After years of education and training, physicians deserve to understand exactly what they are agreeing to before signing an employment contract. Knowing how to review a physician contract before signing can help physicians avoid costly mistakes and make informed career decisions. Yet physician contracts are often lengthy, complex and filled with unfamiliar legal and financial language. The stakes are high: Compensation, work-life balance, malpractice obligations and future career opportunities can all be affected by a single agreement.

Megan Harvey, Chief Human Resources Officer at PracticeLink, explains:

“A physician contract isn’t just a compensation agreement. It’s a roadmap for the employment relationship. Taking the time to understand it, negotiate thoughtfully and seek expert guidance can have a significant impact on both career satisfaction and long-term success.”

According to Ken Allman, founder and CEO of PracticeLink:

“Employment contracts play an important role in determining whether a position is truly the right fit for a physician—factoring in everything from the length of contract restrictions to noncompete clause. The contract is an important variable and perhaps one of the cornerstones of physician employment.”

A thoughtful physician contract review can help avoid costly mistakes and negotiate terms that align with your long-term goals.

PracticeLink and its strategic partners serve as guides throughout this process, offering resources on physician contract review, physician contracts and every stage of the physician job search.

Start by reviewing physician compensation

Compensation is often the first section physicians examine, but it should never be the only one. 

Bruce Reed, Chief Financial Officer at PracticeLink, notes:

“One of the biggest financial mistakes professionals make when evaluating their employment agreements is failing to review the contract in its entirety and focusing too heavily on salary alone.”

Base salary

Review the guaranteed salary, compensation review schedule and any provisions that may affect future earnings.

Productivity bonuses

Understand how bonuses are calculated, when they are paid and whether targets are achievable. Resolveexplains:

“Compensation plans can be  a major source of confusion. Many physicians do not fully understand how they are paid or how compensation formulas are calculated. A mixture of base compensation, quality components, wRVU thresholds, APP supervision and call stipends can create gaps in competitive offers if not analyzed properly.”

RVU compensation formulas

Many physician compensation models use RVU-based incentives. Review benchmark expectations, conversion factors and productivity thresholds carefully.

Signing bonuses

Assess structure, repayment risk and how it fits into your overall goals.

Relocation assistance

Relocation packages can provide significant value. Jeff Ellman of UrbanBound recommends reviewing:

• Covered expenses
• Reimbursement methods
• Tax treatment

Student loan repayment benefits

Navigate advises physicians to evaluate student loan repayment programs carefully, including payout schedules and tax implications.

Discover the power of physician-first filters to find your next job 

Evaluate the schedule and work expectations

Compensation is important but workload often has a greater impact on long-term satisfaction.

Ken Allman explains:

“The contract speaks to every aspect of your employment. You want to know how you’ll be compensated—not just how much but also how you might be incentivized… You’ll want to know how many locations you’ll be expected to cover. You’ll want to know what hours you’ll be expected to cover, in addition to what days.”

Clinical hours 

Review expected clinic hours, patient volume requirements and practice locations.

Call responsibilities

Clarify call frequency, compensation and backup coverage arrangements.

Weekend coverage

Understand expectations for weekend, holiday and after-hours coverage.

Administrative duties

Administrative responsibilities such as charting, committee participation and supervision should be clearly defined.

Productivity expectations

Workload concerns are among the most common physician complaints, so it’s good to have workload expectations in writing.

Review noncompete and restrictive covenant clauses

Restrictive covenants can have a major impact on future career flexibility.

Geographic restrictions

Review the geographic scope carefully.

Duration requirements

Determine how long restrictions remain in place after employment ends.

Specialty limitations

Some contracts restrict practice opportunities within specific specialties or subspecialties.

Patient solicitation restrictions

Review limitations regarding former patients, referral relationships and practice outreach.

Understand malpractice insurance and tail coverage

Malpractice provisions deserve close review because they can create significant financial obligations.

Claims-made coverage

Understand when coverage applies and whether tail coverage will be necessary.

Occurrence coverage

Occurrence policies generally provide coverage for incidents that occur during the policy period, regardless of when claims are filed.

Tail insurance obligations

Physician malpractice tail coverage can be expensive and should never be overlooked.

Who pays for tail coverage

Resolve explains:

“With certain specialties, malpractice premiums—for tail coverage in particular—can reach six figures. Understanding those terms and who’s responsible for that tail payment is  something that gets overlooked a lot.”

Explore articles on physician malpractice insurance

Carefully review termination clauses

Without-cause termination

Review notice requirements and termination rights for both parties.

For-cause termination

Understand circumstances that may permit immediate termination.

Notice requirements

Verify notice periods and continuing obligations.

Post-employment obligations

Review any repayment requirements, restrictive covenants or continuing responsibilities.

Watch for common physician contract red flags

Vague compensation language

If compensation formulas are unclear, request clarification before signing.

Excessive noncompete restrictions

Overly broad restrictions may limit future opportunities.

Undefined productivity targets

Unclear performance expectations can create future disputes.

One-sided termination provisions

Ensure termination rights are balanced.

Missing malpractice details

Every malpractice obligation should be documented.

Feeling rushed

Feeling rushed increases stress and risks. Resolve warns:

“If an employer is rushing you to sign a contract, that can be a red flag.  Generally, you  should be able to take your time to properly evaluate your offers.”

Verbal promises

Physicians should not rely on verbal promises. Remember, “if it’s not in writing, it doesn’t matter.”

When should a physician hire a contract attorney?

Benefits of legal review

A physician contract attorney can identify risks, explain legal language and uncover negotiation opportunities.

What attorneys typically review

Attorneys commonly review compensation, restrictive covenants, malpractice provisions, benefits and termination clauses.

Cost considerations

Professional review often costs far less than the potential financial consequences of an unfavorable agreement.

Situations where professional review is especially valuable

Starting with a letter of intent, physicians can benefit from expert review in every aspect of the process, from overall review of the Letter of Intent (LOI) and contract to student loan repayment and relocation experts. Professional review is especially valuable when:

• The offer includes complex compensation structures.
• The contract contains restrictive covenants.
• The role involves significant financial decisions.
• The physician is relocating or changing practice setting.
• There are red flags.

Physician contract review checklist

Before signing, review:

• Compensation and bonuses
• Benefits package
• Noncompete provisions
• Malpractice coverage
• Termination language
• Schedule expectations
• Career advancement opportunities

A successful physician contract review involves much more than evaluating salary. Physicians should carefully review compensation, scheduling expectations, restrictive covenants, malpractice obligations and termination language.

Beyond signing a contract, the goal is to feel confident about a thorough roadmap that supports your career goals, financial objectives and physician quality of life.

Professional review can uncover negotiation opportunities, clarify obligations and help physicians avoid costly surprises. Before accepting your next opportunity, take time to thoroughly review every aspect of your physician employment agreement.

Browse physician jobs on PracticeLink and learn more about physician contract negotiation.