It’s hard to walk away from a bad deal, especially after you have invested considerable time and energy learning about a practice opportunity. Look for these indicators to help you decide whether to continue pursuing the job.

A disorganized prospective employer is not an encouraging sign. First, can the person recruiting you clearly describe the position and answer your questions? Unclear expectations greatly increase the risk of serious disagreements. Clear expectations are especially important if the employer is recruiting you for a new position.

Does the interview process run smoothly? Is it difficult scheduling telephone interviews or setting up meetings with others during your on-site visit? 

Does the person interviewing you focus on money issues? Does he or she ask how much you would like to earn, rather than describe the compensation package? How does it compare to the other offers you have received? Will you receive a signing bonus and relocation expenses? Does the interviewer push hospital physician recruiting financial incentives, (which are really loans you must repay if you do not continue practicing in the area)? Are you required to pay your own interview travel expenses?

Use your prospective colleagues as surrogates. Are you able to talk informally with physicians in positions similar to the one for which you are applying? Have many physicians left the practice recently? Have the current physicians been with the practice for a while? Does their workload sound reasonable? Can you see yourself working with them? If they seem happy there is a good chance you will be, too. Click here to learn more.

How difficult is it for you to obtain an employment agreement? Does it clearly and accurately describe what the employer offered to you during your interviews or does it vary significantly? Is the language vague? Is the agreement dense, complex, filled with arcane legalese, or excessively long, i.e., more than 30 pages? All could camouflage unfavorable terms and conditions.

Is the agreement strongly skewed in favor or the employer? Does it contain strict language and high penalties? Does it frequently use the phrase, “at Employer’s sole discretion”?

The two areas of highest risk in an employment agreement are the descriptions of the physician’s duties, schedule, and practice location, and the compensation model. Vaguely defined duties enable the employer to demand that you practice outside your area of clinical expertise or preference. A poorly defined schedule could lead to long hours and heavy call. Unspecified locations could require practicing in undesirable settings or long commutes.

A compensation model that offers a low, or no, base salary carries the risk that you might not earn very much. Performance incentives based on your profitability, i.e., practice revenues minus expenses, shift much of the employer’s financial risk to you. Vague performance bonus criteria also increase your financial risk. Beware salary “advances” that you must repay if you do not meet performance standards. Look out for compensation amounts or formulas that are subject to change during the term of your employment.

If you are applying for a position with a private practice, get a clear understanding of the opportunity to become a partner or shareholder in the practice. While you are not asking for a promise of partnership, you do want to know what the offer might look like, e.g., when might you be offered partnership, what’s included, how much it might cost, and how you will pay for it. Incomplete information when beginning employment as an associate increases the risk of disappointment with a partnership opportunity later.

Good faith negotiations can improve a seriously deficient employment agreement. Describe what you view as problems and propose how you would like to revise the language. Does your prospective employer seem to understand what you want? Is he or she working with you to resolve your differences? Alternatively, does he or she assert that you are being offered their unchanging “standard” employment agreement? Is your prospective employer making meaningful concessions, or just minor adjustments? This can be critical when describing your compensation, duties, schedule, and practice location.

Consider your subjective impressions as well as objective information during the interview and negotiation process. In short, how well do you feel the employer is treating you? Good treatment before you are hired suggests good treatment later. On the other hand, poor treatment during the interview and negotiation process can be a harbinger of poor treatment ahead as an employee. A fair employment agreement benefits both physician and employer. A poor agreement enables the employer to mistreat you in various ways. Waving red flags may be signaling that it is time for you to walk away from a bad deal.