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Naturopath Contract Review

Chelle Law provides Naturopath Contract Review for naturopathic physicians entertaining a new job or renegotiating an existing employment agreement. You have worked hard to develop your skills and deserve to advance in your professional career with a fair market value agreement with a review by a lawyer. So, when you are about to enter into an agreement, getting employment agreement services before signing is vitally important. The terms of the agreement will impact your practice and your day-to-day life. Attorney Robert Chelle reviews your agreement, identify the areas that could be improved and assist you in negotiating the best naturopathic contract possible. Physicians that requests Mr. Chelle’s expert assistance receives reviews that are:

  • Available in any state
  • Flat-rate pricing, with no hidden costs
  • Review of your proposed employment agreement or agreements
  • Phone consultation reviewing the naturopathic contract term by term
  • Follow up contact reviews with needed clarifications

Naturopath Physician Contract Negotiations

Physician contracts are a pervasive and obligatory part of every job search for naturopathic physicians. Well-drafted naturopathic physician contracts help to enumerate the responsibilities of the involved parties, divide liabilities, protect legal rights, and insure future relationship statuses. These touchstones are even more crucial when applying their roles to the case of naturopathic physicians employed by a hospital, corporate owned group, or private practice. While naturopathic physician contract drafting and negotiation can be a long and arduous process, a search for quality legal representation is a must in order to ensure that your rights are being protected before you start your new job and sign a new naturopathic physician contract.  The present day conclusion is simple: Physicians should not sign a naturopathic physician contract without having the agreement reviewed by legal counsel.  For instance, concerns include: license defense, board policies, employee salary increases, attorneys fees, salary negotiations upon expiration on the associate agreement, AMA fees, etc.

Physician Contract Review Checklist

Every contract for naturopaths are unique.  However, nearly every naturopathic physician contract for health care providers should contain several essential terms.  If these essential terms are not spelled out in the agreement, disputes can arise when there is a disagreement between the employer and employee as to the details of the specific term.  For instance, if the PA is expecting to work at the practice Monday through Thursday and the employer is expecting the provider to work Monday through Friday, but the specific workdays are absent from the Agreement; who prevails?

Contract Review with AMA Physician Considerations

Spelling out the details of your job is crucial to avoid conflicts during the term of your employment.  Below is a checklist of essential terms that naturopathic physician contracts should contain (and a brief explanation of each term):

  1. Practice Services Offered: What are the clinical patient care duties? Are you given time for administrative tasks?
  2. Patient Care Schedule: What days and hours per week are you expected to provide patient care and have patient contact?
  3. Locations: Which facilities will you be scheduled to provide care at (outpatient clinic, surgical sites, in-patient services, etc.)?
  4. Outside Activities: Are you permitted to pursue moonlighting or locum tenens opportunities? Do you need permission from the employer before you accept those medicine related positions?
  5. Disability Insurance: Is disability insurance provided (short-term and long-term disability)?
  6. Medical License:  Will the practice offer reimbursement for your license or assist in license defense before the licensing board?
  7. Practice Call Schedule: How often are you on call (after hours office call, hospital call (if applicable)?
  8. Electronic Medical Records (EMR): What EMR system is used? Will you receive training prior to providing care?
  9. Base Compensation: What is the annual base salary? What is the pay period frequency?  Does the base compensation increase over the term of the Agreement?
  10. Productivity Compensation: If there is productivity compensation; how is it calculated (wRVU, net collections, patient encounters, etc.)?
  11. Practice Benefits Summary: Are standard benefits offered: health, vision, dental, life, disability, retirement, etc.?
  12. Paid Time Off: How much time off does the job offer? What is the split between vacation, sick days, CME attendance and holidays?
  13. Continuing Medical Education (CME): What is the annual allowance for CME expenses and how much time off is offered?
  14. Dues and Fees: Which business expenses are covered (licensing, DEA registration, privileging, AMA membership)?
  15. Relocation Assistance: Is relocation assistance offered? What are the repayment obligations if the Agreement is terminated prior to the expiration of the initial term?
  16. Signing Bonus: Is an employee signing bonus offered? When is it paid?
  17. Professional Liability Insurance: What type of liability insurance (malpractice) is offered: claims made, occurrence, self-insurance?
  18. Tail Insurance: If tail insurance is necessary, who is responsible to pay for it when the Agreement is terminated?
  19. Term: What is the length of the initial term? Does the Agreement automatically renew after the initial term?
  20. For Cause Termination: What are the grounds for immediate termination for cause?
  21. Without Cause Termination: How much notice is required for either party to terminate the Agreement without case?
  22. Practice Post Termination Payment Obligations: Will you receive production bonuses after the Agreement is terminated?
  23. Non-Compete: How long does the non-compete last and what is the prohibited geographic scope?
  24. Non-Solicitation: How long does it last and does it cover employees, patients, and business associates?
  25. Notice: How is notice given? Contact via email, US mail, etc.?
  26. Practice Assignment: Can the Agreement be assigned by the employer?
  27. Alternative Dispute Resolution: If there is a conflict regarding the naturopathic physician contract, will mediation or arbitration process be utilized?

