How to Negotiate a Physician Employment Contract


As a physician, negotiating with a medical practice you want to join can seem daunting. Perhaps you’ve just gotten out of residency where you’re used to being the mentee but now, you’re navigating private practice and hospital system job opportunities like any other experienced practicing physician. You want to negotiate a contract that includes your ideal salary and benefits, but approach it in a way that leaves everyone feeling positive about the new partnership. Don’t be timid or discouraged—executives at any practice or healthcare system expect doctors to negotiate!

Contract Negotiation Tips

Here are some pointers from our experienced team that will assist you in navigating the job contract negotiation phase:

  1. Only begin physician contract negotiations once you completely understand the offer. Review the salary, incentive-based compensation (if applicable), non-compete clause, complete benefits package, call schedules, reimbursement for calls, code of conduct, conflict of interest policies, how bonuses work, etc. Many organizations bury key parts of an offer in human resources policy manuals and other arcane places. If something seems to be missing, just call your job offer contact and ask— tell them you are giving their offer serious consideration and want to understand the details of the job contract.

    This step is especially important for female physicians: do your salary research. Studies have shown that over the course of their careers, female physicians can make up to $2M less than their male doctor colleagues. Know your worth. MGMA offers some data and physician recruiters can be especially helpful in providing comps.

  2. Consider engaging a contract lawyer who is well versed in physician employment contracts before you sign or agree to anything moving forward. Healthcare provider contracts can vary and can be more complicated than other employment contracts so consult an attorney who is specifically knowledgeable about physician contracts. If they review physician contracts frequently enough, they may even have insider information on how your contract stacks up against competing medical practices or even the hospital/practice where you’re finalizing an offer.
  3. Make a list of the items you want to add, delete or modify in your physician contract. Keep it reasonable: The larger the group, the more difficult it is to accommodate specific requests that have not been granted to the practicing doctors who have already joined the organization.

    Is there some flexibility in terms of the base salary? It would be much easier for me to move forward if the base salary in the contract was increased to $XXX,XXX.

    Is the non-compete clause negotiable? The 50-mile radius seems to be larger than most other clauses I’ve seen in other physician contracts.

    Will your healthcare system sponsor reasonable expenses for a house-hunting trip for me and my spouse? I will need to make at least one more trip to the area for the purpose of finding and purchasing a home.

  4. Know what is a dealbreaker for you, and what is not. List your priorities from “most important” to “least important.”
  5. Be friendly and positive when beginning negotiation conversations.
  6. Deal directly with the principal decision maker. The more people involved in communication, the greater the chance of a serious misunderstanding.
  7. Express gratitude for concessions made and a willingness to be flexible about contract requests that cannot be met then ask for a counterproposal.
  8. If further conversation is required, close the current conversation by reaffirming your intent to join the practice when these final details are resolved. Confirm a date for the next discussion.

Finally, during the physician contract negotiation process there can be a few last hurdles you’ll need to keep in mind:

  • Do not sign a letter of intent (LOI) prior to negotiation. The LOI can set the expectations for the full contract and if there are terms you do not agree with in the LOI, they can be hard to change when the contract comes around.
  • Do not rely on someone’s word—if something that was verbally promised during negotiations or otherwise is not listed in your contract, do not expect it.
  • Do not feel like you have to rush through the negotiation process. Though you may worry you could lose your offer, exercising patience is worth a solid contract and a happy, fulfilling career.

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