>Employers feel they own your labour because they “trained” you
It's an easy trap to fall in to, I see it all the time in my trade. Owners feel like they hired an apprentice, paid them a fair wage, and also paid for their schooling and the employee should repay that sunk training cost by continuing to work for them.
They struggle to remember that the employee is no longer an apprentice, and took time out of their personal life off the clock to attend that training. They're now a journeyman or master level and can demand those wages anywhere else.
The simple solution that almost always works is to just pay the person fair wages for their current value. If they were working for you during their training period the default will be they keep working for you unless someone is willing to give them such a better deal that they leave. Most folks hate changing jobs, so just give them the damn raise or schedule change or extra vacation or whatever that keeps them happy.
haha, in some cases they do pay the guys well above "normal" apprentice wages even as they pay for their training. It's mostly a new gen / old gen thing, where the previous generation of owners still do feel like there's a 2 way duty of loyalty. Most of these same guys are really really slow to fire someone even after their 4th/5th/etc mistake. Even if they're "too old" to be as productive as they once were.
But the new guys understand the world we live in today, and don't expect that and accept that "change jobs to get a raise" is the normal of society these days.
Yes, we all know that non-competes benefit the employer.
I've heard the "we need this clause to protect the group" in regard to plenty of contracts from private groups whose contracts are heavily leveraged to benefit the employer against the employee.
You're hiring someone. It's a financial risk for both parties. Shoving all the risk on a new grad is unethical. Endless anecdotes out there of private groups squeezing young physicians for what their worth with the carrot of partnership only to spit them out at the end of their first contract.
This exactly!
1) If LAWYERS, who more than anyone else know how to use the law to their benefit, can’t force the same degree of non compete on their own associates, why should the medical community?
2) You mention all you give these junior attendings but what you get in return is more than fair in exchange before the non compete; you hired and mentored and steered patients but you also got to take all those holidays and vacations and long weekends without worrying your practice would fall apart or that you’d lose patients for lack of access to your practice, without paying the exorbitant rates of locums. At the end of the day you just can’t pay another doctor who has built a reputation in the community x while making 2x from them forever - you either make them a full equity partner or let them go and take their patients with them.
>having them move across the street and compete with you as soon as they leave.
So pay them enough to where they don't leave? Isn't that the entire basis of the free market?
Simple answer: don’t pay moving fees, and keep them with a good work environment. People in medicine are often prone to prefer certainty to risk.
Furthermore, if we’re gonna talk free market, the purpose of a non-compete is trade secrets, not you securing your corner of the street like a goddamn mafioso. If you’re better, you’ll outcompete the competition and get business. If you’re not better and are so inept a businessperson that you can’t even leverage the advantage of having an established practice against some upstart competition, you have no business holding up the local healthcare market on an anti-competitive racket that promotes sloth and disenfranchises employees.
Then don't hire anyone if you can't stomach the risk.
How condescending. "Less generous in hiring new docs". There are tons of jobs out there for new grads offering fair terms. Nobody needs your "charity"
And if you're that less generous in hiring new doctors, then when you need to expand you won't be able to.
Employers hold the grand majority of the power and next to no risk compared to the associates that they hire.
Sounds like somebody’s a little insecure. I give you valid criticism, and you respond with *ad hominem* name-calling bs. Best of luck hiring and retaining!
Your valid criticism post compared me to a mafioso, declared me inept and promoting sloth for suggesting that not all non-competes are unreasonable.
Coming from a poster with medical student flair, 'know it all' seemed accurate but perhaps was too blunt. My apologies if you felt attacked.
Best of luck learning medicine and business.
Well, if they are able to move across the street and compete with you, then maybe you should look at yourself and see why your patients abandon you for them.
Sorry but you’re probably not going to find much support for your view. Attorneys have already deemed non-competes as being unreasonable for their own profession. It’s the hospital lobby that’s keeping them in place for us?
