Employment Contracts

You’ve done the interviews, you like the team, the location feels right, and the offer letter is sitting in your inbox. Now comes the part most physicians are least prepared for: figuring out whether this offer is actually a good one, and what to do next.

Evaluating a physician employment offer requires looking beyond the headline number. Here’s how to approach it and why getting a professional attorney review is worthwhile.

Start with the full picture, not just the salary

Base salary is the easiest number to compare and often the one that gets the most attention. But it’s rarely the most important factor in evaluating total compensation.

Before you can assess whether an offer is competitive, you need to understand everything in the package:

• Base salary and pay structure: Is compensation fixed, or does it include a production component? If there’s a productivity bonus, what metrics trigger it and over what time period?
• Benefits: Health, dental, and vision insurance should be standard with a full-time offer; you should also look for a retirement plan with an employer match, ample paid time off, a CME allowance, and licensure and dues reimbursement. These have real dollar value and an impact on work/life balance that varies significantly across offers.
• Malpractice insurance: Mistakes happen, and this is often worth five figures, if not six. Is it occurrence-based or claims-made? If claims-made, who covers tail when you leave?
• Signing and relocation bonuses: Are these offered? If so, what are the repayment terms if you leave before a specified period?
• Student loan assistance: Some employers offer loan repayment support, particularly in underserved areas or through federal programs. It’s worth asking about it if it’s not in the offer.

Get confirmation on all the above. Write it all down with the estimated value of each. A lower base salary with strong benefits, a generous retirement match, no repayment required and included tail coverage can outperform a higher base salary with a thin benefits package.

Know what the market looks like for your specialty

You can’t negotiate effectively or even evaluate whether your offer is fair without trustworthy, accurate data. Compensation varies significantly by specialty, practice setting, geographic region, and years of experience. What’s fair for a hospitalist in a rural Washington community may look very different from what’s standard for a subspecialist in a large academic health system.

Benchmarking resources exist specifically to help physicians answer this question. Resolve’s rData, accessible through the WSMA Career Center, draws from thousands of actual physician contract submissions and provides specialty-specific compensation data. The WSMA’s partnership with Resolve gives members access to this data and the Resolve Contract Hub, which shows how a specific offer compares to market norms for your specialty.

The major national surveys (MGMA, AMGA) also provide useful benchmarks, though they can vary in methodology and lag real-time market conditions.

The point is: go into the conversation with data, not just your instincts and high-level understanding.

Evaluate the position, not just the compensation

An offer that looks strong on paper can still be the wrong fit. Before you accept, think carefully about the non-financial terms that will define your day-to-day experience:

• Clinical expectations: What’s the anticipated patient volume? What does a typical schedule look like? Are productivity expectations clearly defined, or are they vague enough to shift after you’ve signed?
• Call schedule: How is call divided? Is there a separate call stipend, or is it built into the base? Will this change as the group grows or contracts?
• Autonomy and governance: Do you have input into clinical decisions and practice operations? If you’re joining a large health system, how much administrative influence will physicians have?
• Partnership or ownership track: If this is a private practice, is there a path to partnership? What are the terms, timeline, and buy-in cost?
• Culture and stability: What’s the turnover rate among physicians in this group? High turnover is one of the most reliable signals that something is wrong. Don’t be afraid to ask directly or to reach out to physicians who have recently left.

Understand what you’re committing to on the back end

Every offer has an exit. Understanding what leaving looks like before you’ve accepted is part of evaluating the offer.

Termination provisions

Can either party terminate without cause and with how much notice? What happens to your compensation and benefits during the notice period?

Non-compete and non-solicitation clauses

These will follow you. Know the geographic radius, the duration, and whether there are any carve-outs or buy-out provisions. In Washington state, non-competes are enforceable under certain conditions, so the specific language matters. (See the WSMA’s FAQ on non-compete clauses for state-specific guidance.)

Tail coverage

If you’re covered under a claims-made malpractice policy and you leave, tail coverage can cost tens of thousands of dollars. Confirm in writing who is responsible for paying the premium and under what circumstances.

These provisions aren’t reasons to decline an offer, but they are reasons to read carefully and negotiate where you can.

Counter thoughtfully, not reactively

If the offer isn’t quite right, you can say so professionally. Most employers expect candidates to negotiate, even if they claim “all our contracts are standard.” Approaching the conversation with specific, data-backed requests is far more effective than a general ask for more.

• Be specific. Saying something like, “Based on MGMA benchmarks for my specialty in this region, I was expecting compensation closer to X,” is a stronger position than, “I was hoping for more.”
• Prioritize. Decide before you counter which terms matter most to you. You’re unlikely to move every provision, so know where you’d trade flexibility.
• Get everything in writing. Verbal commitments during negotiations have no legal weight. If a hiring manager agrees to something such as a loan repayment stipend or a change in the call structure, it all needs to be in the contract before you sign.
• Don’t mislead. If you have a competing offer with a real deadline, it’s appropriate to communicate that professionally. If you don’t, pretending otherwise tends to backfire.

Get a second set of eyes before you sign

Even if you’ve done your homework, physician employment contracts are complex legal documents. Medical school did not train you to understand all the fine print. A physician contract attorney (one who works specifically in this area) can identify provisions you may have missed, flag language that’s unusual or one-sided, and negotiate on your behalf.

The WSMA has partnered with Resolve to connect members with specialized physician-contract attorneys and compensation-benchmarking data. WSMA members can access an exclusive discount by contacting the WSMA at wsma@wsma.org.

An offer is the beginning of a negotiation, not the end of one. Take the time to evaluate it fully. You’ll be living with the terms for years.