In this case, it was up to the employee to school the employer on the law. She explained that her contract and FMLA were mutually exclusive. The terms of her contract alone qualified her for paid leave.

Paid leave is most commonly found in academic and hospital contracts. It can be more difficult to find this benefit in groups whose salaries are based on relative value unit (RVU) productivity or physician staffing or contract management groups. Some productivity-based groups argue that paid leave unfairly burdens working physicians, who essentially are forced to finance another employee’s leave with the RVUs they earn during the absence. Independent contractors are unlikely to find a contract with paid parental leave.

Paid leave can be negotiated. A successful negotiation often depends upon the demand for the position. A group with 10 interested people for every job is much less likely to negotiate than a group that is having a difficult time filling its positions. Physicians who are paid hourly prior to becoming a partner may be in a better position to negotiate paid leave. Presumably, the RVUs a new employee bills will outpace the hourly wage. In such cases, the group can use those profits to subsidize the employee’s leave without affecting fellow physicians’ RVU compensation.

Alternatives to Paid Leave

There are alternatives to traditional paid parental leave. Some employers, most commonly staffing and physician groups, offer low-interest loans to help physicians finance family leave. Commonly, these loan payments are withdrawn directly from paychecks when the employee returns to work. Other physicians are able to “bank” paid sick leave and use their sick leave to fund their parental leave.

There are many different practice types in emergency medicine—being an independent contractor, an employee of a staffing group, or a partner in a democratic group, just to mention a few. Our varied types of practice make it difficult to have a one-size-fits-all answer to paid parental leave, which is why it is so important for physicians to discuss the parameters of parental leave with their new groups and employers and to make sure it is addressed in their contracts.

Resident: Wow. I thought I was getting paid parental leave. Do I have any power to ask for paid leave?

SH: Yes! You bring valuable skills to the table. You have many job opportunities available to you. Not every negotiation will be successful, but you shouldn’t fear negotiation. It’s part of the contracting process. If you don’t ask for paid parental leave, it won’t be given to you. The more physicians negotiate for paid parental leave, the more commonplace it will become in our contracts.