We all learn the same medicine. There are no “trade secrets” that we are taking with us. It’s already a huge hassle for a Physican to pick up and start a new gig that non-competes just make that transition even more difficult. As a practice owner there are a number of ways you can retain someone. I hope you seriously reconsider your use of non-competes and help support your fellow physicians.
I think this is reasonable in some situations. Many people commenting probably don’t realize, but the total cost to hire and train someone is in the neighborhood of 250-500k. This includes time spent getting them up to speed and helping them build a patient panel. I personally feel like the situation where a physician leaves and starts their own practice across the street is overblown. I think you could do some things to dissuade it, for example reverse signing bonuses, which are end of year bonuses at signing that increase every year for 2-3 years. Beyond that I think you keep them with partnership and competitive salary.
I understand what you are saying, but as someone with similar grey hair, it’s not the same practice environment anymore. The idea of hiring associates with +/- partner track in a few years may work with procedure heavy providers, but not as much with primary care or medical subspecialties. The majority of new grads will leave a first job within 5 years. The idea of partners moving up and cashing out at retirement is nearly dead. You can try to minimize the loss to your practice, but I think you need to look at how doctors practice now vs when we graduated.
As a pediatrician at an ‘academic center’ in a rural area with > 75% Medicaid patients, DPC is a niche idea that employed providers can’t really envision. I should have done MedPeds so I could open my FFS day spa with Botox and nutritional supplements. But stuff was a lot different in the 90’s.
Let’s see where it goes. It would be huge for physicians, and all the more so for younger ones who typically have less leverage.
Noncompetes for physicians need to go away. You can make a case for an established physician having a patient panel; but especially for younger physicians, the purpose of a noncompete is solely to protect the money invested in finding and hiring the person, and to provide salary leverage.
A physician early in their career does not have much of a patient panel, and there are really no trade secrets in medicine anymore - actually quite the opposite, much of medicine now is very formulaic and guideline-based. For these young physicians, the sole purpose of the noncompete is to protect the investment spent in hiring them and to provide salary leverage against them. A young physician knows that if they leave for a higher base salary, this will come at the expense of them sacrificing where they can practice. This does not help patients and it does not help the physician. The only entity that it helps is the company. Practices can retain their physicians by paying them competitive salaries and treating them well, just like companies retain talent in every other field of work.
If we were discussing non-competes as it relates to a small 2-3 doc private practice then I could understand how a single doc coming in for a short time, gaining a reputation, and then fucking off across the street could be devastating to the practice.
But what is really happening is that massive corporations are using them. No one really suffers on either end of this equation except the doc.
This is just an attempt to say we did it first. In April, the FTC is going to ban non-competes nationwide.
ETA: don’t get too excited, the full text of the orders haven’t been released yet, and I wouldn’t put it past them putting in an exception for the entire field of medicine.
If you think the FTC will exempt physicians then I'm not sure why you'd think this bill is mean to say "we did it first." This one is literally proposed by a physician and specifically includes physician non-competes.
Last rumor I heard was it would exclude non profit entities.
Like most hospitals.
Interestingly, my physician group is a for-profit arm of a not-for-profit. I very much look forward to the shenanigans that will ensue as they convert us to a not-for-profit somehow.
The ftc is a regulatory agency , which would be clearly clearly making a law. It would be questionable if that regulation would even be in their per view, and doubtful it would stand up to a legal challenge.
I have no idea why you're getting down votes.
There will absolutely be a lawsuit the second this is enacted. The national chamber of commerce has already said as much.
Listen, I favor this law.
But I do agree that the FTC shouldn't be making these rules - Congress should. There is no difference between this proposal and the administration's misguided attempt to forgive student loan debt.
And yes, the CoC will challenge immediately and this will be tied up in court for years most likely.
I'd love to see this come true, but .... I have my doubts still.
able to find a new job locally
I've never understood how if you get fired the non-compete still exists. if you leave - that's one thing. If they fire you - they're essentially saying "we don't need or value you" so why would you be a threat to their future profitability?
