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Sample Report
Emergency Medicine Contract — Sample Analysis
A salary, a bonus—and a threshold that decides whether the bonus pays. This fictional agreement shows the complete report: compensation scenarios, peer comparisons, contract risks, and specific changes to request. Sample risk score: 54/100.
ClauseLine · Contract Analysis · Emergency Medicine
sample-em-contract.pdf
Moderate Risk
0 = physician-favorable · 100 = extreme risk
Physician Bottom Line
The bonus is the headline promise. The threshold determines whether it pays. This illustrative contract guarantees a $285,000 salary and adds $38.50 only for each work RVU above 7,400 per year. At the 7,207-wRVU comparison scenario, annual compensation is $285,000 and the bonus is $0. At 9,049 wRVUs, the same formula pays $348,486.50. These are production scenarios, not actual earnings.
Lead with the threshold. Reducing it to 5,400 while keeping the salary and bonus rate unchanged adds $69,569.50 at 7,207 wRVUs. Raising only the bonus factor to $56.09 adds nothing at that volume while the 7,400 threshold remains. A stronger-looking rate is not the same as a better-paying formula.
The peer charts compare total salary plus earned bonus with an all-in compensation benchmark at the same production level. They do not rank the $38.50 marginal bonus rate as if it were the physician’s entire pay. At the middle production scenario, the all-in rate is $39.54/wRVU.
Protect the increase in writing: require consent before the compensation plan changes, define extra-shift pay, and request employer-funded tail coverage. The termination and restrictive-covenant findings appear below.
Terms Working Against You
- At 7,207 work RVUs, the 7,400 threshold pays no bonus—even if the bonus rate is increased
- Lowering the threshold to 5,400 adds $69,569.50 at that same illustrative workload
- Claims-made policy with no employer-funded tail coverage — estimated $35,000–$70,000 physician exposure
- Non-compete present: 15-mile radius, 24-month duration — see the non-compete section for the Texas state-law assessment
- No extra-shift rate defined for coverage above the 10-shift baseline
Terms in Your Favor
- Guaranteed base salary of $285,000 provides income floor regardless of volume fluctuation
- 12-hour shift structure with 10 shifts/month is within standard EM scheduling norms
- wRVU bonus structure creates upside if threshold is renegotiated downward
Income Snapshot
Compensation and take-home estimates alongside a separately labeled gross revenue model. A production scenario is not a statement of actual annual earnings.
Benchmark-median revenue scenario: 7,207 work RVUs/year. Illustrative production—not your actual annual production, earnings, or collected revenue. Facility revenue assumes hospital-based encounters at the same modeled production volume. Compare compensation and revenue on the same production basis.
At this production basis, modeled gross revenue is $1.16M per year. The compensation amount shown represents 24.5% of that modeled total.
Modeled gross revenue
$1.16M
Professional + facility revenue
Estimated gross revenue at the production basis labeled above, not observed collections.
Your estimated take-home
$213,750 – $261,365
Mid-range: $213,750
Gross $285,000 – $348,487 minus applicable taxes and physician-paid expenses.
Gross professional revenue
$352,639
On 7,207 wRVUs (P50)
Modeled professional-fee revenue, not observed collections.
Gross facility revenue
$811,069
Hospital-based facility scenario
Modeled facility revenue for a hospital-based ED scenario, shown separately from professional revenue. This scenario does not establish the actual practice setting or collected receipts.
These figures count professional and facility fees only. Emergency physicians are also the front door for roughly half of all U.S. hospital inpatient admissions — the downstream imaging, labs, and inpatient revenue you initiate is larger still, and not counted here.
Estimated take-home ranges from $213,750 to $261,365, with a midpoint of $213,750, after estimated taxes and the expense assumptions shown below. Company-paid malpractice is not deducted.
Compensation Analysis
HIGHYour $/wRVU vs the market
Your effective rate of $39.54/wRVU sits at the 23rd percentile for this specialty. The shaded band is the national middle 50% (P25–P75).
