October 6, 2023 • By Dennis Beaver

If you were to ask any physician, these two questions:

(1) “What are the goals of the medical profession?”

(2) How important is trust among doctors?

No doubt, you would hear: “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 – doctors trust each other 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.

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 them become more of a Dr. Jekyll and Mr. Hyde – than caring physicians.

Not Hanging Up My 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 “calls” at three in the morning, and be able to just slow down while still treating patients and not see their brains and bodies atrophy or become victims of age discrimination.

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:

(1) I work three days.

(2) Am no longer doing general surgery, just practicing urology.

(3) Do not have to “take calls.”

(4) 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, 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 recommend three things:

(1) Can Larry get a job at another facility – say, the county hospital – on his terms? Before even speaking with the HR manager, talk with the people over there, be up-front, and ask them if he could work there if things here fall apart. This is his Plan B.

(2) “Don’t assume this new HR manager is acting in bad faith,” they cautioned. “Was she even aware of the earlier agreement? But even if it was not reduced to written form, his work schedule, pay records, and no evidence of taking call is convincing proof.”

(3) Refer to Higher Authority. If you are told, “No, we can’t do this,” then your response should be, “My wife has grown accustomed to me working less. I love working here, but just can’t do this to her. 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 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.