You worked hard to become a physician. Now a contract sits in front of you, full of dense terms, timelines, and numbers. One missed sentence can cost income, freedom, or even your license. You may feel pressure to sign fast. Employers often move quickly. You do not need to. You can slow down, read with purpose, and protect yourself. This guide shows you how to review physician contracts without missing critical details. You will learn what to look for in pay, call duties, noncompete language, malpractice coverage, and termination terms. You will see which clauses create risk and which give you room to breathe. You will also see when to ask questions and when to walk away. Dike Law Group has helped many physicians avoid painful surprises. You can use the same clear steps to turn a confusing contract into a fair agreement.
Step 1. Get clear on your goals before you read
Before you touch the contract, write three short lists.
- What you must have to accept
- What you would like but can trade
- What you cannot accept under any condition
Think about:
- Income needs and debt
- Family time and call limits
- Location ties and noncompete limits
These lists keep you steady when you face pressure or fear. They also help you spot which clauses matter most.
Step 2. Read the pay terms with a cold eye
Pay terms look simple at first glance. They often hide risk in the details. Read every word in the pay section three times.
Key points to check:
- Base salary amount and length of guarantee
- Bonus plan and how it is measured
- Productivity formula and timing of true ups
- Withholdings, clawbacks, and repayment duties
Many contracts tie bonuses to work relative value units. You can read more about RVUs from the Centers for Medicare & Medicaid Services at https://www.cms.gov/medicare/fee-service-payment/physicianfee-sched.
Sample pay structures for a new physician
| Pay feature | Model A
Guaranteed |
Model B
Productivity |
Key risk
|
|---|---|---|---|
| Base salary | High for 2 years | Low for 1 year | Drop in income after guarantee |
| Bonus | Small, quality based | Large, RVU based | Pressure to see more patients |
| Repayment risk | No clawback | Repay bonus if you leave early | Debt if job fit is poor |
Ask for clear numbers, clear formulas, and clear examples in writing. If the math feels cloudy, you carry the risk.
Step 3. Study schedule, call, and work setting
Job burnout often comes from schedule terms, not pay. Read the sections on duties and schedule with care.
Look for:
- Clinic hours and expected patient volume
- Call frequency, call type, and who backs you up
- Weekend and holiday work
- Telehealth or outreach clinic duties
Then match these terms with your family needs, sleep needs, and health. A generous salary cannot fix a crushing call load.
Step 4. Examine noncompete and location limits
Noncompete clauses can trap you. They can block you from working near your home if you leave. Read this section very slowly.
Check three facts:
- How long the limit lasts after you leave
- How many miles from each practice site it covers
- Which types of practice it restricts
Then ask yourself:
- Can you move if the job turns harsh
- Can your family move with you
- Can you afford time without work
If the answers feel grim, push for shorter time limits, smaller mileage, or fewer sites.
Step 5. Confirm malpractice coverage and tail
A single claim can ruin savings and peace of mind. You must know who pays for coverage while you work and after you leave.
Check:
- Policy type claims made or occurrence
- Who owns the policy
- Who pays for tail coverage
Claims made policies often need tail coverage after you leave to protect you for past work. Tail costs can be large. They can reach one to two times the yearly premium. If you must pay for tail, plan for that cost from day one.
You can learn more about malpractice basics from the U.S. National Library of Medicine at https://medlineplus.gov/ency/article/001935.htm.
Step 6. Read termination and “for cause” language
Termination clauses control how the job ends. They also shape your next job.
There are usually three parts.
- For cause termination reasons like loss of license or fraud
- Without cause termination notice time
- Automatic termination events such as failure to get payer numbers
Focus on the notice period for without cause termination. A short notice period can mean sudden loss of income. A very long notice period can trap you in a harmful setting.
Common ranges are 60 to 180 days. Shorter notice helps you leave a bad fit. Longer notice gives both sides time to plan. Choose what feels safe for you and your family.
Step 7. List hidden costs and benefits
Look past salary. Hidden costs can change your real pay.
Check for:
- CME money and days
- License, board, and DEA fee coverage
- Paid time off and holidays
- Retirement match
- Health, life, and disability insurance
- Relocation help and repayment terms
Then list what you must pay on your own. Subtract that from the salary. The result shows your real income.
Step 8. Use a simple three pass review method
You can review any contract with three passes.
- First pass. Read straight through without a pen. Notice your body. Mark where you feel alarm or confusion.
- Second pass. Read again with a pen. Underline every number, date, and duty. Write questions in the margin.
- Third pass. Compare the contract to your three lists from Step 1. Mark each term as must have, trade, or cannot accept.
After this, you will see which clauses need change and which are fine.
Step 9. Ask questions and seek skilled review
You have the right to ask for clear words. You have the right to ask for changes. Many employers expect this.
Prepare three types of questions.
- Clarifying questions about unclear words or math
- Risk questions about noncompete, tail, and clawbacks
- Quality of life questions about call, support staff, and resources
Then consider legal review by a lawyer who knows physician contracts. A short review now can prevent years of regret.
Step 10. Do not sign until your gut feels steady
Read the final version word for word. Confirm that every promised change appears in writing. Verbal promises mean nothing if the contract stays the same.
Ask yourself three final questions.
- Do you understand every key term
- Can you live with the worst case outcome in each clause
- Does your body feel tense or calm when you picture year two in this job
If any answer feels off, pause. You can walk away. You earned your license with long nights and hard choices. You also earned the right to a clear, fair contract that respects your work and your life.
