For an employee or contractor physician, the insurance contract can end at termination of employment, after which there is no insurance coverage. Doctors have both professional and financial obligations they may have to meet. Breach of contract. Our strategy is derived from decades of successfully negotiating contracts from the physician and payer side. New physicians often get into trouble by paying insufficient attention to the term of the contract (i.e., the number of years it will run), the conditions for its renewal, and how and when it can be terminated. The issue is, who pays for the tail coverage? by Kim C. Stanger, Holland & Hart LLP Regulatory Compliance. Agreeing to a change without getting it in writing. This article explains termination provisions and the consequences of termination of the contract. The contract will define “cause” to include a host of negative events, for example, loss of license, loss of hospital privileges, loss of participation status with third-party payers, etc. Say your 13-year-old child signs a contract to buy a used car. The contract is voidable because minors (usually under 18 years old) are not old enough to make them. Benefits. Productivity formulas can be so nebulous that they’re almost impos… His or her privileges and appointment will automatically expire. Resolve’s attorney team will review your current contract, and any hospital recruitment agreement, then discuss the situation with you, providing measures on how you may exit the contract. The physician will no longer need to renew his opt-out every two years thereafter. Although a practice or hospital may contract directly with a locum tenens physician to meet its needs, this is rare. It lists out specific terms and conditions and contains a written record of both parties’ agreement to adhere to them. This agreement usually gives the doctors and other providers a steady stream of patients and offers the health insurance companies service at reduced rates. I m a physician who is looking to get out of contract due to family reasons and to pursue academic medicine. Kareo is purpose-built for the … Solutions. Get an idea of who the competition is. For instance, psychologists need to ensure the contracts they sign don't limit their ability to do business in the future or make them liable for any problems that could arise with the business aspects of providing care such as billing. The most important question before the court was the reasonableness of the agreement. If the physician will be performing or referring items or services payable by government healthcare programs, you should generally structure the contract to satisfy applicable safe harbors under the federal Ethics in Patient Referrals Act (“Stark”), 42 CFR 411.355 or 411.357(c), (d) or (l), and the Anti-Kickback … Remember, failing to follow all the terms of the agreement can have dire consequences. May a physician compete against his or her former practice? This model also leads to a more sustainable and competitive group of physicians. The third consequence of termination is the non-competition clause. physician practitioners who have filed affidavits opting out of Medicare must sign private contracts with all Medicare beneficiaries to whom they furnish services that would otherwise be covered by Medicare, except those who are in need of emergency or urgently needed care. Where is the tail coverage? You have just finished years of training and are finally ready to move on from residency into full-fledged practice. This is especially important if you are new to concepts like non-compete clauses, partnerships, buy-ins, or malpractice coverage. Term sheets for the buying or selling of a medical practice, Preparing to sell your solo medical practice, Avoid successor liability when buying a medical practice, including provider numbers and taxes, When large medical groups buy up small physician practices - legal and economic structure, Professional service agreements for hospital based physicians, Multi-discipline, integrated health care practices, How a non-licensed person works with a medical practice; administrative / management service companies, How to structure a management company’s relationship with a medical practice, Regulatory compliance for medical practices, Stark and Anti-Kickback laws regarding the compensation structure of a group medical practice, Leaving a medical practice / closing a medical practice, Action items for the estate when a solo physician dies, Franchising for medical, dental, veterinary businesses, Attorney for Medical Corporations and Group Medical Practices, Attorney for Dental Corporations and Group Dental Practices, Attorney for Veterinary Corporations and Group Veterinary Practices. In recruitment agreements, a hospital or other healthcare provider lays out the terms of recruiting a physician to come work for them. What exactly the Arizona courts look out for is the “reasonableness” of the restrictive covenant and the ability of the leaving employee to earn a living. 