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29th Apr 2008

The worst associate contract I’ve ever seen

You know I’ve seen a lot of contracts.  But this wins a prize - for unfairness:

1. It’s a 12 month contract.  If the associate (employee) leave, he/she must pay $2500 a month for every month that’s left on the 12 months.  Bad?  Keep reading….

2.  If the employer fires the employee, the employee STILL must pay the $2500 a month for the rest of the contract.  YIKES!  But that’s not all….

3.  The employer can change the amount paid to the employee at any time.  REALLY bad?  Not enough….

4.  The employer also has a non-solicit and a non-compete, so you can’t work anywhere else in the state after you leave.

So, think about this:

Your employer tells you that you’re getting a pay cut.  But you can’t quit because you’ll have to pay off your “breach of contract (see 1 above).  And you can’t work anywhere else because you’ll get sued breaching the non-compete.  See what I mean? 

So…why would you sign such a contract?  

Posted in non-competes, getting an associate position, contract questions, associate and independent contractor issues | No Comments »

26th Mar 2008

Timing is everything - How soon before graduation can I start my practice?

The answer to that question is:  You can’t!  I know you are very eager/anxious to get going.  You have lots of student loan debt to repay, and you’ve found a great location, and you are chomping at the bit.  But you can’t commit to anything until you have your license IN YOUR HANDS! 

I talked to a couple the other day who wanted to commit to a lease.  They are graduating in October.  Give a month or so to process their license (assuming they have already passed all their boards) and they will be lucky if they can get their licenses by December 1.  I suggested they put a contingency in their lease that said they didn’t have to make a final commitment until they have their licenses.  This probably means the property owner won’t start build-out until then. 

It is far better to be patient for a few months while waiting for your license than to take a chance and have to start paying rent and paying back bank loans without a license to practice and no way to generate income to pay these bills. 

Be patient.  I promise it will all happen in due time.

Posted in contract questions, getting ready to practice, startup experiences, startup questions, leasing an office | No Comments »

11th Mar 2008

What is a “deal breaker”?

I was talking with a grad today who was considering an associate contract. He said, “If the doctor won’t bend on this issue (it happened to be on a non-compete), that’s a deal breaker for me.”
I’m always pleased when I hear grads talk about “deal breakers” because it shows that they have thought through the process (whether it’s an associate contract or a practice purchase or something else) and that they know what is acceptable and what isn’t…for them.

Too many young DC’s are afraid to set limits and they are too timid to say, “This is unacceptable to me.” You get what you put up with, so if you don’t set limits on your agreements, you will get walked on, taken advantage of, treated badly.

Decide what your “deal breakers” are and stick to them. Let me know what you think a “deal breaker” is for you.

Posted in contract questions, associate and independent contractor issues, startup questions | No Comments »

06th Mar 2008

Associate/ Independent Contractor Issues - A wrap-up

If you are in the process of looking for an associate position or considering an associate or independent contractor contract, you probably have lots of questions.  Here are some recent blogs and links that might be helpful:

Finding an associate position (from StudentDC.com)

The best way to be paid as an associate

Length of an associate contract

Average associate pay

Leaving an associate position

Signing a non-compete (from StudentDC.com)

If you have questions, feel free to email me (jean@dcpracticesuccess.com) .  Or you can post a question in reply to this blog post and everyone can see my reply.

Posted in contract questions, getting ready to practice, associate and independent contractor issues | No Comments »

06th Mar 2008

How do you “attribute” patients to an associate?

Let’s say you’re looking at an associate (employment) contract, and it states that your commission percentage is based on collections “attributable” to you. What does that mean?
To me, it means that every patient you see, the ones you chart and adjust and shake hands with at the end of the visit, belong to you. If not, what are you getting paid for?

Here’s an example: You bring in three new patients one day. The fees for those patients are $150 each, so you get $450 for the new patients. The other doctor had to leave early to pick up a sick child, and you were asked to see one of his new patients. If you don’t get the fee for seeing his new patient, you just lost your percentage of $150, and in addition, you lost the time because you couldn’t see one of your own patients during that time.

Now, what about the other doctor seeing your patients? Who gets credit for them? If you get credit, then you and the other doctor are granting “professional courtesy” to each other. If he gets credit for seeing your patient, then the same should work for you.

I hope this makes sense. Either you get credit for every patient you see or you and the other doctor agree that you are granting each other a certain number of instances of professional courtesy. It has to be the same for both of you.

If the contract doesn’t make sense, don’t sign it until the doctor clarifies IN WRITING. Remember, what the doctor says has no legal weight. Only what is in writing matters.

Disclaimer: I’m not an attorney or a CPA. I’m providing general information, not legal or financial advice. Consult with your attorney or CPA on all contracts.

Posted in contract questions, associate and independent contractor issues | No Comments »

28th Jan 2008

What effect does the term of an associate contract have?

You have just received a contract to look at for an associate (read: employee) position.  You see that it is a two-year contract and that you cannot leave until the end of the contract.  If you leave, it says, you must pay substantial “penalties” for breaking the contract.  If you don’t want to renew, you must do so more than 60 days before the end of the contract. 

Ok, this sounds pretty ominous, but is it?  Take a deep breath and think about this:  The term of a contract is established for two reasons:

1.  So both parties have an opportunity to renegotiate terms (like pay/work)

2.  So both parties can decide if they want to continue with the relationship.

But there may be a thousand reasons that you might have for wanting or needing to leave the contract within the term.  A family emergency, your spouse’s illness, the realization that you don’t want to live in that town - all kinds of things could cause you to decide to leave.  So why should you be penalized?  You shouldn’t!  So why does the doctor want to penalize you for leaving?  He/she just wants to be sure that patients continue to be cared for, and he/she is not left treating all the patients.  If you give enough notice, or find a suitable substitute, you should be able to leave.

I hope you will not sign a contract that has an “early leave” penalty.  The doctor may tell you he won’t enforce it, but, like I always say, “If it’s not in writing it doesn’t exist.”

Posted in contract questions, associate and independent contractor issues | No Comments »

25th Jan 2008

Associate pay - What is the best way to be paid?

A soon-to-be grad brought me an interesting dilemma the other day.  Here is the choice he was given:

Pay Package #1.  Base plus 35 percent incentive on the monthly collections of the entire office.

Pay Package #2.  Base plus 50 percent incentive on his collections each month.

In other words, is it better to get a greater incentive based on your own work or a lower incentive, but based on the work of the entire office?

After quite a bit of thought, I figured out that it is a classic investment dilemma:  Are you willing to take more of risk for a higher reward or less risk for les of an award?  Another way to state it is:  Would you rather take the sure thing (getting paid based on the office as a whole), or take a chance (what if you can’t produce enough to get the incentive each month?)?

The risk, of course, is in what you think you can do to bring in patients on your own.  If you can bring in a lot of patients every month, you can do really well.  But if one month you are sick, or have a family issue that takes you away from the office or prevents you from marketing, you will only receive your base. 

There may be other considerations I am missing.  I would like to know what  you think - which would you take?  I will tell you what this doctor decided and why, in a later post.

Posted in contract questions, associate and independent contractor issues, financial questions | No Comments »

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