FREE — RED FLAG CONTRACT CHECKLIST
The contract provisions that quietly cost you.
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RED FLAG CHECKLIST · PEDIATRICS
The contract provisions
that quietly cost you.
Data. Leverage. Fair pay.
Panel + well-visits + NICU · specialty-specific
The provisions below are the ones most likely to cost pediatrics 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
Panel size with no cap or productivity adjustment
Pediatric panels grow with each new sibling, school physical, and well-baby visit. An uncapped panel means unbounded message, refill, and form-completion volume at flat pay. Cap panel size or pay per-patient-above-threshold.
Compensation model not specified
Pediatrics uses salary, wRVU, panel-based, capitation, and hybrid models. If the contract is ambiguous, the model can shift at renewal — a guaranteed base silently converting to production-only is the classic pattern.
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.
wRVU rate with no named benchmark
A flat dollar-per-wRVU rate with no reference to 2025 national pediatrics benchmarks ($48–$68/wRVU range, lower than adult medicine) gives the employer full discretion to call any rate market.
Termination without cause under 90 days
Pediatric credentialing and patient transition (especially for chronic-care families) run 90–120 days. A 30- or 60-day window leaves no time to manage transition or maintain continuity for medically complex children.
Subspecialty differential missing
Pediatric subspecialties (cardiology, hem-onc, pulm, GI) often run $50,000–$200,000 above general pediatrics. If you are a subspecialist on the same contract structure as general pediatrics, the differential should be explicit.
NICU and nursery coverage uncompensated
If the contract is silent on newborn nursery rounds, NICU consult coverage, or attendance at high-risk deliveries, that work can be assigned without separate compensation. Quantify the expected non-outpatient burden.
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.
Quality/HEDIS bonus denominator controlled by employer
A bonus tied to system-level metrics, panel attribution rules, or vaccine compliance rates you don't control is structured not to pay out. The denominator, attribution, and physician influence path must be specified.
Non-compete over 10 miles or 2 years
Pediatric patient relationships are extraordinarily local — families pick the closest pediatrician they trust. An aggressive radius effectively bars you from your existing patient base. Narrow scope and duration before signing.
Call burden uncapped or undefined
Specify number of call days per month, weekend/holiday rotation, in-house vs. home, and per-call rate. Pediatric call routinely includes overnight phone-triage volume that goes uncompensated when undefined.
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.
After-hours phone triage uncompensated
After-hours triage can add unpaid time. Specify expected coverage, pay and backup in writing; do not treat a silent contract as a clear pay arrangement.
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, urgent care moonlighting, or telemedicine cap earning potential. Restrict only true conflicts — same geography, same patient population.
For informational purposes only. Does not constitute legal advice.
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