How to Evaluate a Physician Contract Before You Sign

Signing a new physician contract is one of the most important decisions in your career. Compensation matters, but it’s only one piece of the puzzle.

Before you sign, it’s essential to understand exactly what you’re agreeing to, how you’ll be paid, and what expectations come with the role. A well-structured contract protects both you and your employer. A poorly structured one can lead to burnout, compensation surprises, or limited flexibility down the road.

Here’s what every physician should carefully evaluate before signing.

1. Compensation Structure (It’s More Than Base Salary)

Most physician contracts include multiple components of compensation:

• Base salary

• Productivity bonuses (RVU (Relative Value Units)-based or collections-based)

• Quality incentives

• Sign-on bonus

• Relocation assistance

• Student loan repayment

• Call pay

Make sure you understand:

• How productivity is measured (RVUs? collections?)

• When bonus thresholds begin

• Whether compensation is guaranteed or adjusted after year one

• How often compensation is reviewed

Ask for historical productivity data if possible. Knowing what current physicians in the practice are earning provides valuable context.

2. RVU and Productivity Expectations

If your contract includes RVU-based compensation, dig deeper. RVU, or Relative Value Units, award more “points” to physicians who see more patients or care for more complex cases, incentivizing physicians to deliver more value. If this is how payment is structured, make sure you ask:

• What is the expected annual RVU target?

• Is the target realistic based on patient volume?

• How long does it typically take new physicians to ramp up?

• Is there a guarantee period?

A high base salary paired with unrealistic productivity targets can create pressure that leads to burnout.

3. Call Schedule and Workload

Call responsibilities significantly impact work-life balance. Make sure you clarify:

• How often you’ll be on call

• Whether call is paid separately

• If call is shared equally

• Weekend and holiday expectations

• Average daily patient volume

  
  

Two contracts with similar salaries can feel drastically different depending on workload.

4. Non-Compete Clauses

Non-compete clauses can limit your ability to practice in a geographic area after leaving the position. Make sure to review:

• The geographic radius

• The duration (1–2 years is common)

• Whether it applies if you’re terminated without cause

In some states, non-competes are restricted or unenforceable. Consider having a healthcare attorney review this section carefully.

5. Termination Terms

Understand how either party can end the contract.

• Is there a “without cause” termination clause?

• What notice period is required?

• Are there repayment obligations tied to sign-on bonuses?

Flexibility matters. Life changes, and contracts should allow for reasonable exits.

6. Malpractice Coverage

Malpractice coverage is critical and often misunderstood. Make sure to check:

• Is coverage occurrence-based or claims-made?

• Who pays for tail coverage if you leave?

• What are the policy limits?

Tail coverage can cost tens of thousands of dollars. Make sure you know whether that responsibility falls on you.

7. Benefits and Long-Term Value

Compensation extends beyond salary. Look deeper into:

• Health insurance

• Retirement plan and employer match

• CME allowance

• PTO

• Credentialing support

• Partnership track (if applicable)

If partnership is offered, ask:

• What is the buy-in?

• How is valuation calculated?

• What is the typical timeline?

8. Cultural Fit and Stability

Not everything is written in the contract. Make sure you ask about:

• Physician turnover rates

• Practice financial stability

• Leadership structure

• Growth plans

A stable, supportive environment often outweighs slightly higher compensation elsewhere.

9. Always Seek Professional Review

Even experienced physicians benefit from having contracts reviewed by a healthcare attorney. A small upfront investment can prevent costly issues later.

Evaluating a physician contract requires more than comparing salary numbers. The structure, expectations, protections, and long-term opportunities all play a role in your career satisfaction and financial success. Don’t let the fear of being seen as “difficult” or “high maintenance” sway you away from ensuring you’re getting a good deal. You didn’t go through all the pain of medical school for nothing!

Working with an experienced healthcare recruitment partner can also provide insight into whether an offer aligns with market standards.

Before you sign, take the time to review every detail carefully. Your future self will thank you.

Need some help navigating a physician job search? We can help. Reach out to us here.