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Navigating Restrictive Covenants in Physician Employment Agreements

By Ericka L. Adler | November 30, 2011

It’s a busy time of year for reviewing and preparing employment agreements for young residents and fellows across the country. In the next few blogs, I will talk about some common contract issues that arise in these employment agreements.

One frequent provision worth discussion in such contracts is the restrictive covenant. There is a false belief among many young doctors reviewing their first employment agreements that covenants are unenforceable. Nothing could be further from the truth (in most states) and it is important for every physician, whether taking a job or offering one, to understand restrictive covenants as well as their enforceability.

(MORE: Closing Your Medical Practice: Steps to a Smooth Retirement (Part I))

From the perspective of an employer, a lengthy and broad prohibition seems like a great idea. While the fear factor associated with such covenants may be effective in deterring competition in some cases, most states take a common approach to covenants by enforcing those that have restrictions which are reasonable in terms of length, scope, and geography.

There is no one covenant that suits all practices. Covenants are generally enforceable in most states if they apply during the term of employment and for a period of one to three years thereafter. The covenant should prohibit the physician from rendering competitive services only and not simply from practicing medicine or treating patients.

In terms of geography, the covenant should be carefully planned to cover the actual service area of the practice around the offices or facilities at which practice patients are seen. In a rural area, as well as among certain subspecialties, this can mean that covenants of 25 miles or greater may be acceptable. In an urban area, and especially among less specialized physicians, a mile or less may be appropriate.

Covenants which are properly drafted will preserve the protectable interest of the practice without being so overbroad as to be deemed unenforceable in a court of law. Some states allow a court to redraw an overly broad covenant so as to make it more enforceable — other courts may not allow such an approach and will refuse to enforce the covenant completely. For this reason, a properly drafted covenant is important in order for a practice to protect its interests.

Employers should keep in mind that covenants may be unenforceable, depending on state law, until an employee has worked for the practice from 12 months to 18 months, and a covenant introduced to a physician after he or she has already been employed by a practice may not be enforceable unless accompanied by some additional remuneration from the practice to the physician.

From a physician’s perspective, a properly drafted covenant will allow the physician more freedom to live within the same area as the practice without breaching the agreement between the parties. I always suggest that my physicians try to have the covenant waived in the event the physician is terminated without-cause, the physician terminates for-cause, or the physician is not offered partnership. While some practices will agree to these ideas, others will not. A physician should always be willing, no matter how poorly a covenant is drafted, to abide by it upon termination. Proving a covenant is unenforceable is a long and expensive process that is rarely worth the battle.

One final issue to consider regarding covenants is that they typically are prohibited by most recruitment and support agreements requiring a physician to remain in the service area following termination of employment in order for hospital loans to be forgiven. From the physician’s perspective, it’s important that employment agreements not contain these restrictions or they may find themselves in the unenviable position of relocating and repaying loans that could have been worked off. Your counsel should coordinate covenant restrictions contained in the employment agreement and any recruitment agreement.

Whether preparing or reviewing an employment agreement, talk to counsel about the effectiveness and enforceability of the covenant. There are some special considerations with regard to covenants for practices such as hospital-based groups, telemedicine practices, and nursing home or home health physicians. An experienced health lawyer should be able to guide you through the nuances of writing and reviewing these types of employment covenants.

Find out more about Ericka Adler and our other Practice Notes bloggers.

 

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More from Ericka L. Adler:

Negotiating the Sale of Your Medical Practice

Preparing Your Practice for a Possible E&M RAC Audit

Addressing Compensation for Disabled Physicians at Your Practice

Home Health Agency Referrals: A Guide for Physicians

Medical Loss Ratio Rebates: Distributing Them Properly

Abusive Patient Behavior: Physicians Have 'Rights' Too

Don't Waste Patient, Physician Time with Unproductive Visits

Implementing Complementary and Alternative Medicine at Your Practice

Qui Tam Lawsuits: A Threat That Should Concern Physicians

The National Practitioners Data Bank: What Physicians Should Know

Medicare's 2013 Proposed Fee Schedule: The Physician Impact

Physician Recruitment Agreements: Concerns and Considerations

Understanding Physician Recruitment Agreements

Point-of-care Dispensing: Profit, Penalties, and Your Practice

Physicians: Be Cautious When Taking on a Medical Director Role

Understand the Legal Limits of Physician Advertising

Hospital-driven EHR Mandates: Boosting Physician Use, But at What Cost?

Text Messaging and Patients: Benefits and Considerations

Closing Your Medical Practice: Steps to a Smooth Retirement (Part II)

Mentoring Young Physicians: Feedback Is Important to Future Success

Employees vs. Contractors in Medical Practice: What's in a Name?

When the Difficult Physician Is You: Let Your Lawyer Do Her Job

Online Defamation Can Hurt Your Medical Practice Reputation: Be Prepared

OCR's HIPAA Audits: Get Organized and Be Prepared

Creating a Social Media Policy for Your Medical Practice Staff

Addressing Sexual Harassment at Your Medical Practice

Distribution of DHS Income for Physicians: Avoid ‘Stark’ Consequences

Physicians Selling Products: Legal and Ethical Considerations

Balancing Patient Interaction, EHR Use at Your Medical Practice

High-Deductible Health Plans and Your Medical Practice: Be Prepared

How Should Your Medical Practice Handle an Impaired Physician?

Addressing Patient Financial Hardship at Your Medical Practice

Physicians and Self-Prescribing: Just Say ‘No’

Crafting Non-solicitation Provisions in Physician Employment Contracts

Poor Recordkeeping by Physician Employees: Grounds for Termination?

Concierge Medicine: Doing It Right Can Boost Practice Income

Practicing Medicine in New States Can Come with New Issues

Holiday Gifts from Patients: Four Considerations for Every Practice

Navigating Restrictive Covenants in Physician Employment Agreements

Audits: Why They Happen and What Your Medical Practice Should Do

Ancillary Services Can Add Practice Revenue, But Follow the Law

Groupon: Great for Prada Shoes, But Not Physician Services

Discharging Patients with Unpaid Balances

Seven Possible Legal Pitfalls at Your Medical Practice

Clarify Future Equity for New Physicians at Your Medical Practice

Terminating Physicians Paid on Productivity: Contract Issues

Avoid Self-disclosure to CMS: Plan an Annual Legal Audit at Your Practice

Closing Your Medical Practice: Steps to a Smooth Retirement (Part I)





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