OBGYN · DATA · LEVERAGE · FAIR PAY
ClauseLine for OB/GYN
OB/GYN contract analysis: delivery compensation, call structure, surgical case mix, malpractice tail costs, and benchmark comparison against published OB/GYN compensation data.
A few of the things we flag in OBGYN contracts
- Delivery compensation — Per-delivery vs. salary, and how call volume affects it.
- Call structure — Frequency, backup, and what each night is actually worth.
- Malpractice tail — OB tail is among the most expensive — confirm who pays it.
…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 ob/gyn
OB/GYN compensation is really three businesses in one contract — clinic, deliveries, and gyn surgery — wrapped around the most expensive malpractice exposure in medicine. The base number on page one tells you almost nothing; what moves your actual take-home is how each revenue stream is priced, how call is counted when the group shrinks, and who absorbs the tail when you leave. Those terms are negotiable, and the gap between a default contract and a well-negotiated one compounds every year you stay.
Match the guarantee to OB revenue lag
A new OB panel does not pay like a new clinic panel. A patient who books her first prenatal visit today generates the bulk of her revenue at delivery roughly nine months out, and global obstetric billing pays at the end of the episode — so a 12-month salary guarantee can expire before your own patients have produced a single delivery payment. Push for an 18- to 24-month guarantee, or a stepped transition, with no clawback if productivity targets reflect that lag.
Tail terms with a vesting schedule
OB/GYN carries the highest claims-made premiums of any specialty, and tail coverage commonly runs 1.5-2x the annual premium — which makes the tail clause a larger swing than most salary negotiations. Beyond confirming who pays, negotiate how that obligation shrinks: a vesting schedule where the employer's share grows each year of service, full employer payment on any termination without cause, or occurrence-based coverage that removes the question entirely. A blanket physician-pays tail clause quietly functions as an exit penalty that grows the longer you stay.
Guaranteed OR access in writing
Surgical wRVUs out-earn clinic hours, so your effective rate depends on whether you can actually book cases. Contracts that promise a surgical practice but stay silent on block time let scheduling decisions made by others set your income. A stronger version names your weekly OR block hours, addresses robotic platform access if your practice depends on it, and protects new-hire case flow during ramp instead of leaving you last in line behind senior partners.
Price the call you do not have yet
The call rotation in your offer assumes the group stays fully staffed. When a partner leaves, a 1-in-5 rotation becomes 1-in-3 overnight, and most contracts let that happen with no change in pay. Negotiate a stated baseline rotation, a per-shift rate for every call night above it, and a recruitment trigger — if the vacancy is not filled within a defined window, the extra-call rate escalates. That converts the employer's staffing problem from your unpaid burden into their line item.
Common questions
Who pays for tail coverage when an OB/GYN leaves a job?
Unless the contract says otherwise, you do — silence on tail defaults the cost to the departing physician. For OB/GYN this matters more than for any other specialty, because tail is priced off your annual premium and OB premiums are the highest in medicine, with tail commonly running 1.5-2x that annual figure. The strongest positions are employer-paid tail on any termination without cause, a year-of-service vesting schedule, or occurrence-based coverage, which has no tail at all.
How should OB call be compensated in an employment contract?
The contract should state four things: the rotation frequency, whether call is in-house or from home, the per-call rate including weekend and holiday treatment, and what you are paid when you cover more than the stated baseline. Call that is simply folded into base salary is the weakest structure, because every additional night you cover is free to the employer. If the hospital has laborist coverage, the contract should specify which nights it covers rather than leaving that to practice custom.
Is a one-year salary guarantee enough for a new OB/GYN?
Usually not, and the reason is specific to obstetrics: global OB billing pays at delivery, so revenue from the patients you recruit in your first months arrives nine or more months later, after collections lag on top of that. A guarantee that converts to pure production at month twelve can cut your pay right as your panel is about to start paying off. Compare the offer's ramp against published compensation data for your region, and ask for 18 to 24 months of guarantee or a gradual step-down.