Comparison scenario: 7,207 work RVUs/year. The effective rate uses the contract formula at this volume; this is not a statement of actual personal production.
How much of the peer rate you receive
Each line treats the peer benchmark as 100%. The red marker is your effective rate.
Comparison scenario: 7,207 work RVUs/year. The effective rate uses the contract formula at this volume; this is not a statement of actual personal production.
The pay gap at three production levels
Each line compares pay under your contract formula with pay at the specialty-median rate for the same production. The distance between the dots shows the modeled difference.
5,395 wRVUsP25 production
- Your formula
- $285,000
- Peer benchmark
- $302,606
$17,606 gap
7,207 wRVUsmedian production
- Your formula
- $285,000
- Peer benchmark
- $404,241
$119,241 gap
9,049 wRVUsP75 production
- Your formula
- $348,487
- Peer benchmark
- $507,558
$159,071 gap
Three-year cumulative gap
At median peer production, the rate gap totals $357,723 over three years if the formula is unchanged.
Model
Hybrid (Base + wRVU Bonus)
Base Rate
$285,000 / year
Annualized: $285,000 annually, equivalent to $197.92/hour at 7,207 work RVUs and 1,440 annual hours for this scenario. Benchmark-median production scenario, not contract-projected or actual earnings.
Shift differentials: Not specified in contract — no night or weekend differential defined
wRVU Rate vs Benchmark
The stated contract productivity factor is $38.50 per work RVU; it is not necessarily the all-in compensation rate. At 7,207 work RVUs (specialty-median production scenario, not actual or contract-projected earnings), total modeled compensation of $285,000 equals $39.54 per work RVU (23rd percentile). The all-in comparison benchmarks are P25 $43.32, median $56.09, and P75 $73.13 per work RVU. A marginal bonus or additive productivity factor must not be compared on its own with those whole-compensation rates.
Multiplier: $38.50/wRVU · work RVU
Sign-on Bonus
Amount not stated
N/A — no sign-on bonus offered
CME Coverage
Not specified — no CME budget or CME days included
Productivity Bonus
$38.50/wRVU on all wRVUs above 7,400 annually (quarterly reconciliation)
Net Take-Home
Gross (P25 – P75)
$285,000 – $348,487
Mid: $285,000
Classification
W-2
Drives the expense math
Estimated take-home
$213,750 – $261,365
Mid: $213,750
| Expense line | Annual range | Note |
|---|---|---|
| Estimated taxes (federal + payroll + state) | $71,250 – $87,122 | W-2: federal + employee payroll + TX (25% effective). |
Assumptions
- Illustrative annual work-RVU production: 5,395 / 7,207 / 9,049. Salary plus earned bonus is calculated separately at each volume; these are not actual physician earnings.
- The same estimated effective tax rate is applied to each scenario; this is a planning estimate, not an individual tax return.
- Only the deductions shown are included. Unknown health-plan deductions, voluntary retirement contributions, and other personal expenses may reduce spendable pay further.
Value Generated vs Your Pay
Compensation compared with modeled gross professional and facility revenue. Production assumptions are stated beside the chart.
Compensation alongside modeled gross revenue
Benchmark-median revenue scenario: 7,207 work RVUs/year. Illustrative production—not your actual annual production, earnings, or collected revenue. Facility revenue assumes hospital-based encounters at the same modeled production volume. Compare compensation and revenue on the same production basis.
The modeled gross revenue total is $1.16M. The compensation amount shown is 24% of that scenario; estimated take-home is 18%.
Modeled gross revenue
$1.16M
Professional + facility scenario
Your take-home
$213,750 – $261,365
After taxes, benefits, expenses
Gross professional revenue
$352,639
7,207 wRVUs × $48.93/wRVU
Gross facility revenue
$811,069
Hospital-based facility scenario
Hospital facility revenue — how it works
Modeled facility revenue for a hospital-based ED scenario, shown separately from professional revenue. This scenario does not establish the actual practice setting or collected receipts.
