FREE — RED FLAG CONTRACT CHECKLIST
The contract provisions that quietly cost you.
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RED FLAG CHECKLIST · NEUROLOGY
The contract provisions
that quietly cost you.
Data. Leverage. Fair pay.
Stroke call + EMG/EEG · specialty-specific
The provisions below are the ones most likely to cost neurology physicians money, mobility, or leverage. Read each item against your contract and mark whether it is present, missing, or unclear. A single CRITICAL finding warrants careful review before signing.
THE RED FLAGS
5 CRITICAL · 7 HIGH · 3 MODERATE
Stroke call burden uncapped or undefined
Specify the number of stroke-call shifts per month, in-house vs. home, response-time requirement, per-call rate, and tPA decision differential. Stroke call is the single largest unpaid-work exposure in neurology.
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.
Procedure compensation (EMG/EEG/Botox) not separately credited
EMG, EEG, intraoperative monitoring, and Botox injections generate disproportionate RVUs. If the contract bundles procedures into the same rate as office visits, the high-revenue work subsidizes the rest without negotiation.
wRVU rate with no named benchmark
A flat dollar-per-wRVU rate with no reference to 2025 national neurology benchmarks ($62–$88/wRVU range) gives the employer full discretion to call any rate market.
Termination without cause under 90 days
Neurology credentialing, payor enrollment, and patient transition (especially for epilepsy or chronic care patients) run 90–120 days. A 30- or 60-day window leaves no time to manage transition.
Subspecialty mix unilaterally assignable
Language permitting the employer to redistribute high-revenue work (epilepsy monitoring, neurocritical care, EMG) at discretion converts your case mix into something materially less productive without compensation adjustment.
No inpatient consult differential
Inpatient consults carry higher acuity, documentation load, and after-hours follow-up. Without a per-consult differential or hospital stipend, you absorb that load at outpatient rates.
Bonus threshold not tested against your workload
Test the threshold against your credited production, workload and payout period. Model low, expected and high-production payouts before counting the bonus as income.
Non-compete over 15 miles or 2 years
Neurology is heavily referral-driven — your patient base follows you only if you stay nearby. Aggressive non-compete radius effectively kills your continuity-of-care value to the employer's competitors.
Reading volume (EEG/sleep) uncapped
If the contract assigns sleep study reads, ambulatory EEG interpretation, or long-term monitoring at flat compensation, the workload can grow unbounded without pay adjustment. Cap volume or pay per-study.
Unilateral schedule and clinic modification rights
Employer-discretion language over clinic days, site assignment, and procedure block time strips your control over working life — particularly damaging for procedure-heavy subspecialties.
No rate escalation clause
Without annual increases tied to inflation or a benchmark percentile, real compensation declines every year you remain. A flat multi-year rate is a multi-year pay cut.
Compensation model not specified
If salary vs. wRVU vs. per-procedure vs. hybrid is ambiguous, the model can shift at renewal — a guaranteed base silently converting to production-only is the classic pattern.
Sign-on clawback with no pro-ration
Full repayment regardless of tenure treats the bonus as a leash rather than compensation. Negotiate pro-rata over 24 months and a waiver on without-cause termination.
Restrictive moonlighting clause
Broad bans on outside clinical work, EEG/EMG reading services, or expert witness work cap earning potential. Restrict only true conflicts.
For informational purposes only. Does not constitute legal advice.
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