Five Contract Topics Every Physician Needs to Review

How do you negotiate a physician contract?

You finally made it. College, med school, residency, and fellowship, and now you have an offer for your first “real” doctor job. Besides the new title and sweet hours, your fancy new gig comes with another major perk: bargaining power!

That's right—Unlike in residency and fellowship, a lot of attendings actually get to negotiate their contracts. Whether you’re joining a private practice or sticking to a hospital setting, it’s important to review your contract to make sure you understand exactly what the deal is so you can make an informed decision about whether to accept the offer, negotiate, or move on.

That’s why we’re covering five major areas to review in your next physician contract.

How do you review a physician contract?

My biggest recommendation for this is to hire a contract lawyer. Especially for your first negotiable contract, an attorney can help you wade through the legal jargon and acronyms, identify contract “traps,” and make some really helpful suggestions about which provisions you might want to push back on.

Whether or not you hire a lawyer, though, you're going to want to read the entire contract and make sure you understand all the terms (that part can be tricky, though, because you might not know that you don't know what something in the contract means...which is why you should really just hire a lawyer). This often means calling HR to ask for clarifications and getting it in writing. It also means thinking critically about the deal you're being offered, like figuring out whether the compensation is competitive for your speciality and location.

Five contract topics to review.

Without a doubt, you should read your entire contract before signing on the dotted line. Seriously, please don’t treat it like the agreement for your phone’s latest software update. But here are five topics to really focus on:

  • Contract length. The contract term includes stuff like how long your contract is supposed to last, whether you can renew it, and what exactly you need to do to be eligible for renewal. Understanding your contract term is key to understanding what you’re getting into. For example, if the term is super long, like say five years, and you’re not going to be able to adjust your salary to reflect a cost of living increase or get any performed-based incentives during that time, that’s a red flag in my book.
  • Employer’s defined terms. If you notice any bolded or italicized terms in the contract, check the end of the contract for written definitions. Your future employer could mean something totally different than what you thought. Some typical defined terms include without cause, evergreen provision, controlling law, professional misconduct, and sole discretion. You want to be sure that you’re okay with these provisions in the way they’re defined.
  • Obligations. This is just a fancy term for the conditions of employment. It’s everything you’re going to have to do at your new job. Obviously, you want to know if you’re going to be expected to do a bunch of administrative stuff in addition to patient care (or vice versa). If you’re not happy with the responsibilities as originally outlined, you can potentially negotiate a change or look at other job opportunities that better reflect your must haves.
  • Compensation. So yeah, you want to know how you’re going to be compensated. That includes the obvious things like your base salary, any bonuses, and benefits for you and your family. But it also includes stuff like whether any portion of your salary is productivity based, like the number of encounters you bill. So you want to be sure you’re okay not just with the dollar amount but also the way that dollar amount is structured.
  • Contract traps. Employers sneak in these less-than-favorable terms all the time. A major one to look out for is the non-compete clause. A non-compete can stop you from working for another employer if you were to leave the job. That’s right. You could literally be barred from working as a doctor for a certain period of time or within a certain geographic location. And you could owe big bucks if you did end up working for a competitor in breach of a non-compete.

And again, I always recommend spending a few hundred bucks to get a good contract lawyer to help you review your contract and give you some assistance with the negotiations. They’re familiar with the different types of physician contracts out there as well as common variations in defined terms and can give you some really good advice.

One last thing. Sometimes it can take awhile to find the right employer or opportunity. In the meantime, consulting with flipMD can land you a great physician side gig and take the pressure off financially while you search for the perfect fit. 

Gregory Hanson, MD, MPH

Gregory Hanson, MD, MPH

Greg is a PGY-4 interventional radiology resident at Thomas Jefferson University Hospitals in Philadelphia. He graduated from UCLA with his BS in Atmospheric and Oceanic Sciences before moving across the country to New York City. While in New York, Greg obtained his Master of Public Health degree in epidemiology with an advanced certificate in applied biostatistics. He then went on to do his medical school training at Dartmouth Medical School in Hanover, New Hampshire. In June 2018, he started his post-graduate training with a surgical intern year at Jefferson before continuing there for his integrated interventional radiology residency. During his first year of diagnostic radiology, he began offering his services to various clients by any means possible and was able to make additional side income to help support his family through residency training. This is what sparked the idea for flipMD.

Leave a Comment

Related Articles