At 7,207 work RVUs (benchmark-production scenario, not actual or contract-projected earnings), modeled gross professional and facility revenue is $1,163,708 and compensation under the stated formula is $285,000 (24.5% of the modeled revenue). The facility component assumes a hospital-based setting. This comparison illustrates the value associated with physician work; it does not establish actual earnings or collected receipts.
Gross revenue is modeled, not observed collections. The facility component is a hospital-based scenario and does not establish the actual site or its receipts. Estimates vary with payer mix, case mix, site volume and collections performance.
Missing Protections
Employer-funded malpractice tail coverage
Claims-made policy with no tail obligation leaves a $35,000–$70,000 liability entirely on the physician at separation — regardless of the reason for departure.
"Add language that the employer funds tail coverage upon any separation, including termination without cause and voluntary resignation with standard notice."
Defined per-shift rate for extra shifts above baseline
The contract specifies 10 shifts/month but is silent on compensation for additional shifts. Groups regularly request coverage above baseline; without a defined rate, no premium applies.
"Define a per-shift rate of at least $X (at or above blended shift value) for any shifts worked above 10/month."
CME allowance and paid CME days
Professional-society guidance recommends $3,500–$5,000 annually plus 5 CME days. Absence in the contract does not mean the employer will cover it informally — expenses become out-of-pocket.
"Add a CME allowance of $4,000/year plus 5 paid CME days."
Independent wRVU audit right
The CMG controls the billing vendor relationship. Without an audit clause, the physician cannot verify the wRVU count that determines quarterly bonus payouts.
"Add a provision allowing the physician to request supporting billing data for any quarterly period within 60 days of payout."
Non-compete buyout right (statutory in Texas)
Texas law (SB 1318, effective 9/1/2025) requires physician non-competes to include a buyout capped at the physician’s total annual salary and wages at termination. This covenant contains no buyout language — a missing statutory term that also serves as the release valve if circumstances change.
"Add a buyout provision allowing release from the non-compete for an amount not exceeding my total annual salary and wages at termination, as Tex. Bus. & Com. Code § 15.50(b) requires."
Clause Analysis
Contract term
Physician shall receive $38.50 per qualifying work RVU generated above the annual threshold of 7,400 wRVUs.
Only above-threshold units receive the $38.50 bonus rate. At 7,207 work RVUs, salary is $285,000 and bonus is $0. At 9,049 work RVUs, 1,649 units earn a $63,486.50 bonus. The $38.50 is a marginal incentive rate, not an all-in compensation rate.
Request a 5,400-work-RVU threshold first: at 7,207 work RVUs it adds $69,569.50 without changing the salary or bonus factor. Pair it with a proposed $56.09 bonus factor for $101,354.63 total improvement at that volume. These are alternative package comparisons, not amounts to add together.
Contract term
Employer shall provide claims-made professional liability insurance with limits of $1,000,000/$3,000,000. Physician is responsible for all costs associated with extended reporting period coverage upon separation.
Claims-made policies require a tail (extended reporting period endorsement) to cover claims filed after the policy expires. The employer explicitly shifts this cost to the physician. EM tail premiums currently run $35,000–$70,000 depending on state, limits, claim history, and years of coverage. This is a contingent liability that is not visible in the headline compensation number.
Request that employer provide tail coverage on any separation. If employer resists full coverage, negotiate a tail allowance of $50,000 escrowed upon hire, vesting pro-rata over 3 years.
Contract term
Physician shall accrue ten (10) days of paid time off per contract year, prorated during the first contract year. Paid time off does not include continuing medical education days.
Ten days of PTO — 120 hours at this contract’s 12-hour shift length — sits below the national EM median of 160 PTO hours (2025 national data; P25 is 96 hours, P75 is 200 hours). Because CME days are expressly excluded and the contract defines no CME allowance elsewhere, any education time comes out of the same below-median pool or goes unpaid.
Request 160 PTO hours (the national median) and 5 separately designated CME days. If the employer holds at 10 days, secure the 5 CME days as a standalone add — a low-cost concession that protects the PTO pool.
Contract term
Either party may terminate this Agreement without cause upon 60 days written notice.
