Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Military physicians leaving the military

Dennis Hursh, Esq
Finance
July 8, 2022
Share
Tweet
Share

Military physicians leaving the military have several issues that should be carefully evaluated before executing a contract with a civilian employer.

First of all, the income is definitely going to be higher than the military physician salary. Much like a physician coming out of training, military physicians should ask whether the salary is fair, not if they will be making more than they currently earn. Medical Group Management Association (“MGMA”) benchmarks can be utilized to determine if the salary is fair. Importantly, MGMA benchmarks can be analyzed based on years in the specialty. If MGMA has sufficient data for this analysis (not every subspecialty or specialty does have sufficient data), the years in specialty differentiation can be very helpful in analyzing an offer.

MGMA also has signing bonuses, CME, vacation, and call coverage compensation benchmarks. The MGMA data on relocation allowance is also of more than academic interest. Sometimes an employer can be convinced to add the relocation allowance to the signing bonus, so even if the military is paying for your move, you may still be able to utilize the relocation allowance benchmark to your advantage.

Military physicians also seem to be more accepting of the “this is our standard contract” line than their civilian counterparts are. Although that line is utilized frequently (because it works), only a tiny minority of institutions or practices actually require every physician to sign the identical agreement. The recruiter will frequently tell the military physician that the recruiter cannot make any changes to the agreement. This is often true since many institutions and practices only allow a senior executive, with legal input, to change an agreement. It is always worth asking if the recruiter can forward questions regarding the contract to somebody else.

Military physicians also need to carefully review provisions regarding the start date. Civilian employers will require you to be credentialed at hospitals and by managed-care companies. Many first drafts of civilian contracts allow the employer to terminate the agreement or delay the start date until all credentialing is completed. This can cause the physician to move to a new location and rent an apartment (or buy a house), expecting to have income on a given date. If the physician employment agreement does not allow you to start until all credentialing is completed, you may end up effectively unemployed. Landlords and mortgage companies are not particularly understanding if it turns out that you are not being paid when the rent or mortgage is due. The employer should agree to negotiate in good faith with you if not all credentialing is completed at the anticipated start date.

Another issue that the military physician needs to consider is the covenant not to compete. Many physicians feel that there should be no limitation on the ability to practice if the physician leaves an employer. However, most states do allow an employer to restrict the ability of an employed physician to compete with his or her former employer. Too many physicians rely on an attorney’s opinion that a restrictive covenant is not enforceable by a court. In fact, the market will enforce a restrictive covenant that a court would never enforce. Your potential new employer will not risk going to court with the first civilian employer because they are allegedly “intentionally interfering with contractual relations” of the first employer.

The final issue that traps many physicians in their first civilian physician employment agreement is payment of tail coverage for malpractice insurance. There are two types of malpractice insurance: occurrence-based coverage and claims-made coverage. Occurrence-based coverage will cover any claim that occurred during the time that the policy was in place, so if a claim is made after you leave that employer it will be covered. However, claims-made insurance, as the name implies, only covers claims made when the policy was in place. If the employer has claims-made insurance, then an extended reporting endorsement (a “tail”) must be purchased.

Tail coverage can cost nearly half a physician’s annual salary, so the physician may end up trapped in a position that the physician hates because it is simply too expensive to leave. The physician employment agreement should contain a provision addressing who is responsible for purchasing the tail. If the employer is not willing to cover the entire cost of the tail, sometimes they are willing to pay a portion of the tail based upon years of service (e.g., 1/5 of the cost of tail coverage for each completed year of service). When negotiating these agreements, I always attempt to require the employer to pay for tail coverage if the agreement is terminated without cause by the employer or because of the death or disability of the physician.

Military physicians should also realize that not all employers are equal or treat their physicians equally. It would be prudent to investigate how physicians rate their employer at a site such as RYHE.org.

Military physicians entering the civilian job market are in a “seller’s market.” They should get a reasonable employment agreement. It is important to remember that while you were serving your country, you also gained valuable experience as a physician. Do not sell yourself short!

Dennis Hursh is a veteran attorney with over 40 years of experience in health law. He is founder, Physician Agreements Health Law, which offers a fixed fee review of physician employment agreements to protect physicians in one of the biggest transactions of their careers. He can also be reached on Facebook and LinkedIn.

Image credit: Shutterstock.com

Prev

2 questions you should ask when choosing a surgeon

July 8, 2022 Kevin 0
…
Next

A doctor for LGBTQ+ health needs

July 8, 2022 Kevin 8
…

ADVERTISEMENT

Tagged as: Practice Management

Post navigation

< Previous Post
2 questions you should ask when choosing a surgeon
Next Post >
A doctor for LGBTQ+ health needs

ADVERTISEMENT

More by Dennis Hursh, Esq

  • Why hospitals are quietly capping top doctors’ pay

    Dennis Hursh, Esq
  • What independent and locum tenens doctors need to know about fair market value

    Dennis Hursh, Esq
  • What every physician should know before buying into a medical practice

    Dennis Hursh, Esq

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The risk physicians take when going on social media

    Anonymous
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • When physicians are cyberbullied: an interview with ZDoggMD

    Monique Tello, MD
  • Surprising and unlikely rewards of social media engagement by physicians

    Lisa Chan, MD
  • Physicians who don’t play the social media game may be left behind

    Xrayvsn, MD

More in Finance

  • Decoding your medical bill: What those charges really mean

    Cheryl Spang
  • 5 blind spots that stall physician wealth

    Johnny Medina, MSc
  • The most overlooked skill in medicine: contract negotiation

    Cynthia Chen-Joea, DO, MPH and Peter Baum, DO
  • The business lesson new doctors must unlearn

    Stanley Liu, MD
  • The hidden impact of denials on health care systems

    Diana Ortiz, JD
  • Why physicians are unlike the “average” investor

    David B. Mandell, JD, MBA
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...