinar on the topic; it is free to AmSpa Plus members.)

Goals

A practice should consider what it wants to accomplish with a contract with a physician. Does it need to fill a position? Does it want to provide service to more patients? Is a transition of ownership part of the equation? The answer to this can dictate the type of person the practice wants to recruit (i.e., a younger doctor versus a more experienced one) and affect the way the employment agreement is designed. If a physician who has entrepreneurial aspirations is hired to simply tend to patients, for example, neither side will be particularly happy, and the relationship likely will not last very long.

The practice's intentions must be clearly communicated during the recruitment process, and the contract must be built around that philosophy.

Along the same lines, a physician must honestly evaluate his or her goals when negotiating a contract with a medical spa. These contracts typically last for one to two years, but both sides typically expect that the relationship will continue thereafter, so a physician must come to terms with his or her long-term plan. Is this where he or she wants to forge a career? This should influence how the contract is negotiated.

The physician also needs to consider a "plan B"—if this arrangement does not work out, how does he or she continue his or her career? The answer to this question heavily influences how the contract is evaluated. For example, if the physician wants to put down roots in the city where the practice is located but the contract has a restrictive non-compete clause, it is in his or her best interest to negotiate the terms of that clause, as it would severely restrict his or her options if it the relationship with the medical spa does not work out. Click here to learn more about non-compete and non-solicitation clauses.

Compensation

A medical spa needs to balance the practice's economics, the risk tolerance of its owners, and salary expectations in its market when negotiating a contract. A competitive guaranteed base salary with some form of incentive-based bonus system can help secure top talent who might be considering other options. There are several ways this can be arranged, depending on what the physician prefers.

The physician, on the other hand, must understand his or her risk tolerance. While a high base/low bonus structure might appeal to some, others will want to pursue a low base/high bonus structure. The physician must determine his or her comfort level with the contract's salary structure—if it is not optimal, it must be negotiated.

The physician also must be rational when determining his or her actual earning power. If the market does not offer enough potential business to justify taking a low base/high bonus salary, the physician should seek a different deal.

Ownership

The practice must determine what it wants to accomplish in terms of ownership with the hire, as it will affect everything from scheduling and coordination to top-level decision-making. The practice's owner(s) also must consider if the hiring should be part of their exit strategy; if so, the contract must be created with that in mind.

The physician, meanwhile, must determine how he or she would build the practice and determine how the practice's ancillary revenue streams compare to those offered by others. Ownership offers different appearances for different entities, so the physician must establish what he or she wants and what the practice can provide. What is the investment? What is the potential return? What is the risk? The contract should answer all these questions.

Creating a mutually beneficial contract is a complicated matter. Both sides must assess the risks and rewards, and they must also be willing to compromise on less pressing matters. A careful reading of a contract is a must, however—if both sides don't thoroughly read the contract, they have nobody to blame but themselves if it doesn't work out.

For more information about structuring your medical spa profitably and compliantly, attend an AmSpa Medical Spa & Aesthetic Boot Camp and become the next med spa success story.

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