Accepting a new physician position is an exciting career milestone, but before you put pen to paper, it's important to take a close look at the contract. While salary is often the first thing physicians consider, it's far from the only factor that determines whether an opportunity is truly a good fit.
Your employment agreement outlines your compensation, responsibilities, benefits, and legal protections. Taking the time to understand each section can help you avoid unexpected surprises and set yourself up for long-term career satisfaction.
Here are the key areas every physician should review before signing a contract.
1. Look Beyond the Base Salary
Most physician compensation packages include much more than an annual salary. Depending on the employer, your total compensation may also include:
- Base salary
- Productivity bonuses based on RVUs or collections
- Quality or performance incentives
- Signing bonus
- Relocation assistance
- Student loan repayment
- Additional compensation for call coverage
As you review the offer, be sure you understand:
- How productivity is measured
- When bonus opportunities begin
- Whether your salary is guaranteed or subject to adjustment after the first year
- How frequently compensation is evaluated or renegotiated
If possible, ask for productivity benchmarks or compensation data from current physicians within the practice. This can provide valuable perspective on what is realistically achievable.
2. Understand Productivity Expectations
Many physician contracts tie compensation to Relative Value Units (RVUs), making it important to understand exactly what's expected.
Before accepting an RVU-based compensation model, ask questions such as:
- What is the annual RVU target?
- Is that goal realistic based on expected patient volume?
- How long does it typically take new physicians to reach full productivity?
- Is there a guaranteed salary during the ramp-up period?
A generous compensation package may look attractive on paper, but unrealistic productivity expectations can quickly lead to excessive workloads and burnout.
3. Clarify Call Responsibilities and Daily Workload
Work-life balance often depends more on scheduling expectations than salary alone. Two positions with nearly identical compensation can offer very different lifestyles.
Make sure your contract clearly outlines:
- How frequently you'll be on call
- Whether call shifts are compensated separately
- How call responsibilities are distributed among physicians
- Weekend and holiday coverage expectations
- Average daily patient volume
Having a clear understanding of your workload helps prevent surprises after you start.
4. Carefully Review Any Non-Compete Agreement
Many physician contracts include restrictive covenants that limit where you can practice after leaving an employer.
Pay close attention to:
- The geographic area covered by the restriction
- How long the restriction remains in effect
- Whether it applies if you're terminated without cause
Because non-compete laws vary by state, it's wise to have an experienced healthcare attorney explain how these provisions may affect your future career options.
5. Understand the Termination Provisions
No one accepts a position expecting it to end early, but it's still important to know how either party can exit the agreement if circumstances change.
Review the contract for:
- A without-cause termination clause
- Required notice periods
- Any repayment obligations for signing bonuses, relocation assistance, or loan repayment benefits
Having reasonable exit options provides flexibility if your career goals or personal circumstances change.
6. Review Your Malpractice Coverage
Malpractice insurance is one of the most important sections of any physician contract, yet it's often overlooked.
Be sure you understand:
- Whether the policy is occurrence-based or claims-made
- Who is responsible for purchasing tail coverage if you leave
- The policy's coverage limits
If tail coverage becomes your responsibility, the cost can be significant, making this an important detail to clarify before signing.
7. Evaluate the Full Benefits Package
Your total compensation extends well beyond your paycheck. A comprehensive benefits package can add considerable long-term value.
Review items such as:
- Health, dental, and vision insurance
- Retirement plan and employer contributions
- Continuing Medical Education (CME) allowance
- Paid time off
- Licensing and credentialing support
- Partnership opportunities, if applicable
If a partnership track is available, ask additional questions about:
- Buy-in costs
- How the practice is valued
- Typical timeline to partnership
These details can have a substantial impact on your long-term financial future.
8. Consider the Practice Environment
Not every important factor appears in writing. Learning about the organization's culture can be just as valuable as reviewing the contract itself.
Ask about:
- Physician retention and turnover
- Financial health of the practice
- Leadership structure
- Future growth plans
A supportive, stable workplace often provides greater long-term satisfaction than a position offering slightly higher compensation.
9. Have the Contract Professionally Reviewed
Even seasoned physicians benefit from having an employment attorney review their contracts before signing. An experienced healthcare attorney can identify unfavorable language, explain legal implications, and recommend changes that protect your interests.
The cost of a professional review is often minimal compared to the financial and career consequences of signing an unfavorable agreement.
Make an Informed Decision
Choosing a physician position involves much more than comparing salaries. Compensation structure, workload expectations, legal protections, benefits, and workplace culture all contribute to your long-term success and job satisfaction.
Don't hesitate to ask questions or negotiate terms that matter to you. Taking the time to fully understand your contract isn't being difficult—it's protecting the career you've worked so hard to build.
An experienced healthcare recruitment partner can also help you evaluate offers, compare them to current market trends, and identify opportunities that align with your professional goals.
Before you sign your next physician contract, review every detail carefully. A little extra diligence today can save you significant stress and uncertainty in the future.