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Issue No. 7
May, 2010
Ignore The Language Of Your Restrictive Covenant At Your Own Risk
Darren M. Green, JD
MD Preferred Legal Services

All's right in the world.  That perfect job offer has come in.  Euphoria rules the day.  Unfortunately many a physician will let their guard down at this happy time and ignore the critical issues and restrictions concerning their rights should it become necessary to terminate the employment relationship.  Even the best laid plans can turn sour for any number of reasons, and that's the wrong time to realize for the first time that your employment agreement unreasonably prohibits you from plying your trade.  While non-competition, non-solicitation and similar restrictive covenants are largely creatures of state law - and hence the rules governing such covenants tend to vary from state to state - there are a few general principles to consider and evaluate regarding non-competition provisions before signing on the dotted line. 
 
While physician non-competition restrictions are usually difficult to enforce (and in some states entirely unenforceable), this does not mean you should accept whatever language your new employer proposes in your employment agreement.  Defending claims initiated by former employers is expensive and time-consuming, as you'll need a good (a/k/a/ expensive) litigator to push back.  Bear in mind that even if you ultimately prevail in dismissing the claim, it's entirely possible that your new employer will have revoked your employment offer to avoid undue expense, risk or headache on their end. In such a case, the non-competition provision will have succeeded in restricting your activities even though it was ultimately either not enforceable or not applicable to your new position.
 
So, what to do?  First, you may want to take a stab at removing the provision altogether.  Maybe suggest a non-solicit of patients in lieu of the non-compete, as that's often the risk of greatest concern to a practice.  If you lose this battle, your focus should shift towards making sure that the provision is reasonable in terms of geographic scope and timing.  A non-compete which runs for 4 years following termination of employment is, in all likelihood, far too long. 

Shoot for 6 months or maybe a year.  If your practice is located in Chicago, the non-compete should ideally be restricted to other practices within a specified radius of such practice, but at a minimum, restricted to Chicago city limits. 

Next, you should ensure that any restrictions are limited to your specific position at the practice.  In other words, a pediatrician should not be restricted in any way from joining other types of practices.  Finally, and possibly most importantly, the non-compete should become null and void in the event your employer terminates your employment without "Cause" (which should be defined, preferably narrowly, in your employment agreement).  It would be rather unfortunate to be out on the street 1 month after accepting employment due to budgetary constraints at your new practice with no ability to work in your hometown.

Darren M. Green, J.D. has over 14 years experience representing a wide range of clients on employment, corporate, technology, venture capital and other transactional matters.  He is an Adjuct Professor at Northwestern University School of Law and a member of MD Preferred Legal Services.  Mr. Green received his BA from the University of Pennsylvania and his J.D. from the U.C.L.A.School of Law.
Tenancy by the Entirety...Something Every Physician Should Know About

As young, graduating residents and fellows prepare to move from abject poverty to relative prosperity with a new employment contract and a respectable salary, their thoughts often turn to establishing a residence, getting married, starting a family and buying many of those deferred "things" that they could not afford as medical students. Before you get started down the road of the American Dream, stop and get some advice.

I cannot over stress the importance of sound legal advice for any professional embarking on a new career. Good advice is available from any number of quarters including the family attorney and other family members and friends who are older and wiser. But there are those whose job is dispensing financial advice. They are called, not surprisingly, Financial Advisors. And, of course, as in other professions, there are advisors and then there are advisors.

An excellent source for financial advisors who are "fiduciaries" (Financial Advisors who work on a fee only basis placing the interests of the client first) is the National Association of Personal Financial Advisors, NAPFA. All of their members are experienced fiduciaries. Within the association is a group of Financial Advisors who display the MD Preferred Financial Advisor Medallion. They specialize in serving the very special needs of physicians.
Here is an example of the sort of advice that one might expect from an MD Preferred Financial Advisor.

Let's say you are graduating from Fellowship and have accepted an opportunity in another city. You plan to get married and buy a home. You and your spouse select a suitable residence and find yourself at the closing. As your eyes begin to glaze over after reams and reams of paper pass in front of you for your review and signature, the closing office asks, "How will you be structuring the title?"

