Contracts Often Limit Where Physicians Can Work If They Change Employers
By Dennis Hursh
Patients may just shrug when they learn their doctor plans to move to a new office.
After all, they can just follow, right?
Maybe not. Or at least, not easily.
Physician contracts often contain restrictive covenants that limit where doctors can work if they leave their current practices. The idea is to keep them from competing with their old employer.
For example, the contract could require the doctor’s new office to be 15 or more miles away. The doctor also might have to give up privileges at the local hospital.
“These contract provisions hold numerous traps for the unwary,” says Dennis Hursh, an attorney who has provided legal services to physicians for more than three decades and is the author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement.” (www.TheFinalHurdle.com)
Patients can be left scrambling to find a new physician.
The situation can be even worse for the doctor, who essentially might have to start his or her career over again, building a new patient base.
Hursh says it’s not unusual for him to answer desperate phone calls from doctors who paid little attention when they agreed to their contracts, but now wonder whether their soon-to-be-former employers can enforce the restrictions.
“Unfortunately, they probably can,” he says.
Doctors need to be diligent and negotiate favorable terms before they sign an employment contract, he says. Hursh says there are several ways to deal with restrictive covenants so that doctors are not facing career-damaging situations.
• Keep the distance reasonable. Although geographic restrictions are common, in most cases the agreement should not require the doctor’s new office to be more than five miles from the old one. In rural areas, a somewhat larger area may be reasonable, Hursh says.
Also, when employers have multiple offices, the distance rule should apply only to the office where the doctor spent most of his or her working time.
• The general practice of medicine should not be restricted. “It’s one thing to agree that patients will have to drive five miles from your old office if they want to continue seeing you,” Hursh says. “It’s another thing to agree you won’t see patients in hospitals, nursing homes or ambulatory surgical centers that are within the prohibited area.”
• Continuing the doctor-patient relationship. Patients often become attached to a particular doctor and want to stick with him or her. But when a doctor moves to a new practice that can get tricky.
Contracts usually prohibit doctors from directly asking their patients to follow them to the new practice, Hursh says. Barring such solicitation, whether it’s in the office or by phone call or letter, is reasonable, he says. But advertisements by the doctor’s new employer should not be considered direct solicitation.
• Sometimes restrictions should not apply. If an employer fires a doctor without cause, then the restrictive covenant should not go into effect, Hursh says. That’s also true if the employer breaches its agreement with the doctor, although that can be difficult to negotiate, he says.
“An employer could worry the physician will claim some far-fetched theory of an alleged breach to get out of the restriction,” he says. “One way to deal with that might be to list specific grounds for a breach in the contract.”
Hursh says one of the most extreme cases he ever experienced involved a doctor whose non-compete clause prohibited the practice of medicine within 65 miles.
A hospital 62 miles away wanted to hire him.
It was while negotiating a contract with the hospital that Hursh and the hospital’s attorney discovered the restriction.
“The restriction was so ludicrous that we both agreed that the former employer would almost certainly lose if they tried to sue,” Hursh says.
But the hospital figured: why take chances.
The offer to hire the doctor was withdrawn.
Dennis Hursh has been providing health-care legal services for more than three decades. Since 1992, he has been managing partner of Hursh & Hursh, P.C., www.PaHealthLaw.com, a Pennsylvania law firm that serves the needs of physicians and medical practices. He is a member of the American Health Lawyers Association, where he is involved in the Physician Organizations Practice Group.

St. Anthony is pleased to announce the opening of St. Anthony Urgent Care. The new facility is located at St. Anthony North, at the corner of Broadway Extension and N.W. 63rd street.
Under medical director Dr. Chad Borin, providers Kristi McKee, PA-C and Nicole Miller, PA-C, will offer compassionate care for minor illnesses and injuries. St. Anthony Urgent Care is available for non-emergency illnesses such as colds, flu, and sinus infections, as well as minor injuries. Patients visiting the clinic will benefit with fast treatment, an electronic health record, an onsite lab and X-Ray, as well as quick access to specialists.
Open every day from 8 a.m. to 8 p.m., St. Anthony Urgent Care offers convenient hours for those inconvenient moments in our lives.

A special mass and blessing celebrated the newly renovated St. Anthony Hospital Chapel.
Tom and Judy Love made a generous donation to St. Anthony Foundation to renovate the 42 year-old chapel in honor of Archbishop Emeritus Eusebius J. Beltran. The renovation included many updates, including the addition of a stained glass window, almost a century old, of Saint Anthony. The beautiful stained glass window was added to thechapel entry visible from the hospital lobby.
Built in 1973, with over 27,000 visitors a year, the chapel has brought hope and comfort to many over the years. “The chapel is a place of refuge and worship for patients, family members, staff and physicians,” said Karen Green, Director of Pastoral Services. “The very spirit of the chapel brings consolation and strength to people of all faiths,” she added.
“We are truly appreciative of the generous donation made by the Love family. With their kind gift we were able to enhance the St. Anthony chapel resulting in a lovely place of worship, where our patients, guests, and staff can find peace and comfort,” said Tammy Powell, President of St. Anthony Hospital.

