September 2020 Volume LV Number 5


Resident's Corner

September 2020 Volume LV Number 5

A Contract Is Negotiable
Jillian Muhlbauer, D.M.D.
First adult job coming up. Ready to sign a contract? No!
If you are anything like me, my background is entirely science focused. Even with a broad liberal arts education, philosophy and history requirements filled my schedule rather than any business electives. With a job search looming on the horizon, I do not have the confidence to "talk the talk" when it comes to contracts. What advice have I received thus far? Get a lawyer. Great advice, but that doesn’t preclude a little bit of leg work to familiarize and educate myself with components of employer agreements. After all, you can’t get what you want if you don’t know what you’re looking for.
Here is some food for thought for when you go through the first read of your contract:
Tip #1: Figure out what you want. Before that first job inter- view, try to rank what is most important to you. Is it mentorship or opportunity for ownership? Perhaps a flexible schedule or mutual practice philosophy? For recent grads, compensation might rank #1, considering hefty loans from dental school. Maybe sedation opportunities or hospital privileges are your priority. Patient population, community engagement, office culture, anticipated commute... The list is endless, but take a moment to reflect on those must-haves – try to understand your own motives, recognizing that it might change through- out your career.
Tip #2: Understand the position you are being offered. As- sociateships live on a continuum - from pure employee, future partner, or intended practice buyer. Is there a structure in the contract to describe a buy-out plan? Has the practice been ap- praised prior to your addition to the work force? Are you replac- ing an associate or adding on to the practice? If it is the latter, what is the marketing plan to acquire more patients to fill your schedule?

Tip #3: Familiarize yourself with a few key differences.
  • What does it mean to be an independent contractor versus an employee? Your accountant will want to know! Besides important differences in decision making and financial control, independent contractors are responsible for individually filing income, employment, and social security taxes.
  • Understand the ways you can be compensated. Com- pensation based on salary versus commission and bonus structures should be defined. How does compensation based on collections versus production compare? Do those percentages include hygiene or radiographs? Are lab fees deducted? Are percentages calculated on a quarterly basis to account for the peaks and valleys of pay versus produc- tion? 
Tip #4: Customize and negotiate to your needs. For most, that first contract is a stock form, rarely tailored to your needs. But it can be. Most employers are willing to add clauses within reason - clauses that matter to you. You won’t get any modifica- tions if you don’t ask. Some to consider asking for:
  • Inclusion of dues for professional memberships or CE courses.
  • Reimbursement for initial on-boarding costs: moving, licenses.
  • Understand restrictive covenants. Understand geographic restrictions for multiple or future locations. Is the restric- tive covenant active immediately or include an exclusion period? Even if it might not be enforceable, no one wants a lawsuit looming.
Tip #5: Hire an attorney to review your employee contract. Some provisions, such as restrictive covenants and non-solicita- tion agreements, can have a long-term impact on your career. Therefore, it is in your best interest to have an experienced attorney read over your contract. Ideally this person will have some experience in contracts specific to healthcare. Consider interviewing attorneys to find the right fit of personality, expe- rience, and practice record. Fee structures are important too!
Nothing you read here represents legal or professional advice. Want more information? The ADA Center for Professional Suc- cess has a very informative document titled, "Dentist Employ- ment Agreements: A Guide to Key Legal Provisions."
Dr. Muhlbauer is a graduate of the Harvard School of Dental Medicine and current second year resident at Children’s National Hos- pital in Washington, D.C. She is originally from Massapequa Park, N.Y., and is a current member of the AAPD Resident Committee.

Click here for a PDF version of this article.