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Hiring a New Physician: Employment Agreements, Bonuses, etc. in California

Are you a partner in a medical practice? You may be considering hiring a new physician to join the practice. It can be a complicated process in California. There are a number of different considerations that business owners need to consider and address, including employment agreement, compensation terms, and ownership structure. Here, our California business lawyer for employers highlights the key things to know about hiring a new physician to join a group medical practice in the Bay Area. 

You Should Start With a Physician-Specific Employment Agreement

California is an at-will employment law state. Medical practices are not required to use employment contracts to hire employees. With that being said, a comprehensive, professionally-drafted employment agreement is always recommended when hiring a new physician for your group medical practice. The contract should be tailored to physicians. A generic employee offer letter usually leaves too much unresolved. The agreement should identify the physician’s title, clinical duties, schedule, call expectations, supervision structure, administrative obligations, patient documentation standards, and compliance responsibilities. It should also address licensure, board certification, DEA registration, medical staff privileges, malpractice coverage, and participation in Medicare, Medi-Cal, and private payer networks.

Beware of non-compete agreements: California sharply limits restrictive covenants. Business and Professions Code § 16600 generally voids contracts that restrain a person from engaging in a lawful profession, trade, or business. In other words, non-compete should generally be avoided. 

Medical Practices Should Carefully Define Compensation, Bonuses, and Productivity 

Physician compensation should be clear before employment begins. Along with other things, the employment agreement should state base salary, bonus eligibility, productivity targets, collection thresholds, quality metrics, and payment timing. If the practice uses a productivity bonus tied to collections, relative value units (RVUs), profit sharing, or new patient volume, the formula must be precise. 

Know the law: California Labor Code § 2751 requires written commission agreements when an employee’s pay involves commissions. 

Ownership Expectations Should Be Addressed Upfront

Many associate physicians join a group practice with an expectation that partnership may follow. The employment agreement should avoid vague promises. If ownership may be offered later, the agreement should describe the process without guaranteeing admission as a partner. The practice can require minimum tenure, productivity levels, cultural fit, licensure compliance, board approval, capital contribution, or a separate buy-in agreement.

Medical Practices Can Benefit With a Plan for Termination, Transition, and Risk Management

The agreement should explain how the relationship can end. Termination provisions should address without-cause notice, for-cause termination, loss of license, exclusion from federal health care programs, loss of malpractice coverage, substance impairment issues, patient safety concerns, and failure to maintain hospital privileges or payer credentials. As a general matter, the contract should also state things like how compensation, accrued bonuses, benefits, records, equipment, and patient handoff duties are handled at separation. Malpractice coverage deserves special attention. If the practice uses claims-made coverage, the agreement should specify who pays for tail coverage after termination. 

We Provide Business Law Services to Medical Practices in California 

Lynnette Ariathurai is a California business lawyer who works directly with employers, including professional practices. If you have any questions about hiring a new physician for a medical practice, please do not hesitate to contact us today. With an office in Fremont, we work with medical practices throughout the Bay Area. 

business planning, healthcare agencies, hiring a doctor, medical practice hiring