60 days is acceptable but does not address what happens during the notice period. The contract is silent on whether the physician continues to be scheduled for shifts and paid during the notice window, or whether the employer can place the physician on administrative leave without pay while serving out the 60 days.
Add language requiring that the physician continues to receive full base compensation during any notice period, regardless of scheduling status, and that the employer may not accelerate the termination date without paying compensation through the full notice period.
Contract term
The Company reserves the right to modify the Productivity Compensation Plan, including wRVU rates and threshold levels, upon 60 days written notice to Physician.
This provision allows the CMG to reduce the wRVU rate or raise the threshold unilaterally, with only 60 days notice. Combined with the 60-day termination clause, the effective notice period before economics change is 60 days — with no right to exit on better terms than offered at hire. Most national EM staffing groups include similar language, but it remains a risk that should be acknowledged.
Require written physician consent before any reduction in guaranteed salary or bonus rate, increase in the bonus threshold, or adverse change in credited production. A protection tied to the lesser of two rates can permit a cut; preserve the negotiated terms themselves and a right to leave without penalty if adverse changes are imposed.
Contract term
Physician agrees to work a minimum of ten (10) twelve-hour shifts per month as scheduled by the Department Medical Director.
The 10-shift minimum is standard for full-time EM. The problem is the absence of any provision for shifts above the baseline. EM departments routinely face call-outs and coverage gaps. The Medical Director can schedule a physician for additional shifts; the contract does not define the compensation rate for those additional shifts, leaving the employer the ability to argue that extra shifts are covered by the base salary.
Add: "Compensation for shifts worked in excess of 10 per calendar month shall be paid at a per-shift rate of not less than [base ÷ 120 shifts/year], or at a separate per-shift rate to be agreed in writing by the parties."
Contract term
This Agreement shall be governed by the laws of the State of Texas. Any dispute arising under this Agreement shall be submitted to binding arbitration under the AAA Commercial Arbitration Rules.
Texas governing law is consistent with the employer location. AAA Commercial arbitration is standard; the physician should confirm whether the arbitration cost-sharing provision is neutral (each party bears own costs plus half of arbitrator fees) or tilted toward the employer.
Confirm the arbitration cost clause is symmetric. If employer pays for arbitration in full, that is a positive term; if costs are on the physician when the employer prevails, request that each party bear its own arbitration costs regardless of outcome.
Non-Compete
HIGHExists
Yes
Radius
15 miles
Duration
24 months
Governing State
Texas
Enforceability
Likely Unenforceable
Landmark cases: Sadler Clinic Ass'n, P.A. v. Hart (2013, Tex. App.—Beaumont (9th Dist.)): Held that if a physician contends the contractual buyout price is unreasonable, the remedy is binding arbitration to set a reasonable price, not voiding the covenant; covenant remained enforceable subject to arbitration. Note: SB 1318 superseded this arbitrated 'reasonable price' mechanism by imposing a salary-capped buyout, but the case remains accurate as pre-2025 framework.
Texas subjects physician non-competes to physician-specific statutory caps (1-year / 5-mile / salary-capped buyout); a clause exceeding those caps generally does not stand as written. Your 15-mile radius EXCEEDS the 5 mile limit Texas law permits for physician non-competes — as written, this term is broader than the statute allows. Your 24-month term EXCEEDS the 12 month limit Texas law permits — as written, this term is longer than the statute allows. Governing law: Tex. Bus. & Com. Code 15.50(b) (as amended by SB 1318, eff. 9/1/2025); new 15.501 (dentists, nurses, PAs); 15.52.
Malpractice Insurance
HIGHType
claims-made
Coverage Limits
$1,000,000 per occurrence / $3,000,000 aggregate
Tail Coverage
Not provided — physician responsibility on separation
Tail Cost Estimate
$35,000–$70,000 (claims-made policy; dependent on state, limits, and claim history)
Require employer-funded tail on separation and negotiate a "consent to settle" clause that prohibits settlement without physician consent above a de minimis threshold ($5,000–$10,000).
