The idea of a contract is often scary to clinicians primarily because they seem to be in a language other than English, are cumbersome and just don’t make a lot of sense. Contracts, in their basic form are nothing more than a written agreement of the terms for the subject at hand. While they can be verbal, for our purposes we will discuss written contracts.
Contracts are a good thing. They are simply an agreement to the terms of whatever issue is at hand. Having a written contract forces the parties involved to discuss, question and negotiate issues ahead of time. It provides clarity and prevents problems down the line. If necessary, it will jog one’s memory as to what was negotiated and they allow for legal enforcement should it become necessary.
Contracts are used in many situations. Clinicians are most familiar with employment contracts. Contracts are also common with insurance companies and vendors you do business with. Additionally, you’re likely to have a contract or agreement with a collaborating physician, an independent contractor, or even the leaseholder for your office space.
When you are negotiating almost any contract, it’s vital that you prepare yourself in the same manner as you would any time you are negotiating. You’ll have to be clear on what you are negotiating, what you want/they want, what things will you concede and where do you draw the line in the sand and walk away.
Since employment contracts are the most common contracts clinicians will see, let’s take a look at a few items you’ll want to see addressed and written into the contract:
- Start & end dates of the contract. What are the terms for renegotiation, notices etc
- Who is the contract between?
- Responsibilities of each party including patient care and call
- Tools and resources available to allow you to do your job
- Support services: clinical assistance, equipment, collaboration, records, etc.
-  Salary & benefits: What remuneration you can expect; if there is a productivity formula, you’ll need to know how is it calculated; any consequences for not reaching performance goals; salary reviews and increases, CME, insurances, vacation/paid-time-off, etc.
-  Billing Issues: Who is doing the coding and billing, how can your review charges/codes being billed, is “incident to” utilized in this practicing setting and how? Access to billing records?
-  Non-compete Clause: NCC’s are basically restrictions on your practice. They will say that you may not practice in a certain geographic location for a certain length of time after you leave someone’s employ. You want to avoid these if at all possible.
If you think about it, contracts are very similar to the documentation that we make countless times per day. And thus, we would do well to remember the wisdom of “if it’s not documented, it was not done”.
A good resource for clinicians on contracts is Carolyn Bupperts’s Business Practice and Legal Guide which you’ll find on Amazon.
***Disclosure: I am not an attorney. I do not play one on TV, YouTube, or in real life. Use this information at your own risk. And always, consult a real attorney as necessary.
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Barbara C Phillips, NP is a professional speaker, author, clinician and business owner who provides business education, resources and support to Nurse Practitioners, Physician Assistants and other Advance Practice Clinicians — both for the employed and self-employed clinician. Additional information about Ms. Phillips is available at www.BarbaraCPhillips.com.