Career Articles & Tips for Physicians

How to Negotiate Your New Medical Contract

Congratulations, you have a job offer! Now here comes the tricky part—reviewing the employment contract. If this is your first position as a physician, or if it's been a while since you've been handed a contract, you may have some questions. If so, here are a few answers to frequently asked questions:

Question: I've never negotiated a contract before. How do I even ask about negotiating the terms?
Answer: "All parties involved understand there will usually be some sort of negotiation with a contract, whether it's in salary or in the language," says Dave Dertien, a physician recruiter at Avera Marshall Regional Medical Center, Marshall, MN, who has helped many physicians start new jobs. "Typically, negotiation is done soon after the physician and other parties review the contract. If there are terms you would like to change, this is the time to bring it up."

Question: Can I negotiate on my own or do I need a lawyer?
Answer: "Negotiation can be done by the physician with no attorney needed," Mr. Dertien says. But a verbal request in plain language won't fly. "Whether you're working through a recruiter or directly with hospital administrators, be aware that if you request a change, they will expect you to have it written out and in the exact language you want included the contract," he advises.

Question: What "red flags" should I look for in a contract?
Answer: "Take a close look at anything that is not straightforward," Mr. Dertien says. "Is there contract language that requires you to stand on one foot, close the other eye, and sing a tune to get a bonus? That would be an example," he says, only half-jokingly. In other words, make sure you fully understand all the terms of the contract, and that none of them seem extraordinarily unreasonable."

Question: How can I ensure that I will continue to be paid fairly (or be allowed to end my contract) if the hospital system changes hands?
Answer: "This is a highly topical question in light of the many consolidations and mergers of hospital systems across the country. But the answer is fairly simple: "Make sure such language is included and carefully detailed in your contract," Mr. Dertien says. "If it's not, make a request to have it added."

Question: How do I negotiate for less call time?
Answer: "Call can be a tricky thing to negotiate," Mr. Dertien warns. "Some contracts won't spell out the specifics about call." In such cases, ask direct questions about call duties and coverage, and how weekends and vacation are handled. Ask if call will be shared equally among all physicians. "If you want to request an arrangement that's different than the norm, the hospital administration may not include this in your contract but agree to it only in separate documentation," he explains."

Question: Can I negotiate the terms of the non-compete/restrictive covenant agreement?
Answer: That may depend on the location, Mr. Dertien says. "For specific regions, some hospitals are strict on their non-compete," he explains. "Others may carve out some specifics if requested, but without changing the parameters of the non-compete.

Because physicians want to be perceived as dutiful workers, many of them don't like to ask for special treatment or exceptions—and this perception can extend into the contract agreement. But before you sign on the dotted line, make sure you fully understand the terms of your contract so you know the extent of your responsibilities, as well as the facility's responsibilities to you. If you want something changed, it never hurts to ask.

How to Negotiate Your New Medical Contract