Ask any physician:
- What are the goals of the medical profession?
- How important is trust among doctors?
No doubt, their response would be: “The prevention of disease, relief of suffering, care of the ill and avoidance of premature death. These goals are attainable only when there is a high level of trust among physicians.”
Unlike the legal profession — where trust is not a given among peers — doctors trust one another for the benefit of their patients. That said, there is a time when trust should have no role in a critical decision a physician must reach — even when dealing with another doctor — and that is when they are handed an employment contract and asked to sign it.
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In my over 40 years of law practice, I have seen the results of misplaced trust by physicians in our age of corporate medicine and, especially, where physicians become CEOs of HMOs and act more like lawyers. I have seen some become more like Dr.-Jekyll-and-Mr.-Hydes than caring physicians.
He's not hanging up his stethoscope
But there is one more issue that is central to today’s story and has a real impact on the delivery of health care services. It is a fact that many older physicians are hesitant to retire and do not want to hang up their stethoscopes. They know that retirement is often dangerous to one’s health. They want to work fewer hours, not “take call” at three in the morning and be able to just slow down while still treating patients.
Larry is one of them.
82 and still at the office
“Dennis, I am board certified in both general surgery and urology and have practiced for well over 50 years in my agricultural community that is recognized as being short of physicians. I want to slow down and, for the past year, worked out an agreement with our HR manager, which means that:
- I work three days a week
- I am no longer doing general surgery, just practicing urology
- I do not have to ‘take call’
- My malpractice insurance is paid for, including coverage for when I leave the organization
“Everything was fine until the HR manager left due to a family emergency and was replaced with someone far less accommodating. She immediately handed out new contracts to everyone and asked me to sign it that day. I politely said that I wanted to review it with my family and would get right back to her next week. She agreed.
“This contract lacks the things that her predecessor agreed to. Dennis, I am a very non-confrontational person and do not want a fight. What should I do?”
Don't assume the worst or allow yourself to be bullied
So, how do you deal with important contractual issues that are not addressed and avoid getting into an ugly situation? I set up a conference call with Larry and two of my colleagues who specialize in advising physicians in employment disputes. They recommended three things:
1. Can Larry get a job at another facility on his terms? Before even speaking with the HR manager at his current facility, he should reach out to another one, be upfront and ask them if he could work there if things fall apart with his present employer. This is his plan B.
2. Larry shouldn’t assume this new HR manager is acting in bad faith, my colleagues cautioned: “Was she even aware of the earlier agreement?” Even if their agreement was not put in writing, his work schedule, pay records and no evidence of taking call are convincing proof of their terms.
3. If talking with the HR manager fails, Larry can refer to a higher authority. If he is told, “No, we can’t do this,” then his response could be, “My wife and kids have grown accustomed to me working less. I love working here, but just can’t do this to them. Why don’t you discuss this with the CEO, as I am pretty sure he does not want to lose me. And I want to continue calling this my second home.”
Establish an attorney-client relationship
While there are other issues here — possible age discrimination, for example — Larry’s situation is a good example of why physicians, especially young docs out of residency, need to establish a solid relationship with both a lawyer and a CPA who understand the employment challenges facing them and never hesitate to ask for their advice, which is just what they would tell their patients.
Dennis Beaver practices law in Bakersfield, Calif., and welcomes comments and questions from readers, which may be faxed to (661) 323-7993, or e-mailed to Lagombeaver1@gmail.com. And be sure to visit dennisbeaver.com.
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