PM&R Employment Contract Checklist for New Physicians

A first physician employment contract can look familiar after a quick read. The salary is easy to find. So are the start date and basic benefits. The harder questions are often buried in definitions, exhibits, and provisions that do not seem important until the job changes or ends.

For a new physiatrist, the contract should match the position discussed during the interview. If the practice described a predictable inpatient schedule but the agreement permits broad changes to duties, locations, and call coverage, the written contract deserves another conversation.

This checklist is educational and is not legal advice. A physician employment attorney can evaluate the agreement, explain how state law applies, and identify language that may be difficult to change later.

Start with the job itself

The contract should describe your duties clearly enough that you recognize the job you interviewed for. Review the listed facilities, clinical responsibilities, administrative expectations, supervision duties, and call requirements.

Watch for language that allows the employer to assign work at any current or future location. That may be reasonable for a regional practice, but you should understand the possible travel area and whether new locations could substantially change your day.

If medical director duties are part of the offer, confirm whether they appear in the agreement or a separate document. The contract should explain how those duties are compensated and how much administrative time they require.

Understand every part of compensation

Write down each component of the compensation package and the conditions attached to it. This may include base salary, productivity pay, quality incentives, signing money, relocation assistance, or compensation for administrative work.

Ask when the base salary can change. If compensation depends on work relative value units or collections, determine which services count, when activity is credited, and how often the practice provides reports.

Bonuses sometimes include repayment obligations if the physician leaves before a stated period. Find out what triggers repayment and whether the amount decreases as you complete more time with the practice.

Do not rely on a verbal description of the formula. Ask for the actual formula and work through an example. The overview of PM&R compensation models covers useful questions to bring to that discussion.

Put the schedule and call expectations in writing

A contract may define full-time employment without describing the weekly schedule. That can leave considerable room for disagreement.

Review expected workdays, weekend coverage, call frequency, holidays, paid time off, continuing medical education time, and coverage during another physician’s absence. If the role includes more than one rehabilitation hospital or clinical location, ask how travel time affects the schedule.

Call obligations should be specific enough to evaluate. “Call as reasonably assigned” may be common language, but it does not tell you how the current rotation works or how much it could change.

Review professional liability coverage

Confirm who pays for professional liability insurance and what type of coverage the practice provides. Ask whether additional coverage may be needed when employment ends and who is responsible for that cost.

The answer can depend on the policy structure and the contract. This is an area where a lawyer or insurance professional can help translate a short provision into its practical financial effect.

Also review how the agreement handles claims, cooperation with the employer, and access to records after departure.

Read the termination section before imagining retirement

Every employment relationship ends eventually, even when the job is a good one. The contract should explain how either party can terminate the agreement and how much notice is required.

Look at termination with cause and without cause. Find out whether the employer must give you an opportunity to correct certain problems before ending the agreement. Review what happens to unpaid compensation, bonuses, benefits, patient records, and pending collections after your final day.

A long notice period may help the practice arrange coverage, but it can also delay your next move. Think about how the provision would work if you needed to relocate or accept another position.

Examine restrictive covenants carefully

A restrictive covenant may limit where and for how long you can practice after leaving. The exact language matters, including which locations establish the restricted area and which types of work are prohibited.

Do not assume a provision is harmless because someone says it is rarely enforced. Its effect can depend on state law, the wording of the agreement, and how your employment ends.

Nonsolicitation and confidentiality provisions also deserve review. Make sure you understand what contact with former colleagues, referral sources, employees, or patients would be restricted.

The American Medical Association’s contract resources recommend reviewing compensation, working conditions, liability insurance, restrictive covenants, and termination terms with qualified health care counsel.

Check the promises that did not make it into the contract

Compare the agreement with your interview notes, emails, and letter of intent. Look for promises about scheduling, protected administrative time, staffing, equipment, a future partnership path, or a particular facility assignment.

A promise does not need to be made in bad faith to disappear. People forget, roles change, and the person who recruited you may move on. If a term influenced your decision, ask whether it should be documented.

Keep negotiation focused

You may not need to negotiate every paragraph. Start with the terms that affect your ability to do the job, understand your pay, and leave under reasonable conditions.

Ask questions in plain language. What happens if the facility assignment changes? Can the compensation formula be revised during the term? Who pays for coverage after departure? When does the restrictive covenant apply?

The goal is not to make the contract impressive. It is to make the working relationship understandable.

Physiatrists comparing PM&R employment opportunities can review current positions, learn about the physician team, or read the guide to questions to ask before joining a PM&R practice.