Discussion Response

Hello Colleague,

In your post, you have nicely discussed the critical considerations regarding an employment agreement for a nurse practitioner. These are helpful comments on negotiating compensation models, restrictive covenants, termination clauses, and malpractice insurance.

Excellent advice on carefully reviewing the terms in any restrictive covenant, non-compete, or non-disclosure clause. As you noted, these can bind an NP's career mobility and even their ability to share information after leaving an employer in many ways that last well beyond a job (American Association of Nurse Practitioners, 2019). It is essential that, when entering a contract, you are clear on the magnitude and the length of time that it entails.

The discussion that compared various compensation formulas tied to productivity, quality, profit sharing, or patient satisfaction metrics was enlightening. It will all boil down to ensuring the compensation model reflects the value of the NP's contributions and performance (American Nurse Association, 2022). Your advice to assist in estimating dollar amounts associated with the different bonus criteria is sage.

The discussion of malpractice insurance policies was very informative. Weighing the merits of claims-made versus occurrence coverage and your recommendation for NPs to purchase an individual policy independent of employer-provided group coverage provides a valuable frame of reference (American Association of Pathologists' Assistants [AAPA], 2024). Protection of one's professional license and personal assets is paramount.

Finally, employment contracts should include the conditions under which the NP's credentials and clinical privileges at affiliated facilities can be terminated. Hospitals and health systems may expect the cause for termination to relate directly to substandard care or conduct to allow due process (Stanulewicz et al., 2019). Including explicit language within the contract describing the processes for review, hearing, and appeal rights for the NP could likely protect the interests of the NP in such situations.

What do you think of ensuring due process protections through employment agreements that protect against potential termination of credentials and privileges? How would the NPs evaluate such provisions when negotiating the contract?

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