Termination Provisions
MODERATEWithout-Cause Notice
60 days written notice by either party
With-Cause Provisions
Immediate termination for: (1) loss of medical license, (2) DEA registration suspension, (3) conviction of a felony, (4) material breach of the agreement not cured within 10 days of written notice, (5) exclusion from federal healthcare programs.
Physician Rights
60 days written notice to terminate without cause. No right to terminate immediately for cause against the employer (e.g., if the employer breaches compensation obligations). This asymmetry is common but worth noting.
Add a physician right to terminate immediately for cause if employer fails to pay compensation within 15 days of the due date, or unilaterally reduces the wRVU rate below a stated floor without mutual agreement. Also clarify that the physician will be paid in full through the notice period regardless of whether the employer chooses to continue scheduling.
Benefits & Leave
MODERATEHealth Insurance
Group health plan available — employee portion deducted from pay. Employer contribution not specified.
CME
Not specified in contract — no CME budget or CME days allocated
PTO
10 days per year (prorated in first year). Does not include CME days.
Retirement
401(k) participation available after 90 days; employer match not specified
Disability
Not addressed in contract
Malpractice
Claims-made coverage provided; tail not included (see Malpractice section)
Negotiation Strategy
Lead with the threshold that stops the incentive paying, then negotiate the bonus factor as part of a defined package. Preserve the guaranteed salary and require consent before later changes. Address employer-funded tail and restrictive covenants separately; agreement on compensation does not waive the remaining protections.
Opening Move
"At the 7,207-work-RVU illustration, this formula pays no bonus. I would like a 5,400 threshold with the $285,000 salary preserved. At the current bonus rate, that adds $69,569.50 at the same workload. Let’s resolve the threshold and the bonus factor together, then document the remaining protections."
Key Principles
- Bring the complete formula and compare the same workload under each proposed package. Separate a benchmark illustration from your actual production.
- Sequence the asks: (1) threshold + bonus factor with salary protected, (2) tail coverage, (3) restrictive covenants, (4) remaining protections.
- Ask directly for employer-funded tail. Cite competing offers or conversations only if you actually have them.
- At 7,207 work RVUs, a rate-only increase adds $0 with the current threshold. Reducing the threshold to 5,400 adds $69,569.50. Do not treat those changes as equivalent.
- Document all verbal agreements in writing before signing. Email confirming oral modifications is not sufficient — require a formal amendment or addendum.
Sequencing
- 1Request a benchmarking conversation grounded in the 2025 national emergency medicine data with the Medical Director or recruiter before formal offer acceptance
- 2Submit a written counter-proposal covering the threshold and bonus factor with the guaranteed salary preserved
- 3After the compensation package is agreed, address employer-funded tail coverage without conceding the remaining protections
- 4Address non-compete scope as a separate conversation after compensation is settled — treat it as a standalone item anchored on the Texas statutory caps (5 miles / 12 months / salary-capped buyout)
- 5CME and extra-shift rate are low-resistance asks — bundle them into the final redline
Negotiation Priorities
Financial Impact
$69,569.50 additional annual compensation at 7,207 work RVUs; $208,708.50 over three identical years. Salary and $38.50 bonus rate stay unchanged. This is a modeled negotiation improvement, not verified lost earnings.
Current Terms
$285,000 salary plus $38.50 for each work RVU above 7,400 annually
The Ask
5,400-work-RVU threshold with the $285,000 guaranteed salary preserved
Fallback
If 5,400 is refused, model a lower threshold together with a higher guaranteed salary. Do not accept a larger bonus factor as a substitute for a threshold that the agreed workload can reach.
Walk-Away Point
Do not rely on the incentive when deciding whether the offer meets your income needs unless the employer supplies credible production and crediting data showing that the threshold is achievable.
Say this
“At 7,207 work RVUs, the current 7,400 threshold pays no bonus. Please reduce the threshold to 5,400 and preserve the $285,000 guaranteed salary. At $38.50 per eligible work RVU, that change adds $69,569.50 at the same workload. I also want the salary, threshold, and bonus rate protected from unilateral changes.”
