You’ve made it through the interview process, and you’ve been offered the job – congratulations! Physician contracts typically contain many details to protect the practice or hospital you’re joining. It’s incredibly important that you spend the necessary time reviewing your contract to ensure your offer is fair and what you’re expecting.

  1. Salary: In addition to your base salary, if applicable, your contract should state how long it will be guaranteed without adjustments.
    • You may be offered an incentive payment for productivity – it’s important to understand how your performance will be measured and what you’ll need to do to achieve productivity targets.
    • Is there additional pay for call? Or a set number of days expected as part of your base salary?
    • Bonuses/stipends: make sure to understand the stipulations of the bonuses (i.e. if you leave after 9 months, are you required to pay back the bonus?)
      • Relocation bonus
      • Sign on bonus
      • Fellowship stipend
  2. Call and Coverage: Your contract should spell out your call and coverage duties. Most contracts will have loose language around call requirements, so it is very important to discuss during your interview process to ensure you understand what to expect.
  3. Benefits: Along with health insurance, benefits may include life insurance, a 401(k) plan, short- and long-term disability, and parental leave. Many employers will also provide a stipend for continuing medical education, licensing, and membership in medical associations. However, your contract should parse out how those allowances work.
  4. Malpractice Insurance: Most employers pick up the cost of malpractice insurance. Most private practices will not offer Tail Coverage so be prepared to purchase your own tail. Educational institutions, hospitals and multispecialty groups usually do.
  5. Noncompete Clauses/Restrictive Covenants: Noncompete clauses typically forbid you from doing two things for one to two years after the end of your contract: 1.) working for nearby competitors or 2.) luring staff and patients to a different practice. If the employer’s non-compete prohibits you from practicing within a certain mileage radius of them, be sure to understand if this is enforceable from your main clinic location, satellite clinics, etc. Also be aware that non-competes may seek to prohibit you from practicing any form of medicine in the designated area, not just nephrology, so be aware and ask if this is important to you. There are sometimes clauses that will allow you to buy-out of your non-compete.
  6. Termination: Most physician contracts stipulate that you or your employer can terminate employment without cause. However, your contract should state how compensation would work in this case. For example, if your hospital terminates you without cause during a merger, your should receive compensation – typically several months’ salary – when you are let go, since your performance was not at fault.

For termination with cause, your contract should state that your employer is required to provide written notice of why you are being let go and give you time – usually one to four weeks – to address any performance issues. Understanding what your obligations regarding bonuses are if you are terminated is also a good idea.

You also want to be certain that you can terminate the employment agreement without penalthy if you give sufficient notice.

There are several things not typically spelled out in physician contracts so you will want to make sure you discuss these items in detail prior to signing your contract. There topics can include:

  • PTO
  • Partnership track
  • Call – specifics
  • CME – stipend and time off
  • Details of benefits
  • Investments/alternate revenue streams

This is just an overview of what we typically do and do not see in a physician contract, and is not, and should not be construed as, legal advice regarding any particular term in a physician contract. Each contract will be different and it’s important that you do your own due diligence by hiring a professional to review your individual employment offer. Nephrology Connect cannot provide legal guidance on employment offers.