Physician contracts and compensation — reading the terms that matter, wRVU models, negotiation with benchmarks, and the clauses that cost real money.
30 articles in contracts & compensation
Three valuation approaches decide the number, but the compensation formula, the payment structure, and the symmetry of the buy-out decide whether you ever earn it back.
The tax home follows your work, not your family, and a physician who works locums full time can end up with no tax home at all and every housing dollar taxable.
The agency keeps a quarter to a half of the bill rate, and the direct path hands you back the spread along with credentialing, malpractice, and every cancelled week.
Why a distributed dollar escapes 3.8 cents rather than 15.3, what reasonable compensation means when the profit is your own clinical labor, and when the election is a fee.
The ordinary-and-necessary standard applied line by line, the 2026 figures that changed, and the three structures that draw examinations.
One account, one percentage, four dates, and the November check that turns a missed year into a non-event.
Both contribute 20 percent of adjusted net earnings — the deferral, the Roth option, and the pro-rata rule are what separate them for a physician.
Provider features that actually differ, the two deadlines SECURE 2.0 did not merge, the 20 percent employer math, and the year-one trap with a hospital 403(b).
An LLC is a liability structure, not a tax structure — and it does not shield you from your own clinical malpractice.
Full versus prorated schedules, the gross-versus-net trap, the two asks worth negotiating, and the trigger language that decides who pays when you are pushed out.
There is no federal ban — your state statute, and the year you signed, decide whether your non-compete is a real constraint or dead ink.
Notice windows, tail confirmation in writing, the COBRA bridge, retirement account decisions, and PSLF certification — in the order they protect you.
Flat-fee review runs roughly $500 to $2,500 — what that money actually catches, when it is clearly worth paying, and when a structured self-review will do.
Tail coverage is a negotiable contract term with four standard patterns — price the liability, identify your pattern, and make the ask before you sign.
The first Specialty Money Profile: what family medicine actually pays, the three-year training head start quantified, and the contract number that decides your income.
Why a $59 rate can pay less than a $46 rate, why the Medicare conversion factor is not your rate, and how to price the ask in dollars per year.
Employed and independent physicians get paid in structurally different ways. Here is the honest math on both models, including a worked five-year comparison with every assumption stated.
Physician non-competes are governed by state law, not the failed federal ban. Typical terms, the states with physician-specific limits, and the negotiation moves that actually change outcomes.
Lookback periods, threshold resets, payer-mix exposure, and termination clauses quietly reshape what a productivity bonus pays. Here are the seven terms to negotiate, each with a worked dollar example.
A $135/hour locum rate is not a $135/hour raise. Self-employment tax, self-funded benefits, unpaid time off, and PSLF non-qualification all come out of that number. Here is the honest math, both directions.
The academic salary discount is real — and so is six-figure PSLF forgiveness, double retirement deferral space, and protected time. Here is how to compare the two paths on total financial terms, not just base salary.
The worst realistic outcome of a professional ask is "no," yet most physicians never ask. What is genuinely negotiable in a physician contract, what is not, and plain-language scripts for each conversation.
Signing bonuses are withheld at 22% while attendings often face 32–35% marginal rates, and most clawback clauses demand the gross amount back. The math, the traps, and the pro-rata fix.
Some contract terms are negotiable annoyances. Others are structural traps that can cost $100,000 or more. Here are the red flags that justify walking away, with the dollar consequence of each spelled out.
Convert any call offer into an effective hourly rate, compare it against your base hourly rate, and spot the uncompensated call hiding inside "professional duties" clauses before you sign.
Medical director pay is constrained by fair-market-value rules, not just negotiation. Here is how stipends and hourly rates are structured, what documentation hospitals require, and how to evaluate whether an offer is fair.
Tail coverage typically costs 1.5 to 2 times your annual malpractice premium, and employer-drafted contracts often make you pay it. What claims-made coverage means and the exact language to negotiate.
Most employed physicians are paid on wRVUs but few have modeled their own formula. The mechanics of base-plus-productivity comp, a worked example, and the gap math that turns a suspicion into a number.
Practice ownership trades an income floor for an income ceiling. This is the honest version of that trade — buy-in math, ancillary revenue, the management tax, and when staying W2 wins.
Your first attending contract governs hundreds of thousands of dollars a year, yet most physicians sign without a framework for reading it. Here is every major section, what it means, and where the money hides.