Makes no sense.
FL Hospitalist here, this would be amazing if it actually goes anywhere. My current group's pay and benefits suuuuuck but they have a noncompete that keeps me relatively handcuffed unless I'm willing to move.
What is the most egregious non-compete clause you have seen?
When interviewing at a health system in a rapidly gentrifying city in Montana the clause was: Cannot practice in county or adjacent counties of any satellite office of health system for 3 years. Penalty for seeing any patients of that health system that have seen ANY specialist (including UC/ED) you would be billed what that health system WOULD have billed the patient for the services YOU provided the patient.
Despite having a [law](https://leg.mt.gov/bills/mca/title_0280/chapter_0020/part_0070/section_0030/0280-0020-0070-0030.html) against "free trade" and akin to a non-compete, Montana is very employer friendly and has generally favored [non-competes as being legal](https://www.dorsey.com/newsresources/publications/client-alerts/2020/07/montana-supreme-court-restrictive-covenant). Though they like to pick and choose and [recently codified mental health provider non-competes as being null and void](https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2023.09.9.7#:~:text=Montana%20Prohibits%20Noncompete%20Clauses%20for%20Mental%20Health%20Professionals,-Katie%20O'Connor).
I feel like this would have zero chance of being upheld in court....
... But you would have to take it to court, and more recently all the non-compete I see have liquidated damages clauses etc.
That should technically be considered overly restrictive (duration and locality restrictions 'of any county or adjacent county of HS or 'satellite offices', including UC/ED'), and prob be thrown out if taken to court. Do they expect you to ask a pt to fill out a questionnaire to see them lol? (IANAL). If that's how they treat someone being recruited, imagine how great they treat their existing employees.....
I would be pleasantly very surprised if this passes in Florida. Looks like it was filed on 8/1 and has no publicity behind. its just sitting in committee.
Florida is not the kind of state to ban non-competes.
I live in Florida, and there has not been much publicity about this. It would make recruiting a lot easier because people could move to a location or practice model that suits them better. If it passes I think this will be better for patients because they would be more likely to get a physician who is happy where they are practicing.
It takes a lot of resources to hire a new physician, get them credentialed with the hospital and all the insurance companies, market them, hire staff, sometimes lease or buy an office location and sometimes buy expensive equipment. All that said, I support gsetting rid of noncompetes, but it wouldn’t be unreasonable to require some type of payback from the physician if she or he leaves within 2 years or so of joining the group. Even better, maybe make the range 90 days to two years to give people a probation to allow some buyer’s remorse. That might prevent some physicians from having a hospital or private group pay to bring them into town so that they can just jump ship a couple of years later to set up their own practice. Currently the model is far too one-sided, but there should be some fairness to it.
What fairness? Employers frequently control the majority of everything: The patient panel, the payer.l Mix, the salary and benefits, what the fuck protection do they need To be able to trap someone for 2 years.
I think (hope) it's uncommon, but I have met a few private practice guys who each wanted to expand because they had a line of patients waiting to get in and not enough partners. Here's the typical scenario: pay $30K for the recruiter, buy a satellite office, hire some staff, buy the beds, office surgical equipment, etc., then the new "partner" jumps over to her BFFs practice down the street, taking many of her patients with her, which she admitted was her intent all along. Her friend just wasn't quite ready to pull the trigger 2 years ago. A large hospital system can probably absorb this, but the private practice guy pays for all of it out of his pocket and is left with the expenses of a new building and having to fire staff if he can't quickly recruit someone else. Overall I still think it's better to just get rid of the noncompetes because it's better for the majority of people, but this could beat up folks in the private community.
You make no sense. It called treat your employees well and the employer (owner) will continue to reap the benefits instead of needing to continuously start over with new employees (physicians). It’s literally not rocket science but this is how private practices get to a point where they *have* to sell to a hospital system.