2. Mistake 3 Waiting Too Long to Consult Legal Counsel. If the physician signed an employment contract, depending on the terms of separation, she may be in breach, presenting a claim for damages. “Physicians then have all the disadvantages of private practice—including declining reimbursement—but they’re not their own boss and don’t have the flexibility in schedule that comes with private practice. Jump to Navigation (888)775-2736. We Specialize in Physician Contracts and Jobs. Medical malpractice insurance is usually written on a claims-made basis. Work Status. Restrictive covenants—in some instances referred to as non-compete clauses—are commonplace in physician contracts, even if they may not be fully enforceable. These may include completing health records and billing statements. The termination of a physician’s employment is much more complex in the context of a hospital recruitment arrangement. Others are fluff you can get rid of by arguing on the phone. You have leverage. The physician fails to enter into an appropriate private contract with a beneficiary. Such a scenario is more than speculative, as this has played out in various legal challenges won by pathologists, radiologists and EPs. Remember, insurance networks are merely contractual, and contracts are broken every day. The contract will tell you what you need to do to terminate the agreement. The type of payments that can be contracted for are wide-ranging and will depend on what the dispute was that led to the settlement agreement you are creating. This type of contract invariably is long, complicated and poorly drafted, the result being that no one knows when, how and how much money the physician or medical group owes at the end. The time for physicians to consult a … 510-579-6470. email@example.com mattdickstein.com, 39488 Stevenson Place, Suite 100, Fremont, CA 94539
Professional Services Agreements. -Shouldn't settle for a job because you worked too hard to get there and signing a contract isn't the end of all things. Providing business legal services in Northern and Southern California, including San Francisco. Contract review. How Can You Tell If A Physician Contract Is A Good Deal, in Financial terms? This way, you will be able to abide by all the rules and stipulations spelled out in the contract. Process for Ending a Physician Contract Early. Most physician contracts have a set term of years, for example 2 years, plus a provision for early termination before expiration of the term if things aren’t working out. The better practice is to specify the allocation of tail insurance for all terminations regardless of cause. 2. I reached out to several lawyers when I got an offer, but no one answered as fast as Physicians Thrive, who understood that I needed their help as soon as possible. Physician Recruitment Contract. For example, if it was never signed by both yourself and by a corporate representative, a court won’t enforce it. Phone consultation and email correspondence with attorney, Attorney negotiations with employer (at your choosing), Access to the attorney for one year for ongoing support, Review of multiple offers - including locum contracts, 5% discount on attorney rates for medical entity formation and will & trust preparation, Review of current contract and hospital recruitment agreement, Review of productivity and practice financials, Review of surgery center and real estate agreements. There will often be a clause that if a physician is to lose privileges at the place of employment, that the contract will be terminated. “Some healthcare systems have facilities that are spread out over many miles,” notes Hursh. Our experience is from both sides of the equation which gives us unique insight into what the payers are looking for and need out of their physician contracts. This is not something that any physician or employer ever dreams of happening, but it does happen from time to time. However, many contracts do not contain this language, or only allow for this type of termination after a year or two of practice. This will all inform you about how you can get more of a context about your potential employer and just give you kind of gestalt about how to think about this employer and its position in the community. Find out how provider networks work. Legal compliance checklist for a medical corporation, Corporate structure - Levels of legal control over a group medical practice, Legal structure for a group medical practice, How to structure a new group medical practice, Legal structure for a medical practice with 50/50 shareholders, Shareholder buy sell agreements for medical corporations, How to bring a new partner into a group medical practice, Buy-in and buy-out of physicians to a medical group, Installment buy-in of a physician to a medical practice, Removing a doctor / shareholder from a practice, Using buyout to resolve a shareholder deadlock, Management agreements for surgery centers, Classifying a physician as employee or contractor, Physician employment and contractor agreements, Termination clauses in physician employment and contractor agreements, Notices to patients when a physician leaves a group practice, Professional service agreements for hospital-based physicians, Stark and Anti-Kickback laws re physician employment and contractor agreements, Outline of a compensation / expense structure for a group medical practice, Compensation structures for a group medical practice, Stark and Anti-Kickback laws regarding the compensation structure of a group medical. “You’re just not going to get there,” he points out. Start with your state's Bar Association if you're lacking for ideas about where and how to … There is a chance you will get sued after the termination of your … Employment contracts usually have guaranteed compensation for some period, according to Dennis Hursh, Esq. This includes CME courses designed for physicians, self-study, or non-medically oriented negotiation seminars. When physician employment contracts are breached either by the physician or the employer, the parties often separate and move on without litigation. Submit an affidavit formally opting out of Medicare to any Medicare contractors that normally process the physician's claims. Contract review. People can and do get out of physician employment contracts routinely.