When Physicians Should Walk Away From a Job Offer

The decision to turn down a job offer can be a difficult one. Especially for young doctors facing pressure to secure an employment contract. Too many new physicians make the mistake of accepting any offer out of a sense of urgency. Only to then find themselves stuck in a bad position or back on the job hunt within a year or two. To start your employment search with confidence, you need to know when to walk away from a sub-par job offer.

Physicians invest an incredible amount of time, energy, and capital to practice medicine. Every doctor deserves to find a position that offers proper compensation, opportunity, and quality-of-life. Even if it means prolonging your job search, turning down a weak job offer can be the best choice for your career.

At Physicians Thrive, our team of financial advisors has successfully reviewed and negotiated over 20,000 physician employment contracts nationwide. In the past decade, we’ve seen it all when it comes to physician contracts. The good, the bad, and the ugly. If you encounter the following situations during your job search, you should strongly considering walking away from the offer.

The prospective employer responds poorly to negotiation. 

Many young physicians are unsure if it is appropriate to negotiate an initial job offer. As a result, they often do not even try to negotiate. Or review the terms offered in an employment contract. Unfortunately, this often leaves new doctors with unfavorable contract terms and inadequate salaries in the early years of their career.

The advice from financial consultants, hospital recruiters, and human resource departments is unanimous. It never hurts to try to negotiate a contract. Even if a prospective employer says that an offer is not up for negotiation, we commonly find that hospitals and medical groups are reasonable to requests. Whether you ask for a higher salary, different call hours, continuing education support, or an adjusted compensation structure, it is completely acceptable and professional to ask to customize an employment contract. You want your salary to reflect your professional value and priorities.

This is not to say that your negotiations will always be successful, as different employers have different degrees of leeway within their contract offers. However, if an employer becomes hostile or unprofessional in response to your negotiation efforts, this is a serious red flag. For example, in the rare event that an employer threatens to revoke a job offer or reduce a salary offer simply because you asked for some changes to the contact terms, you should seriously reconsider who you are getting into business with. If an employer does not seem to value your priorities or take the time to establish trust and clarity in your initial contract, it doesn’t bode well for the future of your professional relationship.

After negotiation, the offer still does not meet your salary requirements.

The turnover rate for physicians, especially new physicians, is downright alarming. Research shows that 23.8% of all new hires leave within their first year, and the overall turnover rate is nearly double among younger physicians compared to older physicians. Compensation issues are one of the most commonly cited reasons that physicians leave a job.

It is important to have clear, informed salary expectations when you embark on a job hunt. First, you should research industry compensation benchmarks for your speciality, region, and experience. A physician-specific contract review can offer access to deep data insights that illustrate standard salary ranges based on dozens of individualized variables from call hours to practice type. Moreover, a compensation specialist can help you determine a salary range that meets your needs based on your personal financial goals and responsibilities.

When a potential employer cannot meet your salary requirements or make other adjustments to satisfy your overall priorities, even after negotiation attempts, it may be best to walk away from the offer. Accepting an underpaying position can jeopardize your financial stability, and you are unlikely to stay long at a job that undervalues your professional worth.
Curious about salaries? Check out How to Make the Most of a Pathologist’s Salary

You suspect discriminatory practices in the hiring process. 

Federal law makes it illegal for employers to discriminate on the basis of race, color, religion, sex, age, disability, or national origin. These protections extend to many aspects of the onboarding process including hiring, promotions, wages, and benefits. Many states and cities have additional employment protections that must be observed as well.

While these rules may sound clear cut, it can be difficult to recognize discrimination during an employment search. Unfortunately, we do hear from physicians who encounter discriminatory or illegal lines of questioning or negotiation. In some cases, employers may not even be aware that they are violating anti-discrimination laws. Here are a few examples of discriminatory practices in interviews or hiring:

  • Asking a foreign-born physician to accept a lower salary in exchange for sponsoring a work visa.
  • Asking a physician about their plans to have children or child-care arrangements
  • Asking about marital status, sexual orientation or gender identity
  • Asking how old a candidate is
  • Asking about salary history (in certain states and cities)

In some cases, an employer may broach these topics innocently with no intent to discriminate. However, if you get a bad feeling about a certain line of questioning, or if you suspect that a contract terms are discriminatory, you should take your suspicions seriously. A professional contract review team should include a contract lawyer who will be well-versed in employment law, as well as a financial professional who can tell you whether a contract offers inferior benefits, salary, bonuses and financial terms based on industry benchmarks.

If you believe an employer has engaged in unethical or illegal practices in the hiring process, this is a cue to steer clear and look for other offers.

The position does not feel like a good fit. 

This final category can include a broad range of situations. It’s important to trust your gut when considering a job offer. There are any number of reasons that a practice may not be a good fit for a certain physician. During your interview, you should be able to get a sense of an employer’s priorities, values, and workplace culture. If you get the impression that a workplace will not be a good fit for your own professional goals, it is perfectly acceptable to consider turning down an offer.

When you are on the fence about a job offer, it can help to get a second opinion. In many cases, if a job requires relocation, a physician’s spouse will get invited to take part in interviews or tours. Doctors should take their spouse’s opinions about a prospective employer into account. Particularly if it confirms any potential misgivings about a position. Additionally, a physician-specific contract review team can offer insight about the quality of a job offer. Contract review professionals are constantly working with doctors who are looking to change employers. They know what to expect out of the negotiation and hiring process. A physician-specific contract reviewer can tell you which concerns are likely to work themselves out. As well as which issues are likely to lead to quick turnover down the road.


Physicians have every right to be discerning when it comes to accepting job offers. And knowing when to turn down an offer is essential to finding the right position. We recommend that every physician consults with a physician-specific contract review team to evaluate and negotiate employment offers with confidence. To learn more about our contract review services, talk with one of our advisors today.

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