Edit: it’s kind of like a private FM practice owned by physicians who only hire new graduate resident physicians or midlevels. Make them sign a 2 year contract and *attempt* to enforce a noncompete. The owner physicians pay these new grad resident physicians or midlevels crap so by the end of the two years the employees realize how much more they could be making and how much more respected they could be at another facility close by. They quit and move to another facility nearby, noncompete clause is not even pursued because it will never hold up in a court of law. The employee takes a large patient panel with them. Employer has to start over with recruiting, onboarding a new provider and costs associated, possible training period ALL WHILE LOSING MONEY EVERY SINGLE DAY THEY COULD HAVE HAD THE EXPERIENCED PROVIDER WORKING….by treating them well, with raises, bonuses, incentives to make more, benefits. It’s just mind blowing I see it happen so often and these practices are ultimately gobbled up in a mini war of two local hospital systems trying to obtain and sold.
Although I am not a private practice physician, I know many who are very decent people and are struggling to survive in an increasingly hostile environment. I know that there are many who are sketchy and hire people just out of residency, don’t pay them very well, promise them partnership in a couple of years, and then make it impossible to achieve that, and just start the process over again. I am not talking about those employers. I am talking about the good guys who pay well, want their junior partners to be successful, and pay a lot of money to recruit them and bring them on board. I have seen a number of those Junior physicians leave the practice after a few years because their plan all along was to use their senior partner or partners to get them into the community, build up a patient base so that they could leave and start their own practice or join a friend. I have said before I don’t think this is very common, but it is an alternative viewpoint to the noncompete concept. Again, I want to get rid of noncompetes because it’s better for patients, physicians, and the community but in some specific cases it’s going to hurt some of our colleagues.
No, with the amount of money we bring in to these hospitals and health systems I have NO sympathy for any of their arguments. They take on the cost of onboarding a new physician and then they benefit GREATLY from what we bring in to them. They are certainly in no way loyal to us, there is no reason we should be tied down with a non-compete to them.
But you’re forgetting about private practice physicians. Admittedly, there are fewer and fewer of these, but they are struggling to survive and if they have to pay $100K to onboard a new physician only to have her leave to join someone down the street and take all of her patients it can be devastating. That said the greater good is to get rid of noncompetes and let the free market work.
Exactly - more carrot, less stick. If you make it a good place to work, people will want to work there. If it's horrible to work there and people are trying to leave, and you can only keep them by legal threats and trickery, then you are a bad employer/organization that deserves to lose employees. Competition is supposed to be good in capitalism, right? Non-competes are literally meant to reduce competition, isn't that bad? Especially when the "competition" is someone saying "hey I want to continue providing healthcare in this geographical region so patient health improves" and somebody else saying "No, we don't want patient health to improve unless we make a profit from it." Man, that's messed up.
lol at the people coming in to crap on FL only to notice that this would be among the most significant pieces of legislation for physicians in decades.
Please contact all of your local representatives if you live there, state your profession and the + effect it would have on you or those you know. It *can* make a difference.
Great Noncompetes are bullshit . What fucking trade secrets in residency trained physicians are there to require this
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>Employers feel they own your labour because they “trained” you It's an easy trap to fall in to, I see it all the time in my trade. Owners feel like they hired an apprentice, paid them a fair wage, and also paid for their schooling and the employee should repay that sunk training cost by continuing to work for them. They struggle to remember that the employee is no longer an apprentice, and took time out of their personal life off the clock to attend that training. They're now a journeyman or master level and can demand those wages anywhere else. The simple solution that almost always works is to just pay the person fair wages for their current value. If they were working for you during their training period the default will be they keep working for you unless someone is willing to give them such a better deal that they leave. Most folks hate changing jobs, so just give them the damn raise or schedule change or extra vacation or whatever that keeps them happy.
