The Contract Review Checklist Every Medical Professional Should Follow

​​Most physicians spend years training to read complex diagnostic data, synthesize competing variables, make high-stakes decisions under pressure — and then receive an employment contract and feel completely lost. That’s not a personal failing. Contracts are written by lawyers, for lawyers, and they’re deliberately dense. The language isn’t always designed to confuse you, but it often works out that way.

A contract review checklist helps cut through that. It won’t replace a healthcare attorney — nothing will — but it gives you a structured way to move through an agreement without losing track of what matters. Think of it as your pre-signing workup. You wouldn’t send a patient to surgery based on a glance at their chart. We’ve put together a printable PDF version of this contract review checklist you can download and use alongside your review — grab it at the bottom of this page.

Here’s how to approach it.

Start With the Basics (And Don’t Blow Past Them)

It sounds obvious, but the fundamentals are first on the contract review checklist: Are the parties named correctly? Is your name spelled right, and is the employing entity the actual organization you’ll be working for — or is it a holding company or subsidiary you’ve never heard of? Sometimes this matters legally, sometimes it doesn’t, but you should know either way.

Effective dates and start dates often appear in different parts of the document. Make sure they’re consistent and match what you were told verbally. If there’s a discrepancy — say, the contract says you start in October but the credentialing timeline suggests January — that’s worth flagging before you’ve committed to anything. Small errors at this stage tend to become bigger disputes later.

Also define your scope of work clearly. “General surgery” can mean a lot of things depending on where you practice. If you’ve been told you won’t be doing call or trauma, that understanding needs to be in the document.

Compensation: Read It Twice, Then Once More

The salary number gets everyone’s attention. It’s the other parts that tend to bite. Offers aren’t always as good as they initially appear.

Productivity bonuses tied to wRVUs, collections, or patient volume are common — and often described in ways that make them sound more achievable than they are. Before you get too excited about a bonus structure, ask yourself: what would my actual patient volume need to be, at this specific location, with this specific patient mix, to hit that threshold? If the practice is new, if you’re building a panel from scratch, or if the population tends toward lower-reimbursement payers, the math might look very different from the projections you were shown.

Look also at when bonuses are paid. Quarterly? Annually? Upon reaching a threshold? Some contracts describe bonuses in glowing terms in the overview section and then bury a clause later specifying that bonuses are “discretionary” — which effectively means they’re optional. That’s not a bonus structure. That’s a suggestion.

Compensation should also be benchmarked. MGMA data, AMGA surveys, regional compensation reports — these exist for a reason. If your offer is significantly below market for your specialty and region, that’s worth knowing before you negotiate, not after. Physicians who know what peers are earning tend to negotiate better outcomes. It’s not complicated, it’s just information.

Termination Provisions: The Part Nobody Reads Carefully Enough

Termination clauses are where a lot of physician contracts get quietly one-sided. Pay attention to both termination without cause and termination for cause — and understand that these are very different situations with very different consequences.

Without-cause termination typically allows either party to exit with notice, usually 60 to 90 days. That sounds fine. But some contracts give the employer the right to terminate you without cause with 30 days’ notice, while requiring you to give 180 days if you want to leave. That asymmetry is worth pushing back on.

Termination for cause is trickier. A broad definition of “cause” can leave you vulnerable to termination for things that feel subjective — failure to meet undefined productivity standards, conflicts with administration, complaints that haven’t been substantiated. Look for whether the contract gives you notice and a cure period before cause-based termination takes effect. Many do. Some don’t.

Automatic renewal clauses are easy to overlook. If a contract renews automatically unless you give notice by a specific date — 90 days before expiration, say — and you miss that window, you may be locked in for another year under terms that no longer fit your situation.

Termination clauses are where a lot of physician contracts get quietly one-sided, and they’re worth a dedicated section on any contract review checklist.

Non-Competes: Where Physicians Lose the Most Sleep

Non-compete enforceability varies significantly by state. Some states have largely gutted non-competes in healthcare. Others enforce them aggressively. The FTC has been working toward federal restrictions, though the regulatory picture keeps shifting. None of that necessarily helps you if you’re signing in a state where they hold up in court.

What you’re evaluating: geographic scope, duration, and what triggers the restriction. A one-year, 10-mile radius non-compete is very different from a two-year, 30-mile restriction in a mid-size metro where every competing health system is within that radius. The second one might effectively mean you’re leaving the region if the relationship ends.

Non-solicitation clauses — restrictions on recruiting colleagues or contacting former patients — often travel alongside non-competes and deserve their own review. Patient solicitation restrictions in particular can feel like an ethical minefield. In some states, they’re unenforceable on public policy grounds. Worth knowing before you assume the worst.

Malpractice and Tail Coverage

Malpractice coverage is one area where your contract review checklist needs to go beyond a surface read. You want occurrence-based malpractice coverage if you can get it. With occurrence coverage, any claim arising from a patient encounter during your employment period is covered — regardless of when the claim is filed, even if you’ve left. Claims-made coverage only covers claims filed while the policy is active. If you leave the employer, you need tail coverage to extend protection for claims that come in afterward, and tail coverage is expensive. We’re talking tens of thousands of dollars, sometimes more, depending on specialty.

Who pays for the tail? The contract should say. Some employers cover it. Some require you to pay if you leave voluntarily but cover it if they terminate you without cause. Some put the cost on you regardless. If you’re signing a claims-made policy, don’t leave this question ambiguous. Find out the actual dollar figure if you can — call the insurer, or ask for a quote.

