FP · DATA · LEVERAGE · FAIR PAY
ClauseLine for Family Practice
Analysis calibrated to family medicine contracts: wRVU structures, rural and underserved area premiums, OB delivery compensation, panel size protections, and loan repayment structuring.
A few of the things we flag in FP contracts
- Panel-size cap — Protection against a panel that grows without a matching change in pay.
- wRVU structure — How outpatient productivity is counted, including telehealth and messages.
- Loan repayment & clawbacks — Rural and underserved premiums, and the strings attached to them.
…and the full contract, clause by clause — compensation, call, scheduling, non-compete, termination, and every other term that moves your pay or your exit.
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What moves your number in family practice
Family medicine compensation turns on a handful of structural terms: the wRVU conversion factor and the production target it has to clear, how long your income guarantee runs while a new panel builds, and whether rural, OB, or loan-repayment dollars arrive as durable pay or as strings. Two offers with identical headline salaries can diverge sharply by year three on those terms alone. These are the levers where that gap opens.
Match the rate to the target
Most family medicine offers quote the conversion factor and the productivity threshold as separate numbers, and the common pattern is a median-level rate paired with a target set well above median — you work at one percentile and get paid at a lower one. Ask which percentile of published compensation data each number is drawn from, and push for both to sit at the same one. A stronger version names the data year in the contract so the pairing can be re-checked at renewal.
A guarantee that outlasts the ramp
A new family medicine panel takes roughly 18 to 24 months to fill, and production income lags panel growth the entire way. A one-year guarantee that converts to pure production at month 13 delivers a pay cut right as you hit stride. The stronger structure is a two-year guarantee with conversion triggered by panel size or visit volume rather than a calendar date, and explicit language that guarantee-period dollars are never repaid.
Price OB scope separately
If you deliver, that scope changes your call burden, your nights, and your malpractice class — none of which a blended salary captures. Look for a per-delivery payment or OB stipend on top of base, OB call paid on its own schedule, and the obstetric premium differential, including its tail, carried by the employer. The contract should also state what happens to your compensation if you later stop attending deliveries, rather than leaving it to a renegotiation you did not choose.
Rural dollars as durable pay
Rural and underserved premiums are real, but the structure matters more than the headline number. Dollars built into base compound through retirement match and every future raise; the same dollars delivered as a forgivable loan vanish if you leave early and anchor you if you stay. Separately, get written confirmation that the practice site qualifies for federal and state loan repayment programs — that eligibility rides on the location, not your negotiation, and it can outweigh the signing bonus.
Common questions
What is a good wRVU rate for family medicine?
The rate by itself tells you almost nothing — a generous conversion factor paired with an aggressive production threshold can pay less than a modest rate with an achievable one. Compare both the rate and the threshold to the same percentile of published compensation data, adjusted for employer type and region, since hospital-employed and independent-group models price wRVUs differently. Then model your realistic annual wRVU output against the threshold before judging the rate at all.
Should family medicine physicians negotiate separate pay for OB deliveries?
Yes. When deliveries are folded into a blended salary, you absorb extra call, interrupted clinic days, and a higher malpractice class for free. Look for a per-delivery payment or OB stipend, separately paid OB call, and employer coverage of the obstetric premium differential including tail. The contract should also spell out what happens to your compensation if you later drop OB.
How does loan repayment work in a rural family medicine contract?
Usually one of two ways: employer-funded repayment, typically structured as a forgivable loan tied to a service commitment, or eligibility for federal and state programs based on the practice site's shortage designation. Employer-funded money should forgive pro-rata by month and forgive in full on termination without cause. Program eligibility is a property of the location, not your negotiation — verify the site qualifies before you sign, because it can be worth more than the employer's own recruitment package.