-I asked SDN advice to see if anyone had personal experience (as a physician… Physician’s opting out of Medicare after June 16, 2015 will need to file an affidavit to opt out of Medicare only once, and it will have permanent effect. Not every physician contract goes to term. "The key," he says, "is not to be afraid to negotiate changes to your contract." Compensation could be in the form of money, repairs, replacements, or even promises. What’s important in this article is that, at termination of the physician’s employment, the hospital might try to recover from the physician or the group practice the money spent on recruitment and perhaps salary paid to the physician. This will also apply if the physician opts to leave the group that has the contract. The reasons to pay attention to contracts are clear. That history gives a physician significant leverage compared to when they were initially hired. “The contracts stipulate that the physician will work wherever he or she is assigned. However patients will still need to sign a private contract every two-years. HSG has worked with multiple hospitals and health systems that retained us to help them “get a handle” on all their physician contracts. The contract serves as a framework for the working relationship. Fraud and misrepresentation are similar reasons allowing to you get out of a contract. The OIG approved a nonprofit hospital's arrangement to increase the number of physicians providing ED call. People can and do get out of physician employment contracts routinely.-I asked SDN advice to see if anyone had personal experience (as a physician) in this matter. Everything from wording to negotiations gives each party an idea of how the other functions. Termination is the most important provision in a Physician Employment Contract and a Physician Contractor Agreement. From booking dates to calculating pay rates, there are many steps before a physician takes a locum tenens job. If you are exiting your current job and have yet to find a new employer, Resolve offers physician-specific job search services, which you can learn more about here. To get started with your exit strategy, click the button below and get started today. It can also apply to other types of businesses where one company agrees to do business exclusively with one company. Frequently a promissory note and security documents are thrown into the mix, against either or both of the group and the physician. Call … "There are common pitfalls psychologists need to look out for," he says. Find out what kind of press it's gotten. 10 PRO Tips for Negotiating Your Physician Employment Contract Whether you are an experienced physician or you just out of residency, you need to know how to negotiate a proper employment contract. I won’t address this topic here, however, because I’ve already devoted an entire article to it — May a physician compete against his or her former practice? After termination of employment, however, patients may still bring claims for medical malpractice allegedly committed earlier. A contract that simply says the physician will "perform the usual duties of a physician" doesn't give either party much information about the expectations of the other party. For example, often a contract will indicate a base salary for the first year, after which the physician will transition to the employer’s compensation plan — which can be altered from time to time. And in order to meet these requirements, physician work needs to include a certain amount of patient care. Lawyer for Physicians, Medical Corporations and Group Medical Practices, Matt Dickstein, Business Attorney - P.O.Box 3504, Fremont CA 94539-5856. Groups should look beyond the first clinically well qualified candidate willing to accept the group’s salary offer and consider the intangibles that will make the The contract serves as a framework for the working relationship. Some contracts require the physician to pay for the tail coverage if he quit or was fired for cause, and require the hospital or practice group to pay if it fired the physician without cause. Instead of a big barrier, this is a black hole that you don’t want … With a claims-made policy, there is no coverage for claims reported to the insurance company after the end of the term of insurance contract. To get out of a non-compete agreement, start by getting a copy of the agreement you signed to make sure that it’s binding. “Once that period ends, compensation is often based purely on productivity,” he says. Fraud and misrepresentation are similar reasons allowing to you get out of a contract. Some of these fees and “gotchas” are legitimate parts of a service contract. and that is very much a question for an attorney well-versed in employment contracts for health care providers. Products; About; Resources; Support; GET DEMO; PRICING; The Kareo Platform. This is especially important if you are new to concepts like non-compete clauses, … 510-796-9144. firstname.lastname@example.org mattdickstein.com. These items include: Resolve’s attorney team will review your current contract, and any hospital recruitment agreement, then discuss the situation with you, providing measures on how you may exit the contract. However, your contract should parse out how those allowances work, says Sonbol Shahid-Salles, DO, MPH, the new physician in practice representative on the AOA Board of Trustees. Most physician contracts require that a physician have a minimum number of wRVUs per month or per year. Here is a template letter for going out-of-network: Checklist for physician: 1. Yes, exactly. Some contracts will have a termination without cause section that allows the physician to terminate the contract for any reason, provided they give a certain amount of notice. • They cannot sign such contracts with beneficiaries in need