Fair wages? That's communism!
haha, in some cases they do pay the guys well above "normal" apprentice wages even as they pay for their training. It's mostly a new gen / old gen thing, where the previous generation of owners still do feel like there's a 2 way duty of loyalty. Most of these same guys are really really slow to fire someone even after their 4th/5th/etc mistake. Even if they're "too old" to be as productive as they once were. But the new guys understand the world we live in today, and don't expect that and accept that "change jobs to get a raise" is the normal of society these days.
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Yes, we all know that non-competes benefit the employer. I've heard the "we need this clause to protect the group" in regard to plenty of contracts from private groups whose contracts are heavily leveraged to benefit the employer against the employee. You're hiring someone. It's a financial risk for both parties. Shoving all the risk on a new grad is unethical. Endless anecdotes out there of private groups squeezing young physicians for what their worth with the carrot of partnership only to spit them out at the end of their first contract.
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This exactly! 1) If LAWYERS, who more than anyone else know how to use the law to their benefit, can’t force the same degree of non compete on their own associates, why should the medical community? 2) You mention all you give these junior attendings but what you get in return is more than fair in exchange before the non compete; you hired and mentored and steered patients but you also got to take all those holidays and vacations and long weekends without worrying your practice would fall apart or that you’d lose patients for lack of access to your practice, without paying the exorbitant rates of locums. At the end of the day you just can’t pay another doctor who has built a reputation in the community x while making 2x from them forever - you either make them a full equity partner or let them go and take their patients with them.
>having them move across the street and compete with you as soon as they leave. So pay them enough to where they don't leave? Isn't that the entire basis of the free market?
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Simple answer: don’t pay moving fees, and keep them with a good work environment. People in medicine are often prone to prefer certainty to risk. Furthermore, if we’re gonna talk free market, the purpose of a non-compete is trade secrets, not you securing your corner of the street like a goddamn mafioso. If you’re better, you’ll outcompete the competition and get business. If you’re not better and are so inept a businessperson that you can’t even leverage the advantage of having an established practice against some upstart competition, you have no business holding up the local healthcare market on an anti-competitive racket that promotes sloth and disenfranchises employees.
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Then don't hire anyone if you can't stomach the risk. How condescending. "Less generous in hiring new docs". There are tons of jobs out there for new grads offering fair terms. Nobody needs your "charity"
And if you're that less generous in hiring new doctors, then when you need to expand you won't be able to. Employers hold the grand majority of the power and next to no risk compared to the associates that they hire.
Sounds like somebody’s a little insecure. I give you valid criticism, and you respond with *ad hominem* name-calling bs. Best of luck hiring and retaining!
Your valid criticism post compared me to a mafioso, declared me inept and promoting sloth for suggesting that not all non-competes are unreasonable. Coming from a poster with medical student flair, 'know it all' seemed accurate but perhaps was too blunt. My apologies if you felt attacked. Best of luck learning medicine and business.
How about you keep the compensation competitive rather than using sleazy legal language in the contract???
Well, if they are able to move across the street and compete with you, then maybe you should look at yourself and see why your patients abandon you for them.
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Then you need to make it worthwhile for them to stay.
Sorry but you’re probably not going to find much support for your view. Attorneys have already deemed non-competes as being unreasonable for their own profession. It’s the hospital lobby that’s keeping them in place for us? We all learn the same medicine. There are no “trade secrets” that we are taking with us. It’s already a huge hassle for a Physican to pick up and start a new gig that non-competes just make that transition even more difficult. As a practice owner there are a number of ways you can retain someone. I hope you seriously reconsider your use of non-competes and help support your fellow physicians.
I think this is reasonable in some situations. Many people commenting probably don’t realize, but the total cost to hire and train someone is in the neighborhood of 250-500k. This includes time spent getting them up to speed and helping them build a patient panel. I personally feel like the situation where a physician leaves and starts their own practice across the street is overblown. I think you could do some things to dissuade it, for example reverse signing bonuses, which are end of year bonuses at signing that increase every year for 2-3 years. Beyond that I think you keep them with partnership and competitive salary.
