Physician Employment Contract Checklist: 30 Terms to Check Before You Sign

A physician employment contract is a long document written by the employer's counsel, and most of what matters is not in the compensation section. The terms that cost physicians the most are the ones that are easy to skim past: the wRVU threshold, the definition of “cause,” the non-compete radius, who pays tail, and the sign-on clawback. This checklist is the list our recruiters walk through with physicians on every offer, grouped the way contracts are written. It is not legal advice. Have a healthcare employment attorney review the contract; use this to know what to ask them about.

1. Compensation

• Base salary and how it is paid. The number, the pay schedule, and whether it is guaranteed for the whole term or only a guarantee period.
• Compensation model. Straight salary, production (wRVU or collections), or a hybrid. Each has a different risk profile and each needs different terms below.
• Guarantee period. On a production model, how long base is guaranteed while your panel or census builds. One year is common; two is better. Ask what happens to any shortfall at the end of the guarantee: forgiven, or carried forward as a debt.
• wRVU rate and threshold. The dollars per wRVU and the number of wRVUs you must produce before the rate applies. Run the math: base divided by rate equals the threshold, and if the threshold is above what the outgoing physician produced, you will not see production pay.
• How wRVUs are counted. Which CPT codes, which year's conversion table, whether APP supervision credits you, and how claims denied or written off are treated.
• Bonus metrics. Quality, patient experience, citizenship, and productivity bonuses: the metrics, the targets, the payout schedule, and what share of physicians earned the full bonus last year.
• Annual review. Whether base is reviewed yearly, against what benchmark, and whether it can go down.

2. Sign-on, relocation, and loan repayment

• Amount and timing. When each is paid: at signing, at start, or in installments.
• Clawback terms. Commitment length, monthly proration, and whether repayment is the gross or net amount. See physician sign-on bonuses in 2026 for how to read the clause.
• Carve-outs. Repayment should be waived on termination without cause, death, disability, and employer breach.
• Loan repayment structure. Paid to you or to the servicer, taxable or not, and whether it continues if the site loses National Health Service Corps or state program eligibility.

3. Term and termination

• Initial term and renewal. Whether the contract auto-renews and on what notice.
• Termination without cause. Both sides should have it, with the same notice period. Ninety days is typical; 180 is common in specialties where recruitment is slow. Watch for a version where only the employer can terminate without cause.
• Definition of cause. Read the list. Loss of license and exclusion from federal programs belong there. “Conduct detrimental to the employer” with no cure period does not.
• Cure period. Thirty days to fix a curable breach before termination for cause.
• What survives termination. Non-compete, non-solicit, repayment obligations, and tail. This paragraph decides what leaving costs.

4. Restrictive covenants

State law varies here more than anywhere else in the contract, and several states restrict or prohibit physician non-competes outright. Whatever the state, negotiate the scope as if it will be enforced.

• Non-compete radius. Measured from where: your primary site, every site you work at, or every facility the employer owns? The last can cover a region.
• Duration. One year is common. Two is aggressive. Anything longer needs a reason.
• Trigger. Ask for the non-compete to fall away if you are terminated without cause or the employer breaches. Many employers agree.
• Buyout. Some contracts let you pay a fixed amount to release the covenant. A known number beats litigation.
• Non-solicit. Staff and patients. A patient non-solicit should not prevent patients from following you on their own initiative.
• Telehealth and locum carve-outs. Whether the covenant reaches telemedicine into the restricted area, or locum work at a competitor.

5. Malpractice

• Policy type. Occurrence covers any event during the policy regardless of when the claim is filed. Claims-made covers only claims filed while the policy is active, which is why tail exists.
• Limits. Per claim and aggregate, and whether they meet hospital and state requirements.
• Tail coverage. On claims-made, who pays it and when. Best: employer pays on any departure. Common compromise: employer pays on termination without cause or after a set tenure; you pay if you leave early. Get the cost estimate in writing; in obstetrics and surgery it can be a large fraction of a year's premium.
• Prior acts. If you are coming from a claims-made policy, who pays the nose or tail for your prior employer.
• Consent to settle. Whether you have a say before a claim is settled in your name.

6. Duties, schedule, and call

• Clinical FTE definition. Hours, sessions, shifts, or patients per day, in writing. “Full time as determined by the employer” is not a definition.
• Call. Frequency, whether it is in-house or phone, how it is distributed, and how it is paid. Ask what the call schedule looks like today, not what it will look like when the next physician is hired.
• Sites. Where you can be assigned and how much notice you get if a site changes. A contract that lets the employer reassign you anywhere in the system is a different job.
• Supervision of APPs. How many, whether it is paid, and whether their wRVUs credit you.
• Administrative and teaching time. Protected or not, and whether it counts toward FTE.
• Outside activities. Moonlighting, locum work, expert witness work, speaking, and whether the income is yours.

7. Benefits and expenses

• Paid time off. Weeks, whether CME days are separate, and whether unused time is paid out. On a shift model, how PTO reduces the shift count.
• CME allowance and days. The dollar amount, what it covers, and whether it rolls over.
• Licensing, DEA, board, and society fees. Paid by the employer or not.
• Retirement match and vesting schedule. A long vesting schedule is a retention device; know it before you count the match.
• Health, disability, and life insurance. Especially own-occupation disability, which is expensive to buy privately.
• Relocation. Amount, whether it is paid to the mover directly, and its repayment terms.

8. The clauses people skip

• Assignment. Whether the employer can assign the contract to a buyer. If the practice is acquired, your contract goes with it, non-compete included.
• Amendment. Whether compensation plans and policies incorporated by reference can be changed unilaterally. Many contracts say the comp plan “may be amended from time to time.” Ask for notice and a right to terminate without cause if a change reduces pay.
• Indemnification. Whether you indemnify the employer for anything beyond your own negligence.
• Dispute resolution. Arbitration versus court, and which state's law governs.
• Entire agreement. This clause voids every verbal promise. Everything you were told on the site visit has to be in the document or in a signed addendum.

How to run the review

• Ask for the full contract, the compensation plan, and any policies incorporated by reference. You cannot review what you have not seen.
• Build a three-year cash comparison: base, bonus at a realistic level, sign-on, relocation, and loan repayment, year by year. Compare offers on year three.
• List every verbal promise from the interview and site visit and check that each appears in the document.
• Send the contract to a healthcare employment attorney and give them this list.
• Return your requested changes in one round, in writing, ranked by importance. Employers respond better to one organized request than to a series.

For timing, see the first physician job timeline. For what physicians were actually offered this year, see the Offer Report. Current openings are on the physician jobs page.