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You may think you negotiated the job you want. Then the contract arrives, and the promise that mattered most is missing. Would you spot the language that lets the hospital change your location, pay, or duties after you sign? The answer is buried in a few terms you cannot afford to skim.
At Gardner Employment Law, we help physicians identify the language that shapes both their income and their working lives. Start with three questions before you sign.
What Do Capitalized Terms Mean in Your Contract?
A capitalized term generally is defined somewhere in the contract, and the definition applies anytime the term is used. For example, a contract may define “Practice Location,” “Net Collections,” or “Cause” once and then use those defined terms in various sections within the contract. Read the definition every time you see a capitalized term. That definition affects a right or obligation; its ordinary meaning will not necessarily control.
Suppose you thought that your new employer agreed that you will work at only one hospital, but the contract defines “Practice Location” to mean any facility the employer designates. Usage of the term “Practice Location” in the written contract will allow your employer to make assignments far beyond the site you expected. The definition and the duties clause must say the same thing you negotiated and must be defined as you negotiated.
The same problem can alter your bonus or your exit. “Net Collections” may exclude certain payments or permit deductions. “Cause” may trigger immediate termination. “Duties” may pull in a call policy or an exhibit that adds work beyond patient care.
The same reading technique matters for compensation and termination. These examples show where to look:
As you review a new contract, highlight or mark each capitalized term in the contract, especially in the pay, duties, restrictions, and termination sections. Find each definition and every time the capitalized term is used in the contract. Check referenced schedules, exhibits, and policies, especially ones the hospital can change. If the definition reaches farther than you intended, propose a narrower definition and revise the affected clauses.
How Much Will You Actually Be Paid?
To know how much you will receive in compensation, you should be able to calculate the amount of compensation from reading the contract. A salary figure alone does not explain a productivity bonus, call pay, sign-on payment, or repayment obligation.
Separate the guaranteed amount from incentive pay. Also, review the duration as to long your base salary will last. If there is an end poinyt, what replaces it? For a productivity bonus, find the threshold, rate, measurement period, and payment date. “Eligible for a bonus” is not a payment formula. The numbers and factors considered must be stated in your contract.
For example, at $50 for each wRVU above 5,000, 5,100 wRVUs produce a $5,000 bonus. That figure can shrink if the hospital may change your credited wRVUs, raise the threshold, or exclude services. Have the hospital calculate a sample bonus and compare each step with the written formula.
If the formula uses collections, identify when the hospital credits a payment to you and which refunds, discounts, or other deductions reduce it. Check whether you receive pay for work you completed before leaving if the hospital collects after your departure. Read “Net Collections” alongside the termination provisions.
Match the formula to the work. Does your salary include weekend call? Will administrative duties reduce your clinical time while your productivity target stays fixed? Read any sign-on or relocation repayment requirement with the termination clause before you count that money as yours.
What Work Are You Agreeing to Do?
Your duties clause should describe the position you actually discussed and your specific duties. That includes the specialty, the patient population, work locations, schedule, call coverage, and time spent on administrative tasks. A broad promise to perform “other duties as assigned” is very loose. The employer has the discretion to change what you expected you would do.
We helped a client who was looking forward to the new rehabilitation clinic that he was going to create and build for the hospital. He was an expert in physical rehabilitation. The new clinic was his primary reason for leaving his current position and moving to the new hospital. Yet, the proposed contract contained nothing whatsoever about the new clinic. When our client asked about that fact, the hospital refused to revise the wording. Wisely, the physician withdrew his application after realizing that the hospital could refuse to fund this rehabilitation clinic or allow him to build the practice that he had envisioned.
Compare each major aspect of the job with the draft contract:
| Topic | Clarify in Writing |
| Clinical scope | Which services and patient groups are part of the role? Must the physician work outside a subspecialty? |
| Location and schedule | Which sites are required? Can the hospital change locations, hours, or clinic days? |
| Call obligations | How often is call assigned? Which facilities does it cover? Is additional call time paid? |
| Administrative work | What responsibilities are required, how much time is expected, and how do they affect productivity targets? |
A physician recruited for specialized clinical work, for example, may assume the job will focus on that specialty. If the written agreement instead permits the hospital to assign a much wider range of patients or facilities, the physician may face a materially different workload. Specific language can protect both sides by recording the job they intended.
If the hospital says a proposed limit will be honored but will not add it to the agreement, ask why. A written clause can identify the expected work, describe when duties may change, or require the parties to agree to a material change. An email explaining the hospital’s current practice may be useful, but it will not override what is stated a signed contract that gives the hospital broader authority.
What Should You Do Before Signing an Employment Contract?
Before signing any contract that will control your work performance, carefully read the definitions, compensation terms, duties, and termination provisions in particular. List every promise made by the employer that influenced your decision to accept the job, then locate the language that makes it part of the agreement. If the contract omits the promise or defines it more broadly than you expected, raise the issue while you still have room to negotiate.
At Gardner Employment Law, we review and negotiate physician employment contracts so doctors can understand their obligations and advocate for terms that reflect the job they were offered. Contact us before signing to discuss your agreement.