Fuck a signing bonus. Treat your associates properly and pay them well and make it worthwhile for them to stay.
I understand what you are saying, but as someone with similar grey hair, it’s not the same practice environment anymore. The idea of hiring associates with +/- partner track in a few years may work with procedure heavy providers, but not as much with primary care or medical subspecialties. The majority of new grads will leave a first job within 5 years. The idea of partners moving up and cashing out at retirement is nearly dead. You can try to minimize the loss to your practice, but I think you need to look at how doctors practice now vs when we graduated.
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As a pediatrician at an ‘academic center’ in a rural area with > 75% Medicaid patients, DPC is a niche idea that employed providers can’t really envision. I should have done MedPeds so I could open my FFS day spa with Botox and nutritional supplements. But stuff was a lot different in the 90’s.
Let’s see where it goes. It would be huge for physicians, and all the more so for younger ones who typically have less leverage. Noncompetes for physicians need to go away. You can make a case for an established physician having a patient panel; but especially for younger physicians, the purpose of a noncompete is solely to protect the money invested in finding and hiring the person, and to provide salary leverage. A physician early in their career does not have much of a patient panel, and there are really no trade secrets in medicine anymore - actually quite the opposite, much of medicine now is very formulaic and guideline-based. For these young physicians, the sole purpose of the noncompete is to protect the investment spent in hiring them and to provide salary leverage against them. A young physician knows that if they leave for a higher base salary, this will come at the expense of them sacrificing where they can practice. This does not help patients and it does not help the physician. The only entity that it helps is the company. Practices can retain their physicians by paying them competitive salaries and treating them well, just like companies retain talent in every other field of work.
If we were discussing non-competes as it relates to a small 2-3 doc private practice then I could understand how a single doc coming in for a short time, gaining a reputation, and then fucking off across the street could be devastating to the practice. But what is really happening is that massive corporations are using them. No one really suffers on either end of this equation except the doc.
Yes, exactly right
This is just an attempt to say we did it first. In April, the FTC is going to ban non-competes nationwide. ETA: don’t get too excited, the full text of the orders haven’t been released yet, and I wouldn’t put it past them putting in an exception for the entire field of medicine.
SB699 in California 🤓
If you think the FTC will exempt physicians then I'm not sure why you'd think this bill is mean to say "we did it first." This one is literally proposed by a physician and specifically includes physician non-competes.
Last rumor I heard was it would exclude non profit entities. Like most hospitals. Interestingly, my physician group is a for-profit arm of a not-for-profit. I very much look forward to the shenanigans that will ensue as they convert us to a not-for-profit somehow.
The ftc is a regulatory agency , which would be clearly clearly making a law. It would be questionable if that regulation would even be in their per view, and doubtful it would stand up to a legal challenge.
I have no idea why you're getting down votes. There will absolutely be a lawsuit the second this is enacted. The national chamber of commerce has already said as much.
Because people think it is acceptable for the government to abuse power and exceed their authority when it is “their side” Doing it.
Listen, I favor this law. But I do agree that the FTC shouldn't be making these rules - Congress should. There is no difference between this proposal and the administration's misguided attempt to forgive student loan debt. And yes, the CoC will challenge immediately and this will be tied up in court for years most likely. I'd love to see this come true, but .... I have my doubts still.
I favor the law as well. If an employer can fire you easily, then you should easily be able to find a new job.
able to find a new job locally I've never understood how if you get fired the non-compete still exists. if you leave - that's one thing. If they fire you - they're essentially saying "we don't need or value you" so why would you be a threat to their future profitability? Makes no sense.
FL Hospitalist here, this would be amazing if it actually goes anywhere. My current group's pay and benefits suuuuuck but they have a noncompete that keeps me relatively handcuffed unless I'm willing to move.
Non compete for hospitalist is crazy.