Breaking a Physician Contract with a Non Compete

Physicians with non compete clauses in their contract were originally considered as restraints of trade, and thus were invalid on the grounds of public policy at common law; however, many restraints of trade incident to employment contracts were upheld based on the rule of reason.  Thus, restrictive covenants between dentists not to compete after termination of employment are generally enforceable as long as it is reasonable.

However, there are a few states which prohibit non compete clauses.  Please check your state laws for non compete rules and regulations to see what the specific rules for your state are.  The general test for reasonableness of these agreements hold that on termination of employment, a covenant  which restrains an employee from competing with his former employer is termed reasonable if:

  • The restraint is not more than required for protecting the employer,
  • It does not inflict any untold of hardships to the employer, and
  • The restraint is not injurious to the public.

Employment Non Compete Reasonableness

For instance, in Ohio, a non-competition clause was unreasonable when it was noted that a provider’s sub-specialty was uncommon, and that it would be harsh if the restrictive covenant was enforced as the hospital where he was precluded from practicing was only one of the few institutions in the area where he could practice his specialty.

Thus, in Ohio, covenants restraining providers from competing with his employer on termination of employment is considered unreasonable if it inflicts untold of hardship on the veterinarian, is injurious to the public, if the demand for the dentist’s medical expertise is important for the community people and if the dentist’s services are important for the health, care and treatment of public.  However, non-competition clauses for dentists, in general, are enforceable as long as they protect some of the employer’s legitimate interests.  Having a naturopathic physician contract reviewed by a lawyer can assist in avoiding medical legal issues.

Contracts for Physicians that use RVU Compensation

It seems every five to ten years hospitals vacillate on whether to employ naturopaths because the costs associated with employing naturopaths is considerable. Those costs include office space, staff, supplies, equipment, malpractice insurance, CME reimbursement, in addition to the naturopath’s salary. The hospital’s motive behind employing naturopaths is to capture the downstream revenue generated by the physician’s practice. For instance, employed physicians are expected to use hospital services (labs, imaging, rehab, etc.) and other employed specialists when referring patients in need of continued care. The revenue collected from these “in-house” referrals is expected to more than cover the cost associated with employing physicians.

Contract Review of Productivity Bonus

However, when a hospital employs physicians who doesn’t see enough patients or generate enough downstream revenue to cover the costs of their practice the hospital can lose an enormous amount of money. Therefore, hospitals have begun to use productivity based employment agreements with employed physicians to ensure that physicians are financially driven to see more patients. A physician who sees more patients not only bills more from an increase in patient encounters, but also creates more downstream revenue.

How do Physicians Incorporate RVUs in a Contract Review

The most effective productivity based employment model uses the wRVU to determine the compensation of the physician. The wRVU combines the relative level of time, skill, training and intensity to provide a given service (determined through a CPT code) and it places a numeric value for each CPT code billed by the physician. For example, a family practice physician sees a new patient and codes a 99202 for the encounter. Let’s say the wRVU for a 99202 is 1.70 and a family practitioner receives $36.00 per wRVU (known as a compensation factor). Thus, the doctor would generate $61.20 per 99202. Hospitals that use wRVU based employment contracts use a physician’s total wRVU’s generated for a specific period of time to determine how much the physician is compensated. If you are a physician entering into an RVU based contract it is imperative that you understand the intricacies of the contract structure in order to maximize your compensation.

Physician Office Contract Job Risks

Physician face much risk when they take contract matters into their own hands. Physician contract terms are highly negotiable and have a great impact not only on professional life but also on lifestyle, family and the future.  There are many important contract terms and clauses which can present new complex and diverse issues for any PA, including:

  • Unfavorable call schedules
  • No assistance in license defense
  • Small Production Bonuses
  • Lack of Benefits
  • Not enough paid-time-off
  • Not enough vacation time
  • Unfair Non-Compete
  • Inadequate professional liability coverage

NMD Lawyer Contract Review

When your physician contract is reviewed by an experienced attorney, you will find financial benefits which end up outweighing the cost of the review. Leave it to the experts. If you are in need of assistance with employment agreement reviews schedule a Physician Agreement Review with Chelle Law today!