Performance Expectations and Administrative Obligations

When physicians work through a contract review checklist, this section is often the one that looks fine on paper and causes the most problems later. Contracts frequently reference productivity targets, quality metrics, or administrative duties without specifying what those actually mean in practice.

If the contract says you’re expected to maintain certain quality scores, ask: which scores, evaluated how, by whom, and what happens if they dip? If there’s a committee participation requirement, find out whether that time is built into your schedule or added on top of clinical expectations. Some physicians sign contracts that look reasonable on paper and find themselves working far more hours than anticipated because the administrative load was never quantified.

Call coverage is another area where clarity matters. How often are you expected to take call? What does call actually entail at this facility — are you taking calls from home, or are you expected to come in? Is there additional compensation for call, or is it folded into your base salary?

Confidentiality, IP, and Everything Else

Standard confidentiality clauses are mostly fine. The ones worth scrutinizing are overly broad provisions that might restrict you from discussing compensation with colleagues (which, in many contexts, is a federally protected right) or that define “confidential information” so expansively that it could theoretically cover clinical knowledge and methodologies you’ve developed over your career.

Intellectual property clauses can also surprise physicians who do research, write, or develop educational content. If the contract assigns IP broadly to the employer — anything developed “in connection with your employment” — make sure you understand how that’s interpreted. A side CME course you develop on your own time might not be yours anymore if the definition is loose enough.

Get a Professional to Review It Anyway

A contract review checklist gets you oriented. It does not make you a healthcare attorney. There’s a meaningful difference between knowing what to look for and understanding how a specific clause will be interpreted under your state’s case law, or whether a particular indemnification provision is actually unusual or just standard boilerplate that sounds scary.

Physician-focused contract attorneys do this specifically; they aren’t general practitioners who occasionally see employment contracts and will often find things you wouldn’t. They also tend to understand what’s negotiable and what isn’t, which is information you need before you push back on something the employer considers non-negotiable and accidentally sour the relationship before you’ve started.

The cost of a professional review is almost always small relative to the value of the contract you’re signing. If you’re committing to a three-year agreement at $300,000 annually, you’re talking about a $900,000 decision. A few hundred dollars to have an expert read the document is not an optional expense.

At Physicians Thrive, we review physician contracts with an eye toward compensation fairness, legal risk, and long-term career alignment. Contact us to get started.

Physician Contract Review Checklist

Use this as a reference while you work through your agreement. Prefer a printable version? Download the PDF contract review checklist here and check items off as you go.

Contract Fundamentals

• ☐ Parties named correctly, including full legal entity name of employer
• ☐ Effective date and start date are consistent throughout the document
• ☐ Scope of services is explicitly defined (specialty, location, patient population)
• ☐ Any verbal promises or understandings are reflected in writing
• ☐ Any exhibits or addenda referenced in the contract are actually attached

Compensation

• ☐ Base salary clearly stated with payment schedule
• ☐ Bonus structure is objectively defined — not “discretionary”
• ☐ Productivity metrics are realistic for this specific practice setting
• ☐ Bonus payment timing is specified (quarterly, annually, etc.)
• ☐ Offer benchmarked against MGMA or comparable market data for specialty and region
• ☐ Signing bonus repayment terms understood (clawback period, prorated or full repayment)
• ☐ Income guarantees, if any, defined with clear duration and terms

Termination and Renewal

• ☐ Without-cause termination notice period is reasonable and symmetric
• ☐ Cause-based termination includes notice and cure period
• ☐ “Cause” is defined specifically, not left to employer discretion
• ☐ Automatic renewal terms understood; key notice dates calendared
• ☐ Post-termination obligations are reasonable in scope and duration
• ☐ Compensation and benefits during notice period are addressed

Non-Compete and Restrictive Covenants

• ☐ Non-compete geographic radius is workable given local geography
• ☐ Duration is reasonable — one year or less is more typical
• ☐ Enforceability verified against current state law
• ☐ Non-solicitation clause scope is understood (patients, employees, or both)
• ☐ Carve-outs for existing patients documented if applicable
• ☐ Buyout provision exists, or its absence is noted and considered

Malpractice Insurance

• ☐ Coverage type confirmed: occurrence-based or claims-made
• ☐ If claims-made: who pays tail coverage, and under what conditions
• ☐ Estimated tail coverage cost obtained — call the insurer; don’t assume
• ☐ Coverage limits reviewed for adequacy given specialty and jurisdiction
• ☐ Tail obligation confirmed for both voluntary departure and termination scenarios

Duties, Call, and Administrative Load

• ☐ Call frequency is specified — not left to “as needed”
• ☐ Call compensation addressed or explicitly noted as included in base salary
• ☐ Administrative and committee duties quantified or time-bounded
• ☐ Ramp-up or guarantee period included if building a new patient panel
• ☐ Quality metrics defined with specific evaluation criteria

Confidentiality and IP

• ☐ Confidentiality scope doesn’t restrict federally protected communications
• ☐ IP assignment language reviewed for impact on outside writing, research, or CME content
• ☐ Outside employment or moonlighting restrictions understood
• ☐ Social media or public statement restrictions are reasonable in scope

Red Flags — Pause If You See These

• ☐ No clauses giving employer unilateral right to modify compensation or duties
• ☐ No excessive penalty provisions tied to early departure
• ☐ No vague performance standards that could be used as pretextual cause
• ☐ No insurance obligations placed on you that weren’t discussed during offer stage
• ☐ Non-compete duration doesn’t exceed two years or effectively prevent local practice
• ☐ Bonus is not described as “discretionary”
• ☐ Cause-based termination includes a cure period

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Just want the contract review checklist? Download the printable PDF version here — no fluff, just the items you need to work through before you sign.