You look at each other and ask, "How do most buyers structure it?" You are already in trouble. If you have not thoroughly investigated every aspect of the home purchase process, YOU ARE GOING TO MAKE MISTAKES.
· Does the house fit your current economic situation?
· Is it in the right location?
· Does it fit your financial plan?
· Is it in the right location?
· And how should you structure the title?

Going back to our example, the title officer replies, "Most couples place it in Joint Tenancy." Not wanting to appear uninformed, you reply "That will be fine." But will it really? Prefacing my comments with the statement that I am not an attorney or a financial advisor and I am probably the last person to turn to for advice, there is a structure that a high income, high net worth professional should consider...Tenancy By The Entirety.

Both joint tenancy and tenancy by the entirety have a right of survivorship. If one joint tenant dies, the surviving joint tenant automatically owns the entire property. No probate...no new deed. But Tenancy by the entirety has two unique features which distinguish it from joint tenancy.
· Only married couples who are living in the property as their primary residence may own property as tenants by the entirety.
· Property held in tenancy by the entirety is shielded from the creditors of one spouse.

It is this second feature that makes it attractive to physicians. Let's face it, a physician is more prone to being sued and to having their personal assets attacked. A creditor who has a judgment against one (but not both) of the owners of property that is held in tenancy by the entirety cannot force the sale of the property to pay the judgment.
GREECE AND OIL COULD BE BIG FACTORS IN THE HOUSING MARKET
Harry Salzman, MD Preferred Realtor

The domino theory is at work again. If Greece is unable to raise money to pay for government spending, they could go bankrupt. (Hey, hold on, there! You mean countries actually have to pay for the programs their legislators pass. Bummer!!! With our luck, that might even happen here). However, Greece's traditional sources for borrowing are asking if they will ever get their loaned funds back from the Greek treasury. Germany, in particular, is irate that its citizens, who typically retire at a much older age than do Greeks, are being asked to provide pension money for Greek citizens.

If Greece defaults, then German banks will see their capital evaporate. That, in turn, will make it difficult for them to lend to other countries like Portugal or Spain to finance their budget deficits. If these countries also default as a result, then another major credit crisis will hit us. (Ireland would have been on this list of endangered countries, but they decided to reduce their unsustainable government debt by cutting government salaries, furloughing many government employees and convincing its investors that it will repay the loans. Where do those crazy Irish get these strange ideas?)

The bottom line for the U.S. would be that, because of our global linkages, our banks would also take a hit. This would make it very difficult to obtain Jumbo loans and second-home financing. So, if you're thinking of getting a Jumbo loan, or buying a second-home, it would be prudent to make your move right now.

The other source for concern is the oil-spill in the Gulf of Mexico. Obviously, the local economies that will be directly affected by the spill will have a hard time recovering from the effects of the spill. For the rest of us, the price of oil will rise measurably - or more oil will have to be imported. Either way, our cost of living will go up and the recovery from the recession will slow down. Slower economic growth will mean slower job expansion and a higher U.S. budget deficit.

Oh, for the days when worrying about Greece and oil just meant making an appointment to have the car serviced.

Harry Salzman, Salzman Real Estate Services, Ltd, 538 Garden of the Gods Road, Colorado SpringsCO80907, Toll Free: 800-677-MOVE(6683) or 719-598-3200
Size Does Matter
If You Want To Live To Be A Hundred
www.RoundsOnLine.org

Ok, here's the hot scoop from the National Academy of Sciences. The Ashkenazi Jewish community, which is known for its disproportionately large number of centenarians, appears to be blessed with longer telomeres and with a mutant enzyme that keeps their telomeres longer...for longer...much longer. Scientists seem to think that longer telomeres may be one of the reasons that these folks live so long.

I've always suspected that size really does matter but I never thought to put a tape measure to my Telomeres. Actually, I'd never heard of telomeres. It simply hadn't come up in date night small talk. So, I went to my trusty computer and Googled telomeres and discovered that they are actually relatively short sections of DNA at the end of our chromosomes. A BBC science writer compared them to the plastic tips of a shoe lace that keep the laces from unraveling. Leave it to the Brits to come up with an imaginative analogy.

