Negotiating Your First Contract As A Physician

Last Updated on November 27, 2022 by Laura Turner

One of the most common mistakes young physicians make when taking a job is accepting whatever is offered. When you are reviewing a job offer and contract, keep in mind that all terms—not just compensation—can be negotiated.

The contract should contain everything discussed in the interview and more. Do not assume verbal statements alone will be remembered or honored. If a certain issue is important to you, make sure to get it in writing. It is also important you take enough time to carefully review the contract, paying attention to all issues that affect you. Do not feel pressure to sign anything you do not fully understand. Courts typically uphold the provisions of the contract, so be careful what you sign.

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Consider Utilizing An Attorney
You can be sure the practice has an attorney who prepares the contract and protects their interests. It will be worth the money for you to enlist an attorney to review the contract and ensure your interests are protected. This step can save you thousands of dollars up front, as well as protect your interests and income for many years. Select an attorney who has at least three years of experience working with physician contracts and is familiar with the laws where you plan to practice.

Identify Expectations
When reviewing a contract, it is important to know the expectations of yourself and the facility. Make sure the contract outlines expected hours of work as well as your schedule and overtime plans. You should know how many patients you are expected to see each day and what types of patients.
Will you have any non-medical responsibilities? If so, make sure they are identified, especially if they will affect your ability to see patients. You should also know the types of procedures you will be expected to perform.

Some facilities will allow you to work additional jobs, some will not. If you are interested in locum tenens or other outside employment make sure the contract allows for it.

The contract should identify how you are paid. Will you receive a flat salary, be paid an hourly rate, or is your salary based on fees billed, or fees collected, or the profit of the practice? Add into this the potential for bonuses or revenue sharing and compensation can get very confusing very quickly. Make sure you know what is being offered and that it meets your expectations and needs. It is also a good idea to ensure the contract indicated when you can expect raises.

Contract negotiations are also the time to include money for moving costs, transition expenses and signing bonuses. This is all potential money lost if you don’t get it included in the contract.

The contract should outline the full benefits package. Make sure it gives amounts and details on who is covered. Vacation time, sick leave, maternity/paternity leave, military duty should all be covered as well.

Malpractice insurance is a big issue; make sure the contract outlines what the company will provide and details of that coverage. Covering the cost of CME as well as professional dues and fees are also great benefits you can negotiate.

Contract Terms and Termination
Finally, make sure the length of the contract is identified and there are clear provisions for terminating the contract with cause and without cause. Covered causes should be identified. Non-compete clauses should be agreed upon and the way disputes are handled should identified. This could be mandatory arbitration or taking things to court.
Once you accept a position and sign the contract, make sure to review the contract at least once a year with the practice.