Eyeworld

OPHTHALMOLOGY BUSINESS 98 February 2017 by Liz Hillman EyeWorld Staff Writer Navigating contract negotiations who suddenly left the practice, there is likely to be a lot more room for negotiation than in the case of a retiring ophthalmologist, who gave a year or more notice of his intent to retire from the practice." Negotiating within the range of what's acceptable in the field will also help maintain respect with your future colleagues. "If [a practice is] coming in at $190,000, ask for $210,000, settle for $200,000, but don't go asking for $250,000, when that's not in the right ballpark. Try to be reasonable, know what the norm is. If everyone else in the practice is only getting 4 weeks of vacation, don't expect to get 5 weeks," Mr. Kropiewnicki said. Natasha Herz, MD, Kensington Eye Center, Rockville, Maryland, advised trying to find "win-win" points on which to negotiate and giving oneself extra time to consider emotional responses. "If an issue does evoke a strong emotional response, be sure to save your email and revise it in the morn- ing to keep from writing something you can't take back. Remember, the written word is much harsher than the spoken word," Dr. Herz said. From non-competes to buy-ins and buy-outs, there's much to consider before signing on the dotted line Y ou've decided what and how you want to practice. You scoped out locations and interviewed, hoping to find a fit that's good for you and the hiring practice. Now they want to offer you the job and you're inclined to accept, but there's one major thing to settle: your contract. Mark Kropiewnicki, Health Care Law Associates, Plymouth Meeting, Pennsylvania, said his first piece of advice in the contractual process is to have a knowledgeable advisor look over your employment agreement. "Make sure you hire not just a good lawyer, but a good lawyer who happens to know something about the field, as opposed to a good real estate lawyer who can review a contract but doesn't know what the norm is in this kind of situation," Mr. Kropiewnicki said. Someone knowledgeable in ophthalmology contracts will not only have a sense for pertinent legal aspects but will understand the normal range for things like salary, vacation time, buy-in and buy-out structure, and bonuses. "Most people who want to hire me are doing so not so much because I'm a good lawyer, although I am, but because they want to know 'What's the normal deal?'" Mr. Kropiewnicki said. Striking a balance Accepting all the terms of an employment agreement without negotiation is a common mistake, said Lawrence Geller, vice presi- dent of consulting services, Medical Management Associates, Atlanta, as is assuming that all terms of the agreement are negotiable. "Typically, the truth lies some- where between the two extremes," Mr. Geller said. "In my experience, one's ability to negotiate is related to the context within which an ophthalmologist is being added to the practice. By way of illustration, if the practice is recruiting for some- one to replace an ophthalmologist R emember sitting down with your program director or department chair and hashing out the details of your residency contract—number of phacos, call schedule, vacation, pay? Of course you don't. Unless you have experience outside of your medical training, you have probably not negotiated a contract before—and almost certainly not one with the stakes involved when you agree to join a practice. I highly recommend getting an attorney who knows how ophthalmology contracts work. It's usually best to handle the actual negoti- ating and discussions yourself, but an attor- ney will make sure you know the landscape and have the appropriate background. It also is important to have someone look at the contract language itself. At this point, you and the practice have the same goal: They want you to join them, and you want to work there. However, the contract is there in case things don't work out, which unfortunately happens fairly often. Also, no matter what you agree to in your conversations, the wording of the contract itself must reflect that. We're fortunate this month to have guidance from Mark Kropiewnicki and Lawrence Geller, who are both experi- enced at ophthalmology contract negotia- tions. Natasha Herz, MD, is in solo practice in Maryland and is the editor of YO Info, which has published multiple articles with additional valuable advice. Bryan Lee, MD, YES connect co-editor YES connect

• Cover