It would appear that each time a cell divides, its telomeres get shorter...I can think of several politically incorrect analogies myself...but the point of these ramblings is that the hyper active enzyme that the Ashkenazi Jews seem to be blessed with repairs the telomeres and prevents them from shrinking. The magic enzyme is called Telomerase. And telomeres that don't shrink seem to retard the aging process.

The pharmaceutical companies are probably already shifting into overdrive to find a drug that stimulates the enzyme in those of us with life styles that tend to discourage longevity. So keep an eye on your spam files. Before long they will be replacing the Viagra promises with a little blue pill promising longer Telomeres. Of course there will probably be warnings of possible side effects...hair loss, tooth loss, drooping eyelids, erratic driving, memory loss and a bankrupt social security system. But those are small prices to pay for the promise of living long enough to see universal healthcare and a Republican president.
Physician Assisted Suicide Gets Green Light from Montana Supreme Court

Now there are three states in the US where doctors can participate in a terminally ill patient's decision to end their suffering by ending their life. Montana joined Oregon and Washington in allowing their doctors to prescribe lethal drugs to terminally ill patients who want to end their life.

The vote was 5 -2, finding that there is "nothing in Montana Supreme Court precedent or Montana statutes indicating that physician aid in dying is against public policy." Justice W. William Leaphart writing for the majority added, "The 'against public policy' exception to consent has been interpreted by this court as applicable to violent breaches of the public peace. Physician aid in dying does not satisfy that definition. We also find nothing in the plain language of Montana statutes indicating that physician aid in dying is against public policy."

The case involved a retired Billings truck driver and his doctors who hesitated to grant their patient's request that they provide him with lethal medications that he could administer to himself to end his life. And the fact that it would be the patient that self administered the drugs was not lost on the justices. A physicians 'indirect aid' was considered not to be contrary to public policy.
Even among the majority, the reading of the law was not consistent. In fact, this was actually a very narrow ruling in that the justices were taking the position that legislators have not crafted clearly worded legislation that doctor assisted suicide is against public policy. The justices were very clear that there was no 'vindication of constitutional interests' in their ruling.

So, it would seem that, until the legislature steps up to the plate, passes a law against doctor assisted suicide, that law is challenged, moves up the judicial ladder and ultimately ends up before the same justices, physicians have at least an amber light to assist their patients as they seek not just quality of life but quality of death.

But State Solicitor Anthony Johnstone indicated that he plans to push the legislature for clarification. "The Montana Supreme Court recognized that physician-assisted suicide is a policy question for the people of Montana and their Legislature. As we have argued, that is where the resolution of this important issue belongs." Stay tuned.

This and That from Here and There

Don't get sick during July. A recent study by a pair of researchers with too much time on their hands reviewed 62 million death certificates and concluded that medical errors in teaching hospitals rose by roughly 10% each year during July. The study as reported in the Journal of General Internal Medicine concluded that the "July Effect" was probably a result of newly graduated medical residents taking on more autonomy and writing scripts without direct over sight.

Every year your author contributes to the Susan B. Coleman walk to cure breast cancer. I even can be seen wearing a pink shirt from time to time. The contribution was made in the hope that at some indefinite point in the future some progress will be made in controlling this terrible affliction. It would appear that my expectations were far too pessimistic. Researchers at Cleveland Clinic have developed a vaccine that targets the proteins that are only present in breast tumors but not in healthy breast tissue. They hope to begin human clinical trials within the year. In lab results on mice the vaccine was 100% effective!

When was the last time you read an article about the H1N1 swine flu? You may be surprised to learn that the World Health Organization has left the alert level at 6 (the highest possible alert level) and considers that the swine flu is still a pandemic. They plan to re-visit their view in mid-July.

Here is a novel new game that America's youth seems to have embraced..."Sack Tapping." In this game victims are slapped or punched in the groin. It is unclear how one determines who has won this game or how one keeps score. But, doctors are reporting cases of blunt force trauma to the testicles where the organ has twisted up to 360 degrees. Anyone for a nice game of lawn croquet?
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