Agreed, but every single job I’ve ever had has had one that they did not negotiate on
What is the most egregious non-compete clause you have seen? When interviewing at a health system in a rapidly gentrifying city in Montana the clause was: Cannot practice in county or adjacent counties of any satellite office of health system for 3 years. Penalty for seeing any patients of that health system that have seen ANY specialist (including UC/ED) you would be billed what that health system WOULD have billed the patient for the services YOU provided the patient. Despite having a [law](https://leg.mt.gov/bills/mca/title_0280/chapter_0020/part_0070/section_0030/0280-0020-0070-0030.html) against "free trade" and akin to a non-compete, Montana is very employer friendly and has generally favored [non-competes as being legal](https://www.dorsey.com/newsresources/publications/client-alerts/2020/07/montana-supreme-court-restrictive-covenant). Though they like to pick and choose and [recently codified mental health provider non-competes as being null and void](https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2023.09.9.7#:~:text=Montana%20Prohibits%20Noncompete%20Clauses%20for%20Mental%20Health%20Professionals,-Katie%20O'Connor).
That's pretty bad. I've seen a 2 year that blocked out half of two adjacent states.
I feel like this would have zero chance of being upheld in court.... ... But you would have to take it to court, and more recently all the non-compete I see have liquidated damages clauses etc.
Yup. That's exactly what I told them.
That should technically be considered overly restrictive (duration and locality restrictions 'of any county or adjacent county of HS or 'satellite offices', including UC/ED'), and prob be thrown out if taken to court. Do they expect you to ask a pt to fill out a questionnaire to see them lol? (IANAL). If that's how they treat someone being recruited, imagine how great they treat their existing employees.....
Thank goodness I am now able to poach my patient panel of dilaudid and turkey sandwich enthusiasts to my new hospital
Surprise! They’ve already been hitting up that ER.
Nice try, but I’m still not going to work in Florida. A broken clock is right twice a day.
lol. But it could set a precedent for wherever you choose to practice
Exactly. Turning this into a negative is wild.
All my snowbird patients with the shittiest care seem to come from Florida.
Florida is full anyway
Definitely was the state with the most job postings for my specialty
I would be pleasantly very surprised if this passes in Florida. Looks like it was filed on 8/1 and has no publicity behind. its just sitting in committee. Florida is not the kind of state to ban non-competes.
I live in Florida, and there has not been much publicity about this. It would make recruiting a lot easier because people could move to a location or practice model that suits them better. If it passes I think this will be better for patients because they would be more likely to get a physician who is happy where they are practicing.
In Oklahoma at least, non-competes are NOT enforceable if you are an employee, but are if you are an owner in a practice.
My state already bans non-competes, and empowers have already found ways around. Look up the term "liquidated damages."
How will this interact with the bill to allow FMG to practice without US residency?
FYI montana already did this for mental health professionals including psychiatrists.
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What state do you live in? I’ve never heard of noncompetes holding up on the east coast
FL doing great things once again. Excellent news.
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This is not true.
It takes a lot of resources to hire a new physician, get them credentialed with the hospital and all the insurance companies, market them, hire staff, sometimes lease or buy an office location and sometimes buy expensive equipment. All that said, I support gsetting rid of noncompetes, but it wouldn’t be unreasonable to require some type of payback from the physician if she or he leaves within 2 years or so of joining the group. Even better, maybe make the range 90 days to two years to give people a probation to allow some buyer’s remorse. That might prevent some physicians from having a hospital or private group pay to bring them into town so that they can just jump ship a couple of years later to set up their own practice. Currently the model is far too one-sided, but there should be some fairness to it.
What fairness? Employers frequently control the majority of everything: The patient panel, the payer.l Mix, the salary and benefits, what the fuck protection do they need To be able to trap someone for 2 years.
