The devil is in the details, and there are numerous details physicians must manage before their departure.
BY BONNIE DARVES, A FREELANCE HEALTH CARE WRITER
Some physicians land on the ideal practice opportunity early in their careers and find it gratifying enough to stay there for their entire careers, but that’s pretty rare these days. In the real world, physicians change jobs a lot. A recent survey
by CHG Healthcare found that 62% of physicians surveyed changed jobs or job types between 2022 and 2024, up from 43% in CHG’s 2022 survey. And early-career physicians appear to have few qualms about moving on — statistics show that more than
half of physicians will change jobs within five years of leaving training, eyeing better work-life balance, better compensation, or just a better overall fit.
Although it’s become perfectly acceptable for physicians to change jobs for any reason, physicians making their first career move to a new practice opportunity may find that changing jobs, even from one employed position to another, is more complicated
and time- consuming than expected. Even if physicians are successful in choosing their next job in a matter of weeks, making the transition in an orderly manner may take several months. That’s because of the myriad issues involved. Those issues
range from employment-contract provisions, advance-notification requirements, patient responsibilities, and financial considerations at the current job to malpractice coverage both at the new job and between one job and the next.
CreativaImages/Getty Images. Image customization, Sioux Waks.
Proper and prudent departure planning: where to start
The most important considerations in making a move are ensuring, through due diligence, that the next practice opportunity is truly an improvement over the current one and that there are no impediments to leaving the job on the physician’s preferred
timetable. That means that the first order of business is reviewing the current employment contract — closely and in its entirety. Ideally, physicians should review the contract before launching a job search but absolutely before committing to
a start date. Many employment contracts, even those that include “without-cause” clauses that permit physicians to leave at will, require that ample notice be provided. A 60 day notice is common, but some contracts may require that physicians
provide 90 or even 120 days’ notice. And any violation of a notice period could result in financial cost to the physician if the physician is found in breach of the contract.
The following are other employment contract provisions that physicians should pay special attention to and have an experienced health care attorney review early on when they’re planning a move:
Restrictive covenants. Such clauses may dictate where departing physicians may (or may not) be allowed to practice, from either a geographical-radius or competitive standpoint, and should be considered enforceable unless the state
outlaws them. The clause may prevent physicians from practicing within 60 miles, for example, of the current employer’s location or from joining certain nearby organizations considered competitors.
Deferred-compensation considerations. As some physicians have found out, sometimes the hard way, receiving compensation due to them after they’ve left a job can become problematic. Some deferred compensation may be linked to the notice
period, and if that period is inordinately long, physicians may have difficulty getting funds they’re due, according to Jim Wall, a health care attorney at Wall, Babcock & Bailey in Winston-Salem, North Carolina. “Some practices may require an
extraordinarily long notice period, a year, for example, before the physician can qualify for deferred-compensation payments,” he said.
At the other end of the spectrum, physicians who have contracts in which they’re paid based on work relative value units (w-RVUs) may be liable to pay back some of their compensation if they have been overpaid because they didn’t meet productivity
targets. “This is definitely a provision to look for,” Mr. Wall said.
Dawn Plested, a consultant with the Medical Group Management Association, which publishes a leading annual physician compensation survey, urges physicians considering a move to determine how their departure might affect some newer types of compensation,
such as value-based care payouts and prospective bonuses based on quality measures. “Ideally, physicians should log in at least quarterly to find out where they stand with such payments,” she said, and how their departure date might affect payouts.
Retirement plans. It’s important to ensure that the physician’s intended departure date doesn’t conflict with the current employer’s calendar-year requirements or vesting schedule. If, for example, the current employer requires physicians
to work an entire calendar year before receiving that year’s retirement benefits, leaving early could mean leaving money on the table.
Patient-nonsolicitation clauses. This can be a tricky issue to navigate for departing physicians, depending on the contract. An overly broad definition of nonsolicitation may prevent physicians from directly telling patients, or even
fellow staff members who they hope might follow them, that they’re planning to move to a new practice and identifying that practice. “Nonsolicitation and ‘non-hire’ clauses vary considerably, and the language matters. Physicians should be very
careful about such clauses,” said William Mandell, co-managing partner of the health law firm Pierce & Mandell PC in Boston.
For example, while a physician may be in violation of the contract if they direct message patients or staff members about their plans, the contract might not prevent them from announcing their move on social media or LinkedIn. When in doubt, Mr. Wall
advises departing physicians to broach the subject explicitly with their current employers. And Mr. Mandell reminds physicians that an overly broad nonsolicitation clause might be waivable or alterable with an attorney’s intervention. In any event,
physicians should update their social media profiles as soon as possible or as permitted to enable patients to find them.
The above is an excerpt from “Preparing to Make a Physician Practice Move: Prudent Planning is Key” by Bonnie Darves. To read
the full-length article, click here. This article is intended for a national audience. Please be aware that specific laws and practices may vary by state. The information presented does not constitute legal advice.
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