Physician Contract Review: Essential Checklist Before You Sign
A bad physician contract can trap you for years with non-competes, impossible productivity targets, and uncovered malpractice tail costs. This checklist covers everything you need to review before signing.
Contract Review Checklist for Physicians
✓ Compensation: Base salary, RVU targets, bonus structure, sign-on bonus, relocation assistance. ✓ Non-Compete: Duration, geography, specialty scope, exceptions. ✓ Malpractice: Who covers during employment, who covers tail, tail coverage fund. ✓ Call Schedule: Nights, weekends, on-call frequency, call pay. ✓ Termination: Notice period, severance, patient transition plan. ✓ Credentialing: Timeline, who handles, any restrictions. ✓ Benefits: Health insurance, retirement, CME allowance, disability coverage.
Red Flag Terms in Physician Contracts
High-risk terms: Clawback of sign-on bonus if you leave within 2-3 years. Non-compete restricting practice for 3+ years. Unrealistic RVU targets. You pay all malpractice tail coverage. Termination without cause but 90 days notice (limiting your options). Credentialing delays (6-12 months before patients assigned).
Negotiation Points for Physicians
Negotiate: Non-compete duration (1 year max instead of 3). Malpractice tail coverage (employer covers). Sign-on bonus repayment (only if you leave for cause, not without cause). RVU targets (realistic based on market, not artificial inflation). Call schedule (define nights/weekends upfront). Termination (mutual 60 days notice, severance for without-cause termination).
Common Physician Contract Mistakes
Don't overlook: Malpractice tail coverage costs (can be $20K-100K when you leave). Non-compete restrictions (could force relocation after contract). Productivity-based pay incentives (pressure to overbook, burnout). Call schedule expectations (night shifts impact family). Credentialing timeline (how long before you see patients). Termination clauses (what happens if you leave, how much notice).
Frequently Asked Questions
What's most important in physician contract?
Non-compete scope (can it trap you?), malpractice tail coverage (massive expense), and realistic productivity targets. These three have biggest impact on your career.
Should I negotiate every term?
Yes. Healthcare employers expect negotiation. Critical terms: non-compete, malpractice tail, call schedule, termination. Less critical: call pay rate, CME allowance.
What if employer won't negotiate?
Red flag. Employers often won't negotiate, but major items (non-compete, malpractice tail) are worth pushing back. If they refuse everything, that's a sign about workplace culture.
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