Physician Contract Negotiation: Mistakes That Cost You Thousands

Key Takeaways

✅ If you don’t negotiate, you’re leaving money on the table.
✅ Your employer has already budgeted for negotiation - they expect it.
✅ Bad contract terms can trap you in low pay, bad call schedules, and restrictive non-competes.
✅ Confidence beats credentials - know your worth and ask for it.
✅ The worst mistake? Signing a contract without understanding it.

Are You Making These Costly Contract Mistakes?

What’s the biggest financial decision you’ll make as a new attending?

• Buying a house? No.
• Picking a new car? Nope.
• Signing your first contract? Absolutely.

That one piece of paper will determine:

• How much you earn (or how much you lose).
• How much you work (or how much you suffer).
• How much control you have over your career (or if you're stuck with a terrible non-compete clause).

🚨 Most physicians don’t negotiate their first contract. That’s a mistake.

Why? Because hospitals and private practices expect you to negotiate. And if you don’t? They won’t offer more. They will just assume you’re okay with less.

Below the biggest contract mistakes that will cost you money, time, and opportunities - and how to avoid them.

1️⃣ Not Understanding the Employer’s Negotiation Style

What kind of negotiator are you up against?

Your employer negotiates contracts all the time - you don’t. That means they have:

• A legal team who reviews contracts every single day.
• A budget that includes room for negotiation.
• A game plan for what they will and won’t give you.

So, how do hospitals and private practices negotiate? Like a business.

📌 Here’s what they won’t tell you:

• They expect you to push back on salary, benefits, and call schedules.
• They start with a lower offer, assuming you will ask for more.
• If you accept the first offer, you lose.

💡 Your move: Go in prepared. Know the numbers, understand their strategy, and treat this like a business deal - not a favor.

2️⃣ Assuming the Contract Terms Are "Standard" (They’re Not)

📌 Have you heard this before?

• “This is just our standard contract.”
• “All our physicians sign the same thing.”
• “There’s nothing to negotiate.”

🚨 This is a lie.

There is no such thing as a standard physician contract - because every doctor brings different value.

📌 Things that are ALWAYS negotiable:

• Salary (base pay, RVU bonuses, production incentives).
• Signing bonuses & relocation stipends.
• Call schedule & work hours.
• Non-compete clauses & termination terms.

💡 Your move: Never assume something can’t be negotiated. If they say "this is standard," ask, “Has this ever been changed for another physician?” (It has.)

3️⃣ Speaking the Wrong “Negotiation Language”

Your contract negotiation is a business discussion - not a plea.

📌 Here’s how physicians sabotage themselves:

• ❌ “I was hoping for a little more in salary…”
• ❌ “Would it be possible to have fewer call shifts?”
• ❌ “I just want to make sure this is fair.”

📌 Here’s how you should speak instead:

• ✅ "The MGMA median for my specialty in this region is $275K. I’d like my base salary to reflect that."
• ✅ "Given the call burden in this contract, I’d like to discuss a schedule adjustment."
• ✅ "I’d like to align my compensation with the market rate for this role."

💡 Your move: Use confident, clear, professional language. You are not "asking for favors" - you are structuring a fair deal.

4️⃣ Underestimating the Power of a Non-Compete Clause

What happens if you leave this job in 2 years?

📌 A bad non-compete clause can:

• Ban you from working within 50-100 miles of your current employer.
• Block you from seeing your own patients.
• Force you to move, even if you don’t want to.

🚨 Many doctors don’t even READ their non-compete clause before signing.

💡 Your move:

• Ask for a reduction in the radius. (10-15 miles instead of 50.)
• Limit the duration. (1 year instead of 2-3 years.)
• Carve out exceptions. (Teaching, telemedicine, or moonlighting.)

📌 If they refuse to adjust the non-compete? That’s a red flag.

5️⃣ Failing to Negotiate Call Schedule and Workload

Think salary is all that matters? Think again.

📌 What’s worse than a low salary?

• Being stuck on weekend call every other week.
• Seeing twice as many patients as your peers.
• Realizing you have no say in your work schedule.

🚨 Hospitals love hiring new attendings because they expect them to "pay their dues" by taking extra call.

💡 Your move: Negotiate your workload upfront.

• Clarify how call is distributed. Ask: “How is call assigned? Are senior physicians exempt?”
• Set limits. If the contract says “as needed,” push for specifics.
• Get extra pay for extra work. If you take more call, negotiate a stipend.

6️⃣ Not Knowing When to Walk Away

How do you know if a contract is a bad deal?

📌 Red flags that should make you reconsider:

• 🚩 Low salary with no room for bonuses or increases.
• 🚩 A non-compete that would force you to move.
• 🚩 An excessive call burden with no extra pay.
• 🚩 A vague or one-sided termination clause.

🚨 If the contract is bad, the job is bad. It will not magically get better once you start working.

💡 Your move: Always have a backup plan. If you only have one offer, you have no leverage. The best way to negotiate is to be willing to walk.

Your First Offer Is NEVER the Best Offer

🚨 Hospitals and private practices are not charities. They will pay you the least they can - unless you negotiate.

📌 Key takeaways:
✅ Know your worth. Use MGMA data, not guesswork.
✅ Everything is negotiable. Salary, bonuses, schedule, non-compete.
✅ Use confident language. This is a business deal, not a favor.
✅ Read the fine print. Non-compete clauses can trap you.
✅ Be ready to walk. The best leverage is another offer.

💡 Bottom line: If you don’t negotiate, you will make less money and work more hours than you should.

So - are you going to ask for what you’re worth, or are you going to let them decide?