What Every Health Care Professional Should Know Before Signing Their First Contract

February 26, 2026

A job offer in health care, whether as a physician, a certified registered nurse anesthetist, or other advanced practice clinician, often marks the culmination of years of education, training, and sacrifice. However, the accompanying employment contract often contains provisions that may limit the health care professionals’ ability to earn a fair income, attain a healthy work-life balance, or protect themselves in unforeseen circumstances. These clauses are often overlooked and there may not be another opportunity to negotiate the terms once the contract is signed.

Here are some of the key provisions that professionals should look for in their contract.

FTE and Clinical Expectations

FTEs (Full-Time Equivalents) are often defined in ways that go far beyond a standard 40-hour work week. Health care professionals may find that administrative, academic, or non-clinical time is reduced, while patient-facing responsibilities increase without a corresponding increase in salary.

For example, a physician may sign a contract defining “full-time” as 1.0 FTE, only to discover that means 50+ patient contact hours per week plus additional charting time. In another common scenario, a health care professional accepts a position expecting dedicated time for continuing education, but finds that “protected time” (e.g., teaching, onboarding, or administrative duties) is routinely reassigned to cover clinic shortages.

Compensation vs. Responsibilities

When clinical time increases or protected time is eliminated, providers’ base salary should reflect those changes. Supervising clinicians, serving on a board committee, and preparing articles and research are examples of non-clinical time. It is crucial that health care providers clarify expectations for non-clinical duties as said activities do not generate work relative value units (wRVUs).

If productivity-based bonuses are involved (such as with wRVUs), a health care professional should ask whether the patient volume actually supports the incentive thresholds, and if there are caps on bonuses.

Call Coverage and Time Off

Health care professionals should request clarification from their employer about on-call requirements. For instance, the contract may state that on-call requirements are “comparable to similarly situated colleagues.” Given the possibly vague nature of the wording, health care professionals should inquire for details, such as the frequency, duration, and pay of those requirements.

Additionally, employers may expect health care professionals to provide on-call coverage at multiple locations or affiliated hospitals. Health care professionals should review the applicable policies and ask for clarification.

Malpractice Coverage and Tail Insurance

“Tail coverage” is extended malpractice insurance that protects providers from claims made after employment ends. Most employment agreements include malpractice coverage; however, tail coverage is often treated as a separate matter.

Many employers will agree to pay tail coverage under specific circumstances: if the provider terminates employment with proper notice; service is terminated without cause; or the health care professional becomes disabled. Professionals should be clear on their own coverage and feel confident they are taking the appropriate steps to protect themselves.

Non-Compete and Restrictive Covenants

Private equity groups and hospitals will require providers to sign non-compete and non-solicitation clauses. These provisions may limit where and how soon health care professionals can work after leaving their job. These provisions are often buried in separate agreements not referenced in the main contract. Health care professionals should remain mindful of these obligations upon departure of employment as well as during the term of the contract if they wish to engage in other outside activities. Typically, outside activities such as teaching, consulting, or expert witness work need to be approved by employer prior to commencement of those activities.

Given the complexity of employment contracts and the significant impact these provisions can have on a health care professional’s career and livelihood, it is strongly advisable to consult with an experienced attorney before signing. An attorney can help identify unfavorable terms, negotiate better conditions, and ensure that the contract reflects the professional’s qualifications and the years of training they have invested in their career.

---