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Life is full of moving targets, but that doesn’t mean they need to be in our contracts. When I signed a contract at an academic center, the description of my position was simply “1.0 FTE”. I clarified what that meant and I was pointed to a living, breathing written document. The description of the clinic and call coverage was based on the current number of physicians in the practice at that time and was ready and waiting for edits if that number increased (or more likely, decreased) at any time. Yikes! 

In a practice of 20 physicians, a couple of partners out of town or on FMLA at a time was noticeable but did not have a drastic change on my work life balance. Had I been in a group of 5 OBGYN’s that dropped to 3…let the drastic begin!

When reviewing a physician contract, one of the main red flags I scan for is these moving targets. Essentially, I’m scanning for vague language. Where is there too much room for interpretation? Terms like “call to be equal between providers” keeps that call schedule in flux with the change in the group. You could be picking up 2, 4, or 6 more calls a month without any additional compensation if your group shrinks in size. 

6 ways can you address these moving targets:

  1. Outline your schedule in as detailed a manner as possible. Sometimes the contract can get as detailed as outlining the clinic hours (8a to 4p) and which days of the week they are open, while some may only get so detailed as to indicate total patient-facing hours. You could define “an average of 36 patient-facing hours per week” to allow yourself administrative time – and we all know how much time we spend charting, coordinating care, admin’ing before and after seeing our patients! 
  2. Set limits to your total clinic or call liability for a month or a quarter. You could work to include language such as “up to 15 calls per quarter”. 
  3. Predetermine reimbursement rates for work provided beyond the agreed upon maximums. You can suggest that any call shift that is covered beyond the agreed upon maximum is reimbursed at a given, fair rate. 
  4. Add language that states you and your employer need to mutually agree to clinical time outside of the agreed upon duties. This way you have the option to say yes – and earn some additional income! – or no – and spend that time with your friends, family, or on your own, pursuing your outside interests. 
  5. Clearly define your practice location. If a separate clinic site is required one day a week, it could dramatically impact your day should it be an additional 60+ minute drive one-way. You can have a primary location specified with additional upon mutual agreement.
  6. Specify your average number of clinic patients per day. Your day has a very different flow when your patients are allotted specific appointment times versus a day with half a dozen (or more!) double-booked appointment times. 

Work with your employer to help create a contract that allows you to feel protected and heard. At Contract Diagnostics, we can help you review the terms of your contract, identify those moving targets, and brainstorm ways to clarify and negotiate your terms. Whether you need a full contract review, a compensation analysis, or just a free inquiry, see our website for details at

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