Updated November 26, 2020:

Unique Aspects of a Hospitalist Contract

As a relatively new position in medicine, hospitalists play an important role in dealing with acute cases that demand immediate, round-the-clock attention. Hospitalists usually have a unique employment contract, so there are a few key aspects to consider when negotiating and renewing a hospitalist contract.

  • Work schedule and time off. Hospitalists usually work in atypical shifts, such as working for seven days and then off for seven days. When calculating an hourly total, hospitalists may end up working more than physicians with more common schedules do, since they might be expected to cover a 24-hour shift.
  • Productivity. Hospitalist contracts must have clearly defined guidelines pertaining to productivity and should provide an idea of the maximum and minimum numbers of patients they are expected to see. One way to measure productivity is by paying hospitalists according to relative value units (RVUs) instead of hours worked.
  • Non-compete clause. Hospitalists can also work in an outpatient or clinical environment; thus, healthcare attorneys should review any non-compete clauses to determine whether an outpatient position would violate the contract.

Contractual Issues

When it comes to hospitalist contracts, you should remember a few important pieces of information.

  • Understand how your pay is calculated. You should figure out whether payment is based on productivity, shift worked, or another option, and make certain that base pay and any information regarding bonuses or raises is included in your contract.
  • Determine whether there is enough work to support your salary expectations.
  • Know your malpractice insurance. Typically, there are two types of policies: claims made and per occurrence. If you have a claims-made policy, make sure you negotiate for your employer to cover the "tail" insurance so that, if you leave, you have minimal out-of-pocket costs.
  • Have work expectations spelled out. This inclusion makes sure that you can sustain a quality work-life balance.
  • Be aware of what happens with upfront money. If you receive a sign-on bonus or tuition reimbursement, for instance, ensure that this money is forgiven at a prorated amount of the lump sum over the course of your contract.
  • Include information about termination and term. Insurance enrollment and hospital credentialing usually take up to three months, so it's best to avoid a situation in which your employer could terminate you without a 90-day notice, leaving you without income or causing you to have to live away from your family until you find another position.
  • State non-compete covenants. Typically defined by time and distance, make sure your covenants last no more than a year.
  • Review rules and regulations as well as medical staff bylaws. Read these documents before you sign the contract since they define your care and responsibilities.
  • Determine whether the environment will satisfy you. Talk with medical staff currently working at the facility to see whether the job will be a good fit for you.
  • Make sure the contract agreement captures your spirit. Double-check that every promise made during recruitment is included in the contract.

Contract Caveats for Hospitalists

When entering a contract, both parties should identify themselves. For instance, sometimes physicians believe they're contracting with another physician, but the agreement is actually with a corporation. Structuring healthcare industries limit liability, so it's important to know how the contracting entity operates.

Hospitalists should also know what the considerations of the contract are, including:

  • Compensation: bonuses, payment formulas, salary, and profit distributions.
  • Insurance: dental, disability, health, life, and vision.
  • Paid time off: illness, professional meetings, and vacation.
  • Retirement plans: 401(k) and profit-sharing plans.
  • Professional fees: continuing medical education, hospital privileges, and medical licenses.
  • Malpractice insurance and tail coverage.

When it comes to a legally binding contract, each party must acquire an obligation in exchange for consideration. Most contracts fail to have enough information about obligations, but some parties include provisions that impose obligations that are spelled out in other documents. This is problematic because courts will enforce obligations imposed by other documents, even if a party didn't have the document at the time they signed the contract.

Unless stated by law or contract, parties usually have no further obligations to one another upon reasonable termination. Most states presume employment is at will, which means either party can terminate employment at any time without notice for a lawful reason.

Hospitalists should also understand remedies, which define the recourse that is available when a party breaches an agreement. There are three basic forms of remedies:

  • Compensatory damages: monetary awards to compensate an injured party for loss.
  • Liquidated damages: monetary awards to compensate a party for an agreed-upon loss.
  • Equitable relief: non-monetary remedies such as an injunction.

If you need help with a hospitalist contract, you can post your legal need on UpCounsel's marketplace. UpCounsel accepts only the top 5 percent of lawyers to its site. Lawyers on UpCounsel come from law schools such as Harvard Law and Yale Law and average 14 years of legal experience, including working with or on behalf of companies like Google, Menlo Ventures, and Airbnb.