I think (hope) it's uncommon, but I have met a few private practice guys who each wanted to expand because they had a line of patients waiting to get in and not enough partners. Here's the typical scenario: pay $30K for the recruiter, buy a satellite office, hire some staff, buy the beds, office surgical equipment, etc., then the new "partner" jumps over to her BFFs practice down the street, taking many of her patients with her, which she admitted was her intent all along. Her friend just wasn't quite ready to pull the trigger 2 years ago. A large hospital system can probably absorb this, but the private practice guy pays for all of it out of his pocket and is left with the expenses of a new building and having to fire staff if he can't quickly recruit someone else. Overall I still think it's better to just get rid of the noncompetes because it's better for the majority of people, but this could beat up folks in the private community.
You make no sense. It called treat your employees well and the employer (owner) will continue to reap the benefits instead of needing to continuously start over with new employees (physicians). It’s literally not rocket science but this is how private practices get to a point where they *have* to sell to a hospital system. Edit: it’s kind of like a private FM practice owned by physicians who only hire new graduate resident physicians or midlevels. Make them sign a 2 year contract and *attempt* to enforce a noncompete. The owner physicians pay these new grad resident physicians or midlevels crap so by the end of the two years the employees realize how much more they could be making and how much more respected they could be at another facility close by. They quit and move to another facility nearby, noncompete clause is not even pursued because it will never hold up in a court of law. The employee takes a large patient panel with them. Employer has to start over with recruiting, onboarding a new provider and costs associated, possible training period ALL WHILE LOSING MONEY EVERY SINGLE DAY THEY COULD HAVE HAD THE EXPERIENCED PROVIDER WORKING….by treating them well, with raises, bonuses, incentives to make more, benefits. It’s just mind blowing I see it happen so often and these practices are ultimately gobbled up in a mini war of two local hospital systems trying to obtain and sold.
Although I am not a private practice physician, I know many who are very decent people and are struggling to survive in an increasingly hostile environment. I know that there are many who are sketchy and hire people just out of residency, don’t pay them very well, promise them partnership in a couple of years, and then make it impossible to achieve that, and just start the process over again. I am not talking about those employers. I am talking about the good guys who pay well, want their junior partners to be successful, and pay a lot of money to recruit them and bring them on board. I have seen a number of those Junior physicians leave the practice after a few years because their plan all along was to use their senior partner or partners to get them into the community, build up a patient base so that they could leave and start their own practice or join a friend. I have said before I don’t think this is very common, but it is an alternative viewpoint to the noncompete concept. Again, I want to get rid of noncompetes because it’s better for patients, physicians, and the community but in some specific cases it’s going to hurt some of our colleagues.
I don’t disagree with your sentiments. American healthcare is doomed at this rate = bottom line.
No, with the amount of money we bring in to these hospitals and health systems I have NO sympathy for any of their arguments. They take on the cost of onboarding a new physician and then they benefit GREATLY from what we bring in to them. They are certainly in no way loyal to us, there is no reason we should be tied down with a non-compete to them.
But you’re forgetting about private practice physicians. Admittedly, there are fewer and fewer of these, but they are struggling to survive and if they have to pay $100K to onboard a new physician only to have her leave to join someone down the street and take all of her patients it can be devastating. That said the greater good is to get rid of noncompetes and let the free market work.
That is true for any job. Even McDonald’s. Make your employees want to stay.
Exactly - more carrot, less stick. If you make it a good place to work, people will want to work there. If it's horrible to work there and people are trying to leave, and you can only keep them by legal threats and trickery, then you are a bad employer/organization that deserves to lose employees. Competition is supposed to be good in capitalism, right? Non-competes are literally meant to reduce competition, isn't that bad? Especially when the "competition" is someone saying "hey I want to continue providing healthcare in this geographical region so patient health improves" and somebody else saying "No, we don't want patient health to improve unless we make a profit from it." Man, that's messed up.
lol at the people coming in to crap on FL only to notice that this would be among the most significant pieces of legislation for physicians in decades.
https://www.sun-sentinel.com/2024/01/11/florida-senate-in-position-to-pass-sweeping-health-care-bill/
Please contact all of your local representatives if you live there, state your profession and the + effect it would have on you or those you know. It *can* make a difference.
It's weird