Top 10 Reasons NPs & PAs Should Seek Legal Review of Employment Agreements

By Guest Contributor Leigh Ann O’Neill for Lauth O’Neill Physician Agency

Yesterday, we gave an overview of some of the challenges nurse practitioners and physician assistants face upon receiving a job offer. Presented with a lengthy employment agreement, many NPs and PAs neglect to understand and negotiate their contract, instead quickly signing on the dotted line. While employers are almost always well meaning, it’s in your best interest as a healthcare provider to have an expert review your employment agreement to make sure you’re protected and receiving fair representation. To start our series, here are a few reasons why. 

1. Due Diligence and Responsibility.                                                         

NPs and PAs are intelligent people – no one doubts that. The only problem is that your education and training has always been geared toward specific areas and skill-sets that do not include any business or legal acumen. It is safe to say that you have never taken a legal course or received any sort of education regarding contracts or employment law – and why would you?

One of the best markers of intelligence and sophistication is the skill of delegation, which requires the knowledge of when to utilize outside resources. Consider all of the aspects of life that require knowledge and skills outside of the average person’s wheelhouse. Buying a house – purchasing insurance – filing your taxes – investing money. These are all things you would not do on your own, but rather seek professionals to guide you. So why would you sign a contract without seeking the same sort of guidance? Especially when the contract is one that has the power to dictate the course of your career and also the operation of your day-to-day life. Therefore, the wisdom to seek the guidance of those with the appropriate knowledge and experience not only showcases a person’s good judgment, it also highlights a very respectable level of care and attention to detail. Remember that no man is an island and there is no prize for those who insist on “going it alone.”

2. Unbiased and Informed Insight.                                                                  

More often than not, individuals (and particularly healthcare professionals) are shy and hesitant to really dictate their worth and make demands on their own behalf. Part of this is related to human humility and not wanting to brag or make haughty declarations. If you ask someone to make a list of her own best qualities, that list may not be extensive. Alternatively, if you ask that person’s friends and family to make the same list, it would likely showcase a lengthy, comprehensive and wide-ranging documentation of everything that distinguishes her from others. Aside from this tendency toward an overly modest outlook, there is also the fact that nurse practitioners, especially those coming right out of training, do not have experience in employment matters and therefore simply are not informed as to what they are worth and what they should be asking for.                 

When we work as attorney agents on behalf of our clients, we are in a position to highlight all of our client’s values, traits and unique characteristics accurately and without bias or shame. Further, based on our considerable experience, we are able to make fair, reasonable and justifiable requests in order to get our client the best possible deal. 

3. Knowledge of What is Fair and Reasonable.                                                 

As we discussed above, NPs and PAs are often eager to sign the employment agreements that they are offered, almost without even a second thought. Coming fresh out of training, these providers are accustomed to earning a pittance for their hard work and time. So it is no surprise that when they see that first offer and realize they will soon be paid a real and substantial salary, they are ready to dive right in. The only problem is that these nurse practitioners and physician assistants are not in a position to gauge whether the offer is fair and reasonable based on current market norms and standards. Obviously the salary offered is a huge part of this, but there are a variety of other aspects to consider as well, including but not limited to the following: fringe benefits; reimbursement for relocation expenses; reimbursement for CME expenses and professional subscriptions and dues; and contribution toward student loan debt.                                               

The truth is, the only people who are really capable of offering an objective review of whether a contract’s terms are fair and reasonable are professionals who work with and on behalf of healthcare providers. Such professionals (attorneys and CPAs, mostly) review and analyze a large number and variety of employment agreements and as a result, have an objective understanding of what healthcare providers are being offered. Further, such professionals have on objective understanding of what advanced practice providers can reasonably and justifiably request of their employers. Additionally, only certain individuals have access to the facts and statistics concerning physician and advanced practice provider income. The Medical Group Management Association (MGMA) publishes annual data that breaks down healthcare provider compensation based on specialty and the geographic region of the country. The MGMA does not make this information available to the public, but rather is only accessible to members who subscribe and pay a substantial fee. 

Stay tuned to the ThriveAP blog this week for the remaining reasons nurse practitioners and physician assistants should seek legal review of employment agreements. 


Married to a physician, Leigh Ann O’Neill founded Lauth O’Neill Physician Agency when she recognized the importance of healthcare providers having someone in their corner who will guard their legal and financial interests.  Leigh Ann is an expert at helping NPs and PAs negotiate employment contracts.  If you are looking for help negotiating your employment agreement, reach out to her at or 317-989-4833. 



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