Negotiating a contract as a doctor, whether it’s your first or your fifth, can be an overwhelming process. You want to be thorough and informed, but you don’t want to get lost in the weeds of the fine print.

Many people focus on compensation when asking questions about contracts, but there are many other questions you should be asking. Let’s look at seven questions that can help you navigate contract negotiation.

1. How long have you been recruiting for this position?

The answer to this question may provide valuable insight about the offer and the employer. If the position is newly available, make sure the employer is prepared to make an offer. You need to know if they have a minimum length of time to have the position open or a minimum number of candidates they must review before hiring.

If the position has been open for several months, you may want to ask why. This may not be a concern if you are practicing in a small specialty and interviewing in a remote location. However, if you are looking in a well-populated area with many available providers in your specialty, you may want to gather more information.

There are many possible reasons for this type of delay. The employer may have been pursuing a candidate who extended the hiring process but ultimately didn’t sign. The employer could be looking for a very specific personality or skill set that is difficult to find. It’s also possible that the compensation package they are offering is not competitive.

2. What are the schedule expectations? Who determines the exact details?

This question may seem very basic, but asking it while negotiating your contract may alleviate a lot of frustration down the road.

We have spoken with doctors who joined a practice at which everyone had Friday off, and they assumed they would, too. In reality, the practice wanted to expand hours and were looking for someone to cover Friday shifts. Hospitalists may assume they’re working day shifts only, but their contract does not make that clear.

It’s also vital to understand the call coverage expectations, if applicable. A contract may specify that call will be “equally divided,” but there are still many questions to ask.

If you’re joining a group of four, what happens if two of the doctors leave? You’ve suddenly gone from 1:5 call to 1:3 call. While it may be unnecessary to get specifics of actual days and times, asking about general structure and expectations is recommended.

3. What is the expected volume for the position?

A great bonus structure is only valuable if you will have the volume of patients to maximize the opportunity. Make sure you understand the current possibilities as well as limitations. It’s very helpful to understand current wait times for new patients to get an appointment and any hiring challenges that decrease overall efficiency of the practice.

4. Are all physicians in the department/group/team paid based on the same structure?

You don’t need to know the total take-home compensation for each physician in the practice, but we recommend asking if everyone’s pay structure is the same.

Are you being offered a guaranteed base salary while others are paid based solely on productivity? Is the wRVU conversion factor or collections percentage more or less for your colleagues? Does everyone in the department have a portion of their compensation tied to quality metrics?

In your first year in a new job, you won’t necessarily make the same amount as a more seasoned practitioner who has been there for 15+ years, but you do want to know that your potential is the same.

5. What does growth look like?

What does the practice expect from you and for you over the next 2, 5, 10 years? Are you being hired to take over the practice when a senior partner retires? Are they hoping to bring someone on board who is willing to serve as medical director in a few years? Will you be able to develop a new offering based on your unique skills and training?

In some (or a lot of) cases, your new employer may not have given this a lot of thought. Even if you don’t have definite answers at the onset, asking this question can lead to a productive, ongoing conversation.

6. What equipment and resources are currently available? If there are things I need, what’s the process for getting them?

Do they have everything you need? Your productivity and success are dependent upon a lot of things outside of your control. For many specialties, office space and equipment are relatively easy to come by. Others may need access to ASCs, labs, ORs, as well as expensive equipment and instruments.

It’s wise to determine as soon as possible whether the employer has the things you need. If they don’t, ask questions about how you can make that happen. Is there a committee you need to present to? After reaching a certain case volume, will they be willing to increase funding for equipment and/or personnel? If they bring another doctor on board, are there plans to expand the clinic?

7. Are you fully staffed?

It’s helpful to know if the clinic, OR, unit, etc. has all of the needed support staff. The first part of the question is to understand how they define “fully staffed.” You should understand the ideal structure for that employer.

How many nurses, medical/dental assistants, hygienists, technicians, billing clerks, scheduling assistants, etc. work in this location? Are those individuals dedicated to specific providers, or do they work within the entire practice? Does the employer utilize advanced practice providers? Understanding the environment in which you will be working is an invaluable tool when evaluating a position.

From there, it’s important to understand where there are gaps. If half of the available nursing positions are currently open, this will impact how the clinic operates. Across the country, healthcare employers are experiencing shortages of nursing and support staff. This creates a challenge for both patients and doctors.

Many employers tie part of your compensation to quality metrics, which often include patient satisfaction scores. When surveyed about their satisfaction, patients are asked about the entirety of their experience, including wait times and helpfulness of staff. Because of this, an understaffed clinic with a staff spread thin can create a negative experience for your patient and less money for you.

Contract Review For Doctors

Negotiating your contract can be stressful, but working with an experienced contract attorney can help you feel confident in your requests and negotiations. Panacea Legal, a partner of Panacea Financial Holdings, has contract attorneys ready to protect your interests and support your career goals.

Learn more about contract review services here.

Not ready to commit? Schedule a 15-minute consultation with the Panacea Legal team to see how contract review could help you »

Resources For Career Changes

Any career change whether a new role, new employer, or contract renewal can come with uncertainty. Our Resource Library is filled with articles and content created to help you navigate the intricacies of life as a doctor. Check out the Employment & Career Growth section for more information about salary, non-compete agreements, contracts, and more.