What Anesthesiologists Should Consider Before Signing Employment Contracts

What Anesthesiologists Should Consider Before Signing Employment Contracts

At the 2023 American Society of Anesthesiologists meeting, I represented NorthStar Anesthesia at a round table discussion alongside other leaders from ASMG, Envision, NAPA, TEAMHealth, and USAP regarding employer contract transparency. In the crowd were residents, fellows, and medical students -- some in the throes of job searches.

This topic is especially important for new clinicians entering the job market, as most do not know what to expect in an employment contract. There are standard contractual components, such as language around HIPAA and general HR policies, throughout the anesthesia industry, but more specific items can trip up new practitioners.

The below addresses elements of an employer contract agreement I recommend new clinicians pay close attention to as they consider anesthesia employment opportunities.

Navigating Pay Structure and Benefits

Anesthesiologist salaries vary depending on geographical location, markets, and years of experience. However, different hospitals and groups will calculate salaries and incentive pay through different formulas. It’s your right to request that your pay structure is explicitly defined in your written agreement, including any additional stipend for fellowships, specialties, leadership positions, or initiatives requiring extensive work and time commitment (i.e., Director of Quality or Head of a division). You won’t want too rigid of language to allow flexibility as your experience grows, but you will want language which protects you during slower growth periods. You are also able to negotiate signing bonuses and/or relocation expenses to offset expenses.

Physician salary also goes in hand with paid time off (PTO) discussions. PTO allowance varies from employer to employer. If your contract offers less PTO than you expect to use per year, consider negotiating for a slightly lower salary in exchange for additional PTO, or vice versa. However, before engaging in negotiations around PTO, inquire if your employer has a carryover policy or buyout at the end of your contract.

Facility Location and On-Call Requirements

When reviewing your contract, you’ll want to establish a maximum number of calls that could be assigned per month, without additional compensation. Additionally, consider how many facilities you are comfortable working at between hospitals and ambulatory surgery centers (ASC). A contract may not outline your specific practice locations, which can lead to unexpectedly long commutes to different facilities. Ask for your contract to specify where you would be expected to work and require your consent to ask you to work elsewhere.

Ensuring Job Stability and Career Growth

Keep an eye out for mentions of future leadership opportunities, as contract language can become tricky. For example, a contract could mention either you will be made partner after a certain number of years, or it could say you will be considered for a partnership. If a senior role is not explicitly promised in your contract, it can be difficult to secure in the future.

On the flip side, ensure your contract includes language requiring an employer provide a minimum 90-day notice in the event of a staff reduction. This time would allow you to meet residual patient needs as you transition your credentials and services to a new facility. Additionally, review a contract’s non-compete clauses to ensure you stay far away from litigation and/or fines should you want to work at competing locations, and check on the contract’s language regarding solicitations. Ensure you don’t agree to non-compete language which is unrealistic and pushes you out of a county or state, should you decide to change employers.

Benefits of Employment with NorthStar

In terms of employment contracts, those at NorthStar Anesthesia are generous and often surpass the offerings of NorthStar’s competitors. NorthStar invests in your career in a variety of ways, several of those being free continuing education units (CEU), continuing medical education (CMU), and leadership development programs so you can grow in a variety of ways as a physician. I recommend you factor in these sorts of opportunities when you are considering a job offer.

NorthStar also invests in your future, offering its clinicians a 401(k) program and company match, comprehensive life insurance policies, and short-term and long-term disability insurance. Additionally, NorthStar contracts offer competitive benefits with comprehensive health, dental, and vision plans, back-up childcare, and other family benefits. These benefits start immediately upon day one of employment! You can learn more about NorthStar opportunities for physicians here.

Final Thoughts

It’s a great time to be an anesthesiologist, overall. As you navigate your employment contract, remember not to jump at the first opportunity offered to you and read a contract’s language carefully.

Romeo Kaddoum, MD, is the Regional Chief Medical Officer for Michigan and the Senior Vice President of Physician Services for NorthStar Anesthesia.