Physician Contract Negotiation: The Biggest Mistakes Doctors Make (And How to Avoid Them)

Key Takeaways

✅ Your first job contract is not "standard"—it’s designed to benefit your employer.
✅ Everything is negotiable: salary, call schedule, non-compete clauses, bonuses.
✅ If you don’t negotiate, you will lose money and flexibility.
✅ Confidence matters more than experience—hospitals expect you to ask for more.
✅ If you sign a bad contract, leaving will be harder than you think.

Are You Walking Into a Trap?

Let’s start with a question: How many physicians sign bad contracts every year?

Thousands. Probably more.

And why?

• Because they trust HR to be "fair."
• Because they don’t want to "rock the boat."
• Because they assume their contract is just how it is.

🚨 Your contract is not written for you. It’s written to protect the employer.

And if you don’t negotiate? You will get:

• Lower pay than you should.
• More call shifts than your colleagues.
• A non-compete clause that traps you if you leave.

The good news? You can avoid all of this—if you know how to negotiate.

Why Physicians Struggle With Contract Negotiation

Doctors train for a decade, but no one teaches them how to get paid.

What’s stopping you from negotiating?

• Fear of rejection → "What if they take back the offer?" (They won’t.)
• Not knowing the market → "I don’t know what’s fair." (They do, and they hope you don’t.)
• Imposter syndrome → "I should just be grateful." (No, you should be compensated fairly.)
• Thinking negotiation is conflict → "I don’t want to seem difficult." (Your employer expects you to negotiate.)

If you don’t negotiate, you are saying yes to whatever they give you.

The Biggest Contract Mistakes Physicians Make

1️⃣ Signing Too Fast

Most new physicians get their contract, skim it for salary, and sign. Huge mistake.

📌 What’s usually hidden?

• A non-compete clause that makes leaving a nightmare.
• A bonus structure that sounds great but is impossible to achieve.
• Call obligations that aren’t mentioned upfront but pile up later.

💡 Your move: Take time. Get a lawyer. Read every clause like your career depends on it—because it does.

2️⃣ Thinking Your Contract Is "Standard"

📌 Fact: There is no such thing as a standard contract.

Hospitals and private practices have room to negotiate. They just won’t tell you that.

✅ Your contract says your salary is $250K?
→ They probably have $275K+ in the budget.

✅ They say the non-compete is "non-negotiable"?
→ They waive these all the time—for doctors who ask.

✅ They tell you everyone gets the same call schedule?
→ That’s not true. Senior doctors negotiate better terms.

💡 Your move: Assume everything is negotiable. Because it is.

3️⃣ Focusing Only on Salary

Your salary is important, but your contract is more than just a number.

📌 What else should you negotiate?

• Call schedule → Are you taking more call than others?
• Signing bonus → Can this be increased?
• Non-compete clause → Can this be removed or shortened?
• Loan repayment → Can they help pay off med school debt?
• Work RVU structure → Is the bonus actually achievable?

💡 Your move: Pick at least three things to push for.

4️⃣ Underestimating the Non-Compete Clause

🚨 This is the most dangerous part of your contract.

A bad non-compete clause can force you to move if you leave your job.

📌 What to check:

• How long does it last? 1 year? 2 years? Longer?
• How far does it extend? 10 miles? 50 miles? A whole state?
• Does it cover all specialties? Even ones you don’t practice?

💡 Your move: Negotiate this hard. If they won’t remove it, at least shrink the radius.

5️⃣ Believing "We Don't Have the Budget"

Employers love to say: "We’d love to pay more, but we just don’t have the budget."

📌 Here’s the truth:

• They have the money. They just don’t want to spend it on you.
• They expect you to ask. The doctors who negotiate get more.
• Budgets are flexible. If they want you, they will find the money.

💡 Your move: Hold your ground. Ask for more. The worst they can say is no.

How to Negotiate Like a Pro (Even If You Hate Negotiating)

1️⃣ Know the Market Rate

📌 Where to find salary data?

• MGMA compensation reports → The best data, but often behind paywalls.
• Doximity & Medscape salary reports → Solid reference points.
• Talk to colleagues → Ask what they make. Yes, really.

💡 Your move: Get real numbers before you negotiate.

2️⃣ Don’t Just React—Control the Conversation

📌 Example: How to handle their first offer

✅ Employer: "The starting salary is $220,000."
✅ You: "MGMA data shows the median is $265,000 in this region. I’d like to discuss aligning my salary with that."

💡 Why this works:

• You’re leading the conversation.
• You’re using data, not just opinion.
• You’re setting the terms, not them.

3️⃣ Negotiate More Than One Thing

If you just ask for more money, they might say no. But if you negotiate multiple things, you give them options.

📌 Ask for:
✅ More salary
✅ A better signing bonus
✅ A reduced call schedule
✅ A higher CME allowance
✅ Loan repayment assistance

💡 Your move: Pick 3-4 things and negotiate all of them.

4️⃣ Use Strong Language (Never Say "I Was Hoping...")

📌 Say this, not that:

✅ Instead of: "I was hoping for more money."
✅ Say: "Based on market data, I’d like to discuss a salary of [$X]."

✅ Instead of: "Is there any way to improve this offer?"
✅ Say: "Given my contributions, I’d like to discuss adjusting my compensation."

🚨 Never ask if something is negotiable. Just negotiate it.

Your Contract Defines Your Future

🚨 Your employer will not fight for you. You have to fight for yourself.

📌 Remember:
✅ Your contract is not "standard." Everything is negotiable.
✅ If you don’t ask, you will lose money.
✅ The worst they can say is no.
✅ The best? A higher salary, better schedule, and a contract that protects you.

💡 Bottom line: Negotiate like your career depends on it—because it does.

Now, your choice: Are you going to ask for what you deserve, or are you going to take whatever they give you?