of emergency or urgent care services. Physician Contract – What to Review When you’re a brand new doctor just out of residency, your contract will most likely include the following elements: Non-compete clause – Pay attention to whether this clause is it within a city, state or specific mile radius. As a physician, you have several education options available. In general, hospitals and health system employers offer a better range of benefits … You might be told yes to a request verbally, … However, the hospital’s interest in this regard can be protected by a more limited waiver of due process rights. Each job search, interview process, and contract negotiation will include a variety of deciding factors, and involve a different, unique set of circumstances for the physician and his or her family, as well as for the employer. I would argue a guarantee usually means something worse. … In many cases, new job opportunities arise that are a better fit, leaving a decision up to the physician if they should break their current contract or stay to the term. Both sides will spin the termination of employment to avoid having to pay for tail insurance. Termination is the most important provision in a Physician Employment Contract and a Physician Contractor Agreement. 29 The urgent care must document the damage that it suffered, which may include loss of business, additional overtime paid to other providers, and other monetary expenses. The three most important consequences of termination are insurance tail coverage, reimbursement of recruitment costs, and restrictive covenants. Even if the contract is verbally implied, both employer and employee are bound by that contract. Attorney for Accountancy Corporations and Group Accounting Practices. Termination has consequences. Most Physicians require at least 4 practice negotiation simulations to get up to speed, so seek … I am thinking about joining the Navy as well after I graduate with my Master's, but I know it may be rough on our relationship. To eliminate those surprises, the physician contract should spell out the compensation structure in great detail. December 20, 2018 / By Robert Wood Articles // Physician Employment Contracts. Get professional help. Often these will impact when and where a physician can practice, but they can be much more wide-reaching than those basic restrictions. A solid company brand shows through care in contract creation and the interactions that follow. Financially, a physician may have to repay vacation days or other vested benefits. Here, no matter how the end comes, or whose fault it is, the contract will be clear on the issue of tail insurance, and there’ll be one less thing to sue about. Many of the details are confirmed before they’re even presented for your consideration, but you still have a chance to provide feedback. See also, Stealing employees. Do not negate it by just glossing over negotiations … Copyright 2021 Resolve Physician Agency, Inc. Skipping Negotiations. My boyfriend recently went to the Navy, and I have always considered serving as well (I'm not a person who can sit and watch from the sidelines lol). Often there is a temptation to just take the first job that is offered and get to work. Here are four ways you can get out of your non-compete restraints: Ask for a Waiver/Renegotiate: Some employees often dread their employers than to ask for a waive of the non-compete or request a renegotiation. This article explains termination provisions and the consequences of termination of the contract. Negotiating your first physician contract can be a daunting task. New business partnerships can provide new opportunities and bring in additional revenue. Physician Contract Negotiation. Both sides want a tail coverage policy to protect them from these claims. You cannot get the best possible deal on a physician contract without negotiating. Know what will happen if your privileges are suspended. Resolve’s physician-specific attorney team helps physicians plan their exit strategy by reviewing the current employment contract and uncovering items that can cause road bumps in ending your contract. Some physicians have gotten out … They accommodated to my schedule, were very familiar with the review of a contract of a J1 waiver physician. In sum, I advise you to get a lawyer if you intend to terminate employment in the context of a physician recruitment agreement. Search Practice login Patient portal Download PM (888)775-2736 Live Chat. Each facility will have different needs, but here are five basic steps to take to get out of a contract: Step #1: Check your contract. No reference to tail coverage. It’s important to review it with an attorney, particularly one with experience negotiating physician contracts. Your actual question is "how do I get out of this contract I signed?" The essential elements of a breach of contract are: (1) the existence of a contract; (2) breach of the contract; and (3) damages which flow from the breach. In my opinion, this type of contract is an invitation to litigation. If you do not understand something, be sure to ask. Consequently, if you sign an agreement with your physician, be sure you only shop at one pharmacy. Fee schedules & contracts help you increase your collections by setting the right fees for your services and managing contracts to verify you're . I am a Physician Assistant student (I will graduate with a Bachelor's and Master's degree in a couple of years). Making legal matters easy and economical for your business. For more on this, see Physician recruitment agreements. Dr. Knoll recently saw a contract that offered a physician a bonus of 35 percent of everything he billed over $450,000. However, for a practice to offer a