Jarrod Shapiro, DPM Joined Mountain View Medical & Surgical Associates of Madras, Oregon July 2008

Employment Contracts Thus far in my podiatric career I have been an employee. My first position out of residency was as an associate to another podiatrist, while my new position in a multi-specialty practice has me employed by a hospital. In each of these cases I obviously negotiated a contract. This is, of course, a common event for physicians whether it's negotiating an employment contract, an insurance contract, or a lease contract. As with any legal relationship the contract dictates the terms of the relationship and creates the structural framework for the respective participants. As I'm not a lawyer, and can't reasonably discuss contract legalities, I'd like to talk about those parts of the contract that were important to me.

In any negotiation you're likely to have to compromise on some things in order to receive those benefits you want.  For example, having a higher base salary may be more important to some than medical insurance.  Much of this depends on personal situations.

Here's a list of some of the contract terms I've negotiated thus far in my career:

• Salary – Base + incentive bonus
• Health Insurance (+/- dental and vision)
• CME allowance
• Vacation time
• Driving mileage – more important if you'll be driving between multiple office locations.
• Work hours – this is usually specified in the contract, but I've never actually negotiated it, expecting to work far more hours than “full time.”  However, you will want to know the call schedule, especially if sharing call with multiple doctors.
• Dues – state component, APMA, board dues, professional society dues, etc.  Make sure these are included. 
  These get pretty expensive when added together.
• Disability insurance
• Life insurance
• 401K/retirement benefits
• Company car – I did not negotiate for this, although I have heard of this included in contracts.
• Patient distribution – More important with associateships.  Are you going to see new patients in a 50/50 ratio with your employer?  Will you have to see their postops?  This was unimportant since I'm the only podiatrist in the practice.
• Financial aid payments

By no means is this list exhaustive.  Salary is obviously the most significant term in the contract.  Depending on your situation the salary structure may differ.  For instance, I am married with a child, so I can't afford to negotiate a low base with high bonus, which may be more profitable in the long run.  For me the most important components to my contract were (in order of importance) salary, medical insurance, dues and CME, and vacation time. 

The one component I did not negotiate but wished I would have is the financial aid payments.  For me, this is a relatively large monthly bill that I'd like to avoid.  However, unless you're planning to work for a larger employer like the government (Veteran's Affairs or Indian Health Service) your employer will probably not be able to afford this.

No matter what your situation or perspective, keep these two things in mind:

• Any expense you leave out of the contract you're going to pay for, which equates to a lower salary.
• You've received the best podiatric training, and have spent years learning your specialty, which means you should get paid what you're worth.

If you feel the contract is not to your benefit then renegotiate or walk away.  The contract should be created with respect on both sides.  This is the start of, hopefully, a long and profitable relationship. 

What contract terms are important to you? What are your concerns when it comes to contracts? 

Write in and start a discussion.  Best wishes.

Jarrod Shapiro, DPM
PRESENT New Docs Editor
[email protected]

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