Financial Impact
Rate-only change: $0 improvement at 7,207 work RVUs while the threshold stays at 7,400; $29,005.91 at 9,049 work RVUs. Combined 5,400 threshold + $56.09 rate: $101,354.63 improvement at 7,207 work RVUs. The combined figure already includes Priority 1; do not add the two.
Current Terms
$38.50 per work RVU above the annual threshold; salary paid separately
The Ask
Proposed $56.09 bonus factor with the threshold reduced to 5,400 and salary preserved
Fallback
Compare any alternative bonus factor using above-threshold production only. $56.09 is a negotiation target, not a verified median for marginal bonus factors.
Walk-Away Point
Do not exchange guaranteed salary for an incentive whose eligible volume and reconciliation cannot be verified.
Say this
“With the threshold at 5,400, a $56.09 bonus factor produces $386,354.63 at 7,207 work RVUs, including the $285,000 salary. Please provide the crediting and reconciliation terms in writing so we can evaluate the whole package, not just the advertised rate.”
Financial Impact
$35,000–$70,000 one-time contingent liability eliminated — equivalent to $11,700–$23,300/year reserved across a 3-year term. Typically hits at job transition when the physician is least liquid.
Current Terms
Physician responsible for all tail costs on separation
The Ask
Employer provides or pays for tail coverage on any separation
Fallback
If full employer-funded tail is refused, secure a $50,000 tail allowance escrowed at hire, vesting pro-rata over 3 years — converting an unpredictable $35,000–$70,000 exit cost into a funded benefit.
Walk-Away Point
Minimum acceptable: $50,000 tail allowance escrowed at hire, vesting over 3 years.
Say this
“The claims-made policy leaves me with a $35,000 to $70,000 tail obligation at separation, regardless of who initiates it or why. Employer-funded tail on any separation is the standard across comparable positions, and I would like that language added. If the company prefers, a $50,000 tail allowance escrowed at hire and vesting over three years accomplishes the same protection.”
Financial Impact
As written, the covenant exceeds the Texas statutory caps on both radius and duration. Conforming it cuts the restricted period from 24 to 12 months and the restricted area from 15 to 5 miles. The salary-based buyout limit depends on the applicable salary and wages, not a fixed dollar amount established by these production illustrations.
Current Terms
15-mile radius, 24-month duration, no buyout provision — Texas governing law
The Ask
5-mile radius and 12-month duration (the Texas statutory maximums under SB 1318), a buyout capped at total annual salary and wages at termination, and language voiding the covenant on involuntary discharge without good cause
Fallback
There is no fallback above the statutory caps — any radius over 5 miles or duration over 12 months exceeds what Texas law permits for physician non-competes. If the employer resists a full rewrite, secure the 12-month duration and the salary-capped buyout first; the buyout is a mandatory statutory term, not a concession.
Walk-Away Point
Any covenant broader than 5 miles / 12 months, or without the salary-capped buyout, exceeds what Texas law permits — do not accept terms broader than the statute.
Say this
“Texas law caps physician non-competes at a 5-mile radius and 12 months and requires a buyout capped at one year of total salary and wages — this covenant is written at 15 miles and 24 months with no buyout. I would like the covenant conformed to the statutory limits and the buyout language added, as Tex. Bus. & Com. Code § 15.50(b) requires.”
Generate Counter-Proposal
What this section does
- Generates a full counter-proposal letter in your chosen tone (warm or firm), addressed to the employer, citing specific specialty benchmarks and your negotiation priorities.
- Lets you select which priorities to include, and supports both new-offer and renegotiation letter types with an optional contract start date.
- Output is editable, copyable, and prints to PDF alongside the report — ready to send, or revise it first.
Unlimited Q&A
Example question
Unlimited Q&A — ask follow-up questions about your analysis
Ask about any clause, negotiate strategy, what specific language to request, or what a term means in practice. Answers are grounded in your actual contract text and benchmarks for your specialty. Yours forever — come back any time.
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