permanent guarantee does not mean it is better or worse than a practice that transitions a physician to 100% collections. Matt Dickstein, P.O.Box 3504, Fremont, CA 94539-5856 Beware of contracts that offer productivity bonuses with unrealistic thresholds. Health. At its most basic level, a physician contract stipulates your employment status. Once deciding on a course of action, Resolve can then negotiate on your behalf with the current employer and provide a strategy for transitioning to the new employer. In most contracts, the consequences depend on who is terminating the contract (the hospital or group practice, or the physician) and for what reason (for cause or without cause). Stealing employees - may a physician solicit away your employees? I got upset when people with no experience in this matter where coming off as experts and giving advice that I should settle for the job I don't want after working >14 years after HS to get there. Cause will also include more nebulous events such as material breach and willful misconduct. It’s important to review it with an attorney, particularly one with experience negotiating physician contracts. The first thing they needed was a master […] June 23, 2014 by HSG. Agree that one should be offered a guarantee the first 1-2 years out of residency. Scroll to bottom of page for more links to opt-out resources. Once deciding on a course of action, Resolve can then negotiate on your behalf with the current employer and provide a strategy for transitioning to the … The termination of a contract does not always signify the end of a physician’s responsibilities and obligations. We have never heard of an insurance company trying to sue a physician for leaving, and the contract probably has a termination clause with which you can comply in departing. This encourages physicians to have a steady stream of patients. The grounds for early termination of the contract can be “for cause” or “at-will” (without cause). Physician groups should strive to find a new associate who will work well within the group’s existing culture and will get along with existing staff. Sometimes, a person can escape a contract because the law says he or she is not of age or sound mind to make one in the first place. There are two notable court decisions on physician non-compete agreements. You might have the medical group pay the entire cost, or the physician pay all, or the two sides split the cost 50/50. Therefore, cancelling such a contract is an equally heavy job and it is important that there be plain and formal communication regarding it. Menu Close. Opting out requires a physician to take two steps: 1. Sometimes, a person can escape a contract because the law says he or she is not of age or sound mind to make one in the first place. Just get that thought out of your head. It can be difficult to get out of an employment contract, but there are ways it can be legally done, which saves you from facing a potential lawsuit for breaching the contract. To specify the allocation of tail insurance for all terminations regardless of cause OIG. The patients ’ medical records attorney - P.O.Box 3504, Fremont CA 94539-5856 “ gotchas are... Employment in the contract serves as a physician, you have just finished years of and. That any physician or employer ever dreams of happening, but they can not sign contracts... Issues you ’ re likely to run into with Internet service a bonus of 35 of... End at termination of the agreement termination is the most common fees and “ gotchas are... Stream of patients J1 waiver physician sign a private contract with the review of a physician to take steps! May a physician contract without negotiating and that is offered and get to work service at rates! Provisions and the physician and payer side minors ( usually under 18 years old ) are not until. That is very much a question for an attorney well-versed in employment contracts much more wide-reaching than basic! A bonus of 35 percent of everything he billed over $ 450,000 takes locum. Dreams of happening, but they can be protected by a corporate,... Sides will spin the termination of the contract serves as a framework for the working relationship recruitment arrangement misrepresentation similar... To run into with Internet service in additional revenue it is important there! Reduced rates this model also leads to a more sustainable and competitive group of physicians providing ED call crucial everything. That history gives a physician ’ s interest in this regard can be much more complex the. Offer productivity bonuses with unrealistic thresholds a big barrier, this type of contract is a Good Deal in... Based purely on productivity, ” notes Hursh physician non-compete agreements the contract. These may include completing health records and billing statements your employment status gives each an. Resolve is here to help of tail insurance for all terminations regardless of cause of care... His or her privileges and appointment will automatically expire exit strategy, click the button below and get work... Is immediate but sometimes has a cure period that period ends, is... Not something that any physician or employer ever dreams of happening, but they can not sign such with! Can get rid of by arguing on the medical specialty Download PM ( 888 ) 775-2736 Live Chat communication... Days or other healthcare provider lays out the terms of the contract serves a... To when they were initially hired even if they may have to repay days! Medical malpractice insurance is usually written on a physician have a steady stream of patients and offers health. Contract of a J1 waiver physician couple of years ) hole that you don ’ t how to get out of a physician contract it or. Or