INTEGRIS Health Edmond is named one of America’s Best Hospitals for Emergency Care by the Women’s Choice Award. This coveted credential places INTEGRIS Health Edmond in the top one percent for emergency care.
“The Women’s Choice Award seal delivers a powerful message to the women of Edmond and surrounding areas,” says hospital president Avilla Williams. “It offers them reassurance and peace of mind that INTEGRIS Health Edmond is clinically excellent and prepared to care for and treat their families when they need it most.”
Emergency services account for more than 125 million hospital visits annually, and all clinicians must have expertise in caring for patients across their life span, often when their health care needs are urgent and unplanned. Unlike other hospital departments that interact with the same patient and families for an extended period, emergency staffs typically have one patient encounter, often when anxiety and fear is at its peak.
Hospitals earning the Emergency Care Award consistently rank in the top 25 percent of the 3,800 hospitals reporting on their emergency department’s performance to the Centers for Medicare and Medicaid Services. The eight measures CMS publicly reports relate primarily to the amount of time taken in the ER such as time for diagnosis, medication, and admission to the hospital, and are weighted according to the priorities of women surveyed.
“We have found that recommendations are an important consideration used by women in selecting a hospital for themselves and their family. By helping women know which hospitals in their area provide the best critical care, we are able to help them make better decisions, especially when it comes to emergency situations,” said Delia Passi, chief executive officer and founder of the Women’s Choice Award.
Year after year, the Women’s Choice Award is the only credential that identifies the nation’s best health care institutions by measuring against the needs and preferences of women, when it comes to treatment and a quality hospital experience. This credential signifies INTEGRIS’ commitment and passion towards an extraordinary health care experience for women and all patients.

It’s hard to be a journalist these days. I’m sure if you asked the parent of a college student studying journalism, they would probably tell him or her that it is next to impossible to sustain yourself at it. And that would not be far from the truth. As the dissemination of the written word is changing, the field for journalism is too. In the near future, printed books, movies in theaters and newspapers and magazines, as we know them today, may cease to exist, but, unfortunately, the evolution of the printed word doesn’t seem to be the only colossal battle facing reporters of this generation, or the next.
Today even if you asked the roommate or friend of the kid dreaming of journalism school, their peers might also tell the writer who dreams of telling news from around the world, to consider something else. Why? Because journalists have become the story themselves and it’s not a good one. The storytellers on the front lines have become targets of violence, hunted down, killed, in an effort to stop the news. This is particularly strange as news today so often comes in single sentences, often in a press release created by a publicist, not a newsperson, via text, Twitter, daily blasts and onscreen pop-ups, pretty much as it happens.
This makes much of today’s “news” little more than a voyeuristic opinion told from inside an office or, in many cases, inside someone’s bedroom, churned out by people without any reasoned viewpoint or expertise, people who spew often ill-informed, baseless comments on other peoples carefully planted statements, giving real reporters and the profession they’ve trained for, a bad name.
What will become of news if it is reduced to little more than catty sound bites from stay-at-home bloggers? I imagine it would be a little like listening to sportscasters deconstruct the big game a day after it’s been played — without ever seeing the game itself.
That’s not to say that some commentary doesn’t still have gravitas. Presidential speechwriters give the president a tone and a flare while reporting on the state of the union. There’s Vice News, which places writers right in the center of the action, allowing them to comment in long form in personal documentaries, and then there are political cartoonists, who satirize the day’s events, tilting at windmills and popping the inflated egos of the world’s powerful, ruffling the feathers of the unhinged and the fanatical.
Safety and security are never on the list of reasons why a journalist begins his or her life’s work, but having safety and security taken away — by either evolution or force — might just marginalize the field so much that we will be left with nothing but the Monday-morning quarterbacks.
Personally, I consider writing an art form. But I have children of my own now who are, thankfully, nowhere near old enough to begin picking college majors. When it’s time, will it be wise to push them toward the reporter’s path, mighty as it may be?
Time and evolution will tell.

Date/ Day/ Location/ Time/ Registration #/ Instructor

May 19/ Tuesday/ Midwest City/ 9 am – 3:30 pm/ 691-4091/ Palinsky
Rose State – Tom Steed Bldg. – 6191 Tinker Diagonal
May 30/ Saturday/ Okla. City/ 9 am – 3:30 pm/ 775-9009/ Edwards
Statemens Club – 10409 N. Vineyard Dr.
Jun 4/ Thursday/ Okla. City/ 9:30 am – 4 pm/ 951-2277/ Palinsky
Intergis 3rd Age Center – 5100 N. Brookline
Jun 8/ Monday/ Midwest City/ 9 am – 3:30 pm/ 737-7611/ Edwards
Midwest Senior Center – 8521 E. Reno Ave.
Jun 12/ Friday/ Okla. City/ 9 am – 3:30 pm/ 951-2277/ Edwards
S.W. Medical Center – 4200 S. Douglas, Suite B-10
Jun 13/ Saturday/ Okla. City/ 9 am – 3:30 pm/ 486-1385/ Edwards
Epworth Vila Retirement – 14901 N. Penn
June 16/ Tuesday/ Edmond/ 1:30 -3:00 pm/ 210-6798/ Palinsky
AARP State Office – 126 N. Bryant Ave.
“WNTT (We Need To Talk) Seminar Free”
Jun 27/ Saturday/ Moore/ 9 am – 3;30 pm/ 735-9638/ Palinsky
1st Methodist Church – 201 W. Main

