The contract provisions that quietly cost you.

ASA unit conversion factor with no benchmark

A flat dollar-per-ASA-unit rate with no reference to 2025 national benchmarks gives the employer full discretion over future adjustments and obscures whether you are at, above, or below market.

Medical direction ratio above 1:4

Supervising more than four concurrent rooms breaks federal medical-direction billing rules and shifts the rooms to medical supervision rates — losing roughly 50% of the unit-based revenue.

Claims-made malpractice, no tail commitment

Silence leaves who pays unresolved. Ask for employer-paid tail in writing for resignation, termination and nonrenewal; confirm the policy terms.

No minimum case volume or hours guarantee

Without a floor on case volume, hours, or call commitment, the employer controls your income by controlling room assignments and the OR schedule.

Termination without cause under 90 days

Hospital and surgery-center credentialing runs 90–120 days. A 30- or 60-day without-cause window leaves no time to credential, relocate, or replace income.

Stipend or hospital subsidy assignable to employer

If the hospital subsidy or coverage stipend flows to the group rather than to physician comp, your effective rate can be cut without renegotiation when subsidy terms change.

Call burden uncapped or undefined

Specify the number of call shifts per month, weekend/holiday rotation, in-house vs. home call, and per-call rate. Uncapped call language is one of the largest unpaid-work exposures in anesthesia.

CRNA supervision differential missing

When supervising CRNAs in a care-team model, you carry medicolegal risk and billing responsibility. The contract should state your supervision differential or per-room credit explicitly.