Elements of a Nurse Practitioner or Physician Assistant Employment Contract

If you are part of the management team of a medical practice, you are keenly aware that matters related to human resources require more of your attention than you expected (and certainly more than you would like). Payroll, benefits, attendance, work schedules and vacation time are all issues requiring monitoring and administration. And those are just issues involving existing staff. Hiring new employees involves a myriad of other items, but none more important that the Nurse Practitioner or Physician Assistant Employment contract. 

When the parties negotiate an employment contract with clearly defined terms and conditions, it eliminates much of the uncertainty often present during the initial period of employment if not down the line as well. Such an agreement also gives both parties a solid foundation upon which a long lasting and mutually beneficial relationship can be built. By reducing confusion, you minimize the opportunity for disappointment and resentment, if not open conflict. 

The following are some terms and conditions that are widely included as part of a Nurse Practitioner or Physician Assistant employment contract (note, however, that this is not intended to be legal advice):

• Duration 
  • This clause should clearly state the period of employment contemplated (subject to any Termination provision, addressed below) and the length of renewal, if any. 
• Compensation
  • If the NP or PA is to be strictly an hourly or salaried employee, this provision is quite simple.
  • On the other hand, if the compensation package is more “entrepreneurial” in nature, the agreement should detail productivity and/or revenue projections and what performance standards must be met to trigger additional compensation. 
  • Not all value that an employee brings can be monetized, however. Are there intangibles for which the employee can be paid (such as cost-reduction through meeting efficiency targets or excellent patient satisfaction survey results, for example)?
• Benefits
  • Vacation and sick time (which can be combined as “Personal Time Off “), group health benefits, and bonuses would all appropriately be contained in a Nurse Practitioner or Physician Assistant employment agreement. 
• Termination
  • Notwithstanding the fact that the employment contract may have a defined duration, it should contain language that provides clear notice as to how employment may be terminated (even if it simply makes reference to the Policies and Procedures Manual of the practice). 
    • If that is the case, you must be certain to provide a copy of the Manual to the employee during onboarding and require that they sign an acknowledgment of receipt for it.
• Professional Liability Insurance
  • The contract should clearly specify the insurance required, identify who is responsible for obtaining and maintaining the coverage and who has responsibility for the cost. 
• Non-Compete/Restrictive Covenant Provision
  • This particular clause of any Nurse Practitioner or Physician Assistant employment contract requires extreme caution as states frequently legislate the extent to which an employer can limit an individual’s freedom to engage in his or her chosen provision. 

The above is, of course, not an exclusive list of all terms and conditions of a Nurse Practitioner or Physician Assistant employment contract that may be relevant to your particular circumstances. An employment law attorney can help you draft the appropriate document once you and the applicant have negotiated the terms of employment, thereby providing all involved the desired peace of mind and, hopefully, a healthy employment relationship. 

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