The prices for the classes are: $15 for AARP members and $20 for Non-AARP. Call John Palinsky, zone coordinator for the Oklahoma City area at 405-691-4091 or send mail to: [email protected]

Per the Journal of the American Medical Association, hearing loss is one of the most common chronic health conditions and has important implications for a person’s quality of life. However, hearing loss is substantially undetected and untreated.
At INTEGRIS Health we believe everyone age 55 and older should have their hearing checked every year as part of their overall wellness.
In recognition of National Speech and Hearing Month, the INTEGRIS Cochlear Implant Clinic will offer complimentary hearing screenings for individuals who have not yet been diagnosed with a hearing loss. If you currently wear a hearing aid or have been diagnosed with a hearing loss, a screening will not be sufficient.
The doctors of audiology at the INTEGRIS Cochlear Implant Clinic can help determine if you have a hearing loss and what treatment options they can offer you. The screenings are available by appointment only.
For more information or to schedule an appointment for a complimentary hearing screening, please call the INTEGRIS Cochlear Implant Clinic 405-947-6030.

Dear Savvy Senior,
Do you know of any financial assistance programs or other resources that can help seniors with home improvement projects? I would like to help my 86-year-old father make a few modifications to his house so he can live there as long as possible, but money is very tight. Inquiring Daughter

Dear Inquiring,
There are actually a number of programs available that can help seniors with home repairs and improvement projects for aging-in-place, but what’s available to your dad will depend on his financial situation and where he lives. Here are some different options to explore.
Medicaid waivers: If your dad is low-income and eligible for Medicaid, most states have Medicaid Home and Community Based Services waivers that provide financial assistance to help seniors avoid nursing homes and remain living at home. Many of the waivers pay for home modifications to increase a person’s ability to live independently. Each state has different waivers with different eligibility requirements and benefits. Contact your Medicaid office (see medicaid.gov) for more information.
State and local programs: Some states and local governments have financial assistance programs, often called “nursing home diversion programs” or “deferred payment loans” that are not funded by Medicaid. These programs, which may include grants or loans or a combination, helps pay for modifications that enable low to moderate income elderly and disabled to remain living at home. Modifications covered typically include accessibility improvements like wheelchair ramps, handrails and grab bars. And some may be used for home improvements like roofing, heating and cooling, insulation, weather-stripping and storm windows.
To find out if there’s a program in your dad’s area, contact the city or county housing authority, the local Area Aging Agency (call 800-677-1116 for contact information) or the state housing finance agency – see ncsha.org/housing-help.
Federal programs: The Department of Housing and Urban Development offers HUD Home Improvement Loans, which are HUD insured loans made by private lenders for home improvement and building projects. Contact a HUD approved counseling agency in your area (call 800-569-4287) to learn more.
And the U.S. Department of Agriculture has a Rural Development program that provides grants and loans to low-income, elderly or disabled, rural homeowners for home repairs and improvements. Your local USDA service center (see offices.sc.egov.usda.gov) can give you more for information.
Veteran benefits: If your dad is a veteran with a disability, the VA provides grants like the SAH, SHA and HISA grants that will pay for home modifications. See benefits.va.gov/benefits/factsheets/homeloans/sahfactsheet.pdf for details and eligibility requirements.
Another possibility that’s available to veterans enrolled in the Medical Benefits Package is Veterans-Directed Home and Community Based Services. This program provides veterans who need help with daily living activities with financial assistance to help them remain living in their homes, and provides them with a certain amount of discretion to use those funds. To learn more see va.gov/geriatrics, or call 800-827-1000.
Non-profit organizations: Depending on where your dad lives, he may also be able to get home repair and modification services through the national, non-profit organization Rebuilding Together (rebuildingtogether.org, 800-473-4229). They provide services to low-income seniors, veterans and military families, families with children, people living with disabilities and victims of disaster.
You should also check with the Area Aging Agency to see if any other local organizations that offer volunteer home modification help to low-income seniors.
Reverse mortgages: Available to seniors 62 and older who own their own home, or owe only a small balance, and are currently living there, a reverse mortgage (see reversemortgage.org) will let your dad convert part of the equity in his home into cash – which can be used for home improvements – that doesn’t have to be paid back as long as he lives there. But, reverse mortgages are expensive loans, so this should be a last resort.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.