When you are in the process of completing a residency or fellowship, looking for a radiology job becomes a daunting task. Not only are you trying to find a career that will last for years, but you are also left alone swimming through the complexities of contract negotiations, an area you probably have not experienced before. It’s a brave new world.
So, what do you do? As a typical resident, you find general information on the internet about the basics of contracts. And if you contact an attorney, he will probably give you generalities about how to approach contract negotiations. But, this post is different as it outlines what negotiation points a practice is more likely to give to the applicant.
To that end, today, you will get an insider’s view of what you are most likely to be able to negotiate and which benefits you may find difficult to change. You will also receive the perspective of someone who works as a private practice partner and advocates for his residents. Remember, I am not an attorney, so I am not providing legal advice. Instead, I am telling you what I think practices are more likely to leave on the table for negotiation and what items practices do not want to touch.
Depending on the desirability and location of the practice, however, you may be able to get a lot more, or you may have no wiggle room at all. That is something you will have to judge for yourself based on what you know about the practice. So, let’s go through some of the basics.
Benefits You Can Negotiate More Easily
Moving Expenses
Moving can cost a lot. Generally, you are talking about multiple thousands of dollars, especially if you move a substantial distance. However, many practices will usually be willing to include this benefit into the contract. Why? First, it is a tax-deductible expense for the business so that the practice will pay for it in pretax dollars. And then, it pays to create as many connections for you to the area as possible. What better way to accomplish this than to provide for moving expenses?
401k Plan Perks
Typically, practices tend to be more flexible with indirect expenses such as matching contributions to a 401k plan. Why? Again, it is a pretax benefit that the business can write off. Yet, it does not appear as an increase in income. Partners would prefer to negotiate a 401k plan than a salary because increasing a wage could lead to adding on additional income to other employees. It is much harder to calculate indirect perks!
Time Spent In Particular Departments
Maybe you hate mammography or can’t stand interventional procedures. In the beginning, discussing your expectations for where you want to work in the practice is entirely reasonable. For some applicants, this can make or break the quality of a job. And, for the imaging business, this can be a minor concession compared to other benefits!
Malpractice Tail Insurance
Malpractice tail insurance can cost an employee thousands of dollars when they leave a practice. So, this can potentially be a significant cost saving. And the practice can pay for coverage with pretax dollars. Like the 401k plan, it differs from the subheading of salary/income. For these reasons, the imaging business may be more willing to budge a little on a negotiated contract.
Restrictive Covenants
Nowadays, many practices place restrictive covenants within the contract to prevent the applicant from leaving and working for a local competitor. Each state enforces these covenants differently, and the time and distance restraints can vary widely. But, this can potentially lead to a problem if you want to continue living in the area and decide to quit your job. However, it is very unusual for a practice to enact the clause on a former employee legally. (although possible!) So, if you need to stay in the area, no matter how the job goes, this may be an item that you should consider entering into contract negotiations.
More Difficult Items For Contract Negotiations
Annual Income
Salaries are usually the most challenging item to negotiate. Why? Although typically not allowed, employees will often compare salaries, and tempers can flare if the employees perceive their salary as unfair. In addition, the partners usually compare the salaries of all their employees and themselves. It becomes hard to create a fair deal that does not impact others in practice. Some employees may have had more experience, and others bring particular skills to the practice. So, it can seem unfair among the partners as well. Unless you are in an enviable position of working at an undesirable location or you have a particular skill that the practice cannot find elsewhere, annual income is not as easily changed.
Years To Partnership
Years to partnership can also be a very touchy subject. Partners may have invested themselves in the business for years. And, you want to change the system to give you fewer years to partner? That typically does not fly as well as negotiating other benefits. In addition, large sums of money are at stake for each year removed from the track. So again, you will be hard-pressed to negotiate fewer years to partnership.
Buy-ins
Typically, a buy-in or sweat equity is an amount you pay to the practice for the privilege of becoming a partner. This number can vary from a nominal amount to millions of dollars. Again, emotions can flare when you decide to change the amount it costs to enter a partnership, as you may have to pay less than the other partners. In addition, some practices own equipment or real estate. It would be unfair for the practice to give away these assets. Depending on the business, this can be a challenging item to negotiate as well.
Loan Repayment
Unfortunately, residents bemoan student loans more than anything else. And the high debt burdens residents must face paying for the privilege of going to college and medical school can be overwhelming. To make things even worse, however, most practices will not make this an employee perk because the practice cannot deduct the money pretax. Perhaps even more important than that, the business has to trust that the employee will not skip town and leave the practice prematurely. As you can see, imaging businesses take a lot of risk by adding this benefit to sweeten the deal for the applicant. Therefore, a new employee getting loan repayment as a benefit is unusual unless the practice is in desperate need of the applicant.
Contract Negotiations: A Battle Or The Beginning Of A Great Friendship?
Finally, I have not mentioned the most critical point of contract negotiations. A contract is only as good as both of the parties’ word. A contract can be ironclad for the employer or employee. Regardless, the specifics outlined by a contract are rarely used if the employee likes the job, and the employer likes the employee’s work. Only when things don’t go as planned the contract becomes truly important. So, here’s the bottom line and the irony of it all. As crucial as contract negotiations can be, invest more time and effort in figuring out whether the job is right for you rather than worrying about the nitty-gritty details of the contract. Good luck!
Comments
Have any strong opinions about other items that should be negotiated in a contract? We would love to hear your thoughts by commenting below!
