Meet Jon Appino of Contract Diagnostics

When you graduate from your medical training you know a whole lot about medicine, and not a ton about business. There aren’t classes on contract negotiations and non compete agreements. As physician assistants, nurse practitioners, physicians and healthcare providers this lack of negotiation knowledge can be a substantial blind spot.

Jon Appino and his team at Contract Diagnostics help physicians, providers and their families get the best possible employment compensation through information, consulting, and coaching on their employment contracts. They offer tons of free education and resources for negotiation and Jon was so generous in answering all our contract questions. 

In this episode we covered confidence when addressing contract questions, how to approach negotiations with curiosity, understanding non-compete clauses and what red flags to be on the lookout for at your employer. You’ll learn how to feel more confident approaching negotiations head on with direct communication and candor. 

Having a discussion about salary doesn’t need to be stressful or something that you avoid. Whether you are a new graduate or a seasoned provider, there is something to be learned from this episode. Press play to learn how to negotiate effectively and from a position of interest, not entitlement. 

Watch the Contract Episode on YouTube

Contract Clarification is Key

Reviewing your employment contract is absolutely necessary and here’s why. Your contract clarifies how much money you’ll earn and how much time you’ll give your employer in exchange for that money. 

Contracts cover what days, times and when you will work. It clarifies things like covering call, shifts, and compensation in general and specifically. 

When reviewing a contract, what to talk about is important. It’s a whole additional factor of how you ask 

When The Job Duties Increase

Let’s address the elephant in the room: other duties as assigned. The only constant in life is change. Things change. As things change within your group and department, your roles and responsibilities will change, too. 

When those changes are assigned and that “tag, you’re it!” email comes into your inbox and informs you that you’ll be covering call, staffing weekends or covering holidays when you previously didn’t. Here is Jon’s best advice for other duties when they are “assigned” to you.

First, address the issue head on. Resist the temptation to group message your colleagues and text your best friend complaining about what work is asking you to do. Instead, skip the email and request a meeting. Talk to the person who assigned the task and get it out on the table.

You have two options: Do the task and ask for more compensation or decline. Declining sounds like respectfully saying that you won’t be doing the extra duties. Be prepared to pivot depending on what your employer says in this situation.

Alternatively, consider agreeing to do the task in exchange for increased compensation in the form of money or comp time. Think about limiting your agreement to cover this task to a time-bound boundary “I’ll cover additional call for 3 months for X amount per weekend, and when we hire, I’ll take a half share of call for 6 months.” 

Plan for Proactive Performance Reviews 

Remember that performance reviews are not only to be directed by your employer as part of a formal annual evaluation. Be proactive about requesting feedback regarding your performance.

These meetings can be a great opportunity to get a good feel for how your employer feels you are performing your tasks but also are a key opportunity to request re-evaluation of your compensation model.

During those discussions, it’s a great time to addend your agreement to include those other duties as assigned that you’ve taken on over time. Also, take a moment to evaluate your entire compensation package. 

Think about PTO, CME time and dollars, call compensation, administrative time, improving your flexibility and template. All of these are pieces of your complete compensation package that are up for evaluation initially and re-evaluate. 

Details: Non Compete Clauses & Restrictive Covenants 

Non compete clauses typically restrict your ability to practice in a certain radius of where you work for a certain duration. Before you sign any non compete clause or restrictive covenant, you need to understand a few things.

First, you need to understand what the clause is prohibiting, specific duration and mileage. Second, you need to understand about a non-compete from the primary site, from the most frequent site. Third, you need to understand what the standard is in your specialty, state and area of the country. 

Non-compete clauses are complicated and nuanced. Never sign anything that you don’t fully understand. Ask as many questions as you need in order to understand what you are agreeing to as a part of your employment contract, but more specifically any type of restrictive covenant. 

How to be more Confident with Negotiation 

Your employer is expecting you to ask questions. Reframe negotiating as you ask questions to clarify your contract and your obligations.

Negotiations can be seen as clarifying the expectations and your compensation. Instead of seeing the conversation in negotiating and asking for more, more, more, try to view this discussion as the opportunity to clarify and make sure that you understand what you are agreeing to.

Asking these questions is to gather more information. See instead of this as a big ask as a part of negotiation as it’s a fact-finding mission. Better yet, consider negotiations as a difficult conversation with a patient.

In figuring out what’s going on with your patient, you have to ask questions. You have to elicit what the situation is and what their expectations are. The same is true for negotiations. 

Your employer is the patient in this scenario. You’ve been trained to have hard conversations with patients. This clarifying question conversation is just like a difficult patient encounter but with an employer instead of a patient. 

To ensure you are prepared for your next negotiation, download The PA Pay One Sheet here.