For Emergency Medicine Physicians
The 7-clause checklist for your next EM contract.
What to find, what to ask, what to fix. No email required. Free.
About this checklist
This is the same seven-clause framework ClauseLine uses internally when running a paid contract analysis — condensed for self-review. The benchmarks are sourced from the 2026 EM compensation data set (median total comp $397,648; wRVU median 7,207) and apply to attending-level EM positions across community, academic, and CMG settings. Use it before you receive your offer to know what to look for, or after you receive it to flag the clauses worth pushing back on first.
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Seven clauses to read before you sign
Each clause: what to check, why it matters, and the 2026 EM market benchmark.
What to check
Confirm whether pay is expressed as dollar per hour or dollar per work RVU. If the contract is hybrid, both numbers must be present and defined.
Why it matters
At the 2026 EM median of $397,648 total comp, the implied hourly rate runs from $221 to $276 depending on whether the group assumes 1,440 or 1,800 clinical hours per year. A 360-hour swing is a $56 difference per hour — and you may not be told which assumption applies unless you ask.
Market benchmark
2026 EM median: $397,648 total comp. Hourly implied range: $221–$276 depending on hours assumption.
What to check
If the contract has a wRVU-based productivity bonus, find the threshold number. Write it down and compare it to the 2026 EM median of 7,207 wRVUs.
Why it matters
If the bonus threshold is set at or above the median, only the top half of physicians will ever earn it. A threshold below the median creates meaningful upside. At or above the median is mostly marketing.
Market benchmark
2026 EM wRVU median: 7,207. Threshold at or above that number = top-50%-only bonus.
What to check
Read the clawback clause carefully. Three traps to look for: (a) cliff vesting — you owe 100% back if you leave before a specific month, (b) no carve-out for termination without cause — you owe it back even if the employer ends the contract, (c) acceleration on group sale or restructure.
Why it matters
Standard market practice is pro-rata monthly forgiveness with a without-cause carve-out. If your contract has cliff vesting and no without-cause protection, you are carrying significant financial exposure from day one.
Market benchmark
Market standard: pro-rata monthly forgiveness + without-cause carve-out. Anything else is a negotiation point.
What to check
Identify the policy type: occurrence, claims-made with employer-paid tail, or claims-made with physician-paid tail. If the contract is silent on who pays the tail, assume you pay.
Why it matters
Occurrence policies need no tail. Claims-made policies do. Tail premiums typically run 1.5–2x the annual premium and can cost $30,000–$60,000 out of pocket. A silent contract is a contract where you bear that cost.
Market benchmark
Acceptable: occurrence OR claims-made with employer-paid tail. Flag: claims-made with physician-paid tail or no mention of tail responsibility.
What to check
Find both numbers: geographic radius in miles and duration in months. Check whether there is a carve-out for termination without cause. Look up your state’s law on physician non-competes before assuming it is enforceable.
Why it matters
Standard EM market: 15-mile radius, 12-month duration. Red flags are anything over 25 miles, anything over 18 months, and no without-cause carve-out. A growing number of states — California, Oregon, Colorado, Massachusetts, and others — now void or sharply limit physician non-competes; check your governing state before assuming yours is enforceable.
Market benchmark
Standard: 15 mi / 12 mo with without-cause carve-out. Red flag: 25+ mi, 18+ mo, or no carve-out.
What to check
Find the termination-without-cause notice period for both directions — what the employer owes you and what you owe the employer. Look for asymmetry.
Why it matters
Most EM contracts allow without-cause termination with 60–90 days notice on both sides. Asymmetric notice — you give 90 days, they give 30 — is a contract hygiene issue worth correcting before you sign, not after.
Market benchmark
Standard: 60–90 days both directions. Flag: asymmetric notice, especially employer shorter than physician.
What to check
If the contract is hybrid (base + productivity bonus), confirm whether the base is a true floor or a draw against future earnings. The language “draw” or “advance against productivity” signals a recoverable advance, not a floor.
Why it matters
A true floor means you keep the base regardless of production. A draw means a bad quarter leaves you owing the group money. Physicians who underperform in year one can end the year with a negative balance under a draw structure.
Market benchmark
Market standard: true floor. Flag: “draw” or “advance against productivity” language in any base comp clause.
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This checklist is informational only and does not constitute legal advice.