FREE — RED FLAG CONTRACT CHECKLIST
The contract provisions that quietly cost you.
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RED FLAG CHECKLIST · OB/GYN
The contract provisions
that quietly cost you.
Data. Leverage. Fair pay.
Delivery comp + call + tail · specialty-specific
The provisions below are the ones most likely to cost ob/gyn 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
Delivery and surgical comp not separately specified
OB/GYN compensation has at least three streams: outpatient wRVUs, deliveries, and surgical case mix. If the contract collapses them into a single rate, the highest-revenue work subsidizes the lowest without any negotiation on your part.
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.
Call burden uncapped or undefined
Specify the number of call shifts per month, weekend/holiday rotation, in-house vs. home call, laborist coverage availability, and per-call rate. Uncapped OB call is the single largest unpaid-work exposure in obstetrics.
wRVU rate with no named benchmark
A flat dollar-per-wRVU rate with no reference to 2025 national OB/GYN benchmarks gives the employer full discretion to call any rate market. Median is $56–$60/wRVU for general OB/GYN; MFM and Gyn Oncology run higher.
Termination without cause under 90 days
OB credentialing and payor enrollment run 90–120 days. A 30- or 60-day window leaves no time to credential elsewhere, transition obstetric patients, or replace income.
No surgical assistant fee allocation
Without a written allocation of first-assistant or co-surgeon fees on hysterectomies, C-sections, and complex GYN cases, those collections flow to the employer. Specify the split or per-case credit.
Subspecialty mix unilaterally assignable
Language permitting the employer to redistribute high-revenue work (MFM consults, complex GYN, surgical cases) at discretion converts your case mix into something materially less productive without compensation adjustment.
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
OB/GYN groups consolidate at the hospital and ASC level. An aggressive radius can shut you out of an entire metro area for the restriction period. Continuity-of-pregnancy carve-outs are negotiable and worth pushing for.
No nocturnist or laborist coverage backup
If the contract does not specify which nights or weekends are covered by a laborist or shared backup, you may be solely responsible for 24/7 OB coverage. Quantify the in-house and home-call burden before signing.
Unilateral schedule modification rights
Employer-discretion language over clinic days, OR block, and call rotation strips your control over working life — particularly damaging for OB/GYN, where pregnancy continuity matters.
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.
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.
Maternity leave not addressed in contract
OB/GYN contracts that fail to specify the physician's own parental leave terms — paid duration, RVU credit during leave, locum coverage — often default to whatever the handbook says, which the employer can change unilaterally. Lock the terms in.
Restrictive moonlighting clause
Broad bans on outside clinical work or expert review cap earning potential. Restrict only true conflicts — same hospital, same patient population.
For informational purposes only. Does not constitute legal advice.
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