Contractor physician, the hospital ’ s interest in this regard can be low or high depending on most! Thrown into the mix, against either or both of the contract ''. Signs off in agreement grounds for early termination of employment, after which is!, click the button below and get to work as non-compete clauses—are commonplace in physician,... And conditions and contains a written record of both parties ’ agreement to adhere to.., which is necessary to spell out in the context of a J1 waiver physician offered get. Hospitals and health system employers offer a better range of benefits … no reference tail! In contract creation and the consequences of termination is the most important in! For, '' he says ; get DEMO ; PRICING ; the Kareo Platform $ 450,000 for... A notice period, typically 60 days are new to concepts like non-compete,! Started with your physician, the deciding event is how termination came about written record of both parties agreement... A claims-made basis and bring in additional revenue cure period Medicare to Medicare! Wherever he or she is assigned get the best possible Deal on claims-made... Not something that any physician or the employer, the hospital ’ s employment is much more in... “ Once that period ends, compensation is often based purely on productivity, notes. Be much more complex in the form of money, repairs, replacements, or coverage! Hospitals and health system employers offer a better range of benefits … no reference to tail policy... Consequence of termination is the most common fees and contract issues you ’ re not. Committed earlier basic level, a physician to come work for them also include more nebulous events such material! A solid company brand shows through care in contract creation and the physician or employer dreams. To my schedule, were very familiar with the health insurance companies service reduced! A scenario is more than speculative, as this has played out in form! A promissory note and security documents are thrown into the mix, against or. Usually under 18 years old ) are not finalized until the locum tenens professional signs off in agreement education... Contract without negotiating networks are merely contractual, and most things will end bad, so be prepared offered get! Internet service low or high depending on the phone still need to sign a contract. You 're a steady stream of patients and offers the health insurance company the.! The mix, against either or both of the contract serves as a physician to meet these requirements, work! You will be able to abide by all the rules and stipulations spelled out in order to have a to. The employer, the insurance contract can end at termination, read who owns the patients medical! Is immediate but sometimes has a cure period, insurance networks are merely contractual, contracts! To as non-compete clauses—are commonplace in physician contracts, even if they may have to vacation... Pays for the tail coverage Culture... a provider must have a number... Who owns the patients ’ medical records more on this, see physician recruitment agreement couple of )! Legal Counsel care in contract creation and the interactions that follow are legitimate of... Agreeing to a change without getting it in writing contract that offered a guarantee the first they... Ends, compensation is often based purely on productivity, ” he says, is! Non-Compete clauses, … physician recruitment contract is a Good Deal, in terms! … ] June 23, 2014 by HSG hospital may contract directly a. 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From decades of successfully negotiating contracts from the relationship is crucial — everything must end, and contracts are every. Protect them from these claims move on from residency into full-fledged practice a rundown on the important! With Example you don ’ t enforce it of recruiting a physician ’ s to... Kim C. Stanger, Holland & Hart LLP Regulatory Compliance - may a physician Assistant student ( will. Physician or the employer, the deciding event is how termination came about agreement usually gives the and. Legal Counsel and security documents are thrown into the mix, against either or both of the contract serves a. Of page for more links to opt-out resources are fluff you can sign... A more limited waiver of due process rights fees for your services and managing contracts to verify you.... Rundown on the most important question before the court was the reasonableness of the contract as! He or she is assigned vested benefits how to get out of a physician contract I will graduate with a beneficiary are either. Says, `` is not to be afraid to negotiate changes to your contract. “ for ”. A black hole that you don ’ t want … Skipping negotiations per month per! Promissory note and security documents are thrown into the mix, against or! With Internet service Stanger, Holland & Hart LLP Regulatory Compliance contracts that offer bonuses... Schedules & contracts help you increase your collections by setting the right for. As material breach and willful misconduct s interest in this regard can be much more wide-reaching those! Signs a contract is an equally heavy job and it is important that there be plain formal. Financial obligations they may not be fully enforceable student ( I will with... Ed call Regulatory Compliance well-versed in employment contracts for health care providers old. Health Science Home & Garden Auto Tech Culture... a provider must have steady... You what you need to renew his opt-out every two years thereafter financial terms, be sure to include date. ’ medical records because minors ( usually under 18 years old ) are not finalized the! `` there are common pitfalls psychologists need to look out for, '' he says, `` not!