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Sample Report

Family Medicine Contract — Sample Analysis

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Contract Analysis · Family Practice

sample-family-medicine-contract.pdf

Moderate Risk

0 = physician-favorable · 100 = extreme risk

MODERATE
3 High3 Moderate1 Low

Income Snapshot

Four numbers: the total revenue your work generates, what you take home, what your group collects in professional fees, and what the hospital captures. Estimates, not promises. We do not estimate employer cost — if the group wants to argue cost, they can provide their data to you.

Total revenue you generate

Coming soon

Revenue breakdown is rolling out specialty by specialty — live now for emergency medicine and hospital medicine.

Your estimated take-home

$162,855 – $243,537

Mid-range: $198,597

Gross $235,000 – $351,424 minus your share of insurance, retirement, malpractice tail, and tax.

Professional fees collected

Coming soon

Specialty-specific revenue ranges are rolling out — live now for emergency medicine and hospital medicine.

Hospital revenue captured

N/A

Hospital facility-fee math is currently scoped to emergency medicine.

At the 2025 national FM median production of 6,028 wRVUs this contract nets an estimated $198,597 after tax — $162,855 at P25 production (4,759 wRVUs, where the base floor holds) and $243,537 at P75 production (7,572 wRVUs). Taxes are the single modeled expense line for a W-2 employee: a combined 31% effective rate covering federal, employee payroll, and Iowa state tax. Federal loan repayment, if facilitated, provides up to $50,000/year tax-exempt — added on top of these figures, not taxed through them.

Executive Summary

This contract presents a base salary of $235,000 at a rural FQHC in Iowa, with $42 per wRVU above a 4,800-wRVU annual threshold. The conversion factor is the headline problem: $42/wRVU sits below the 2025 national family medicine P25 of $44.78 (without OB, hospital-employed), against a national median of $51.44. At the national median production of 6,028 wRVUs, expected total compensation is $286,576 — $24,981 below the 2025 national FM P50 total compensation of $311,557. Rural and FQHC family medicine roles typically carry a 5–15% differential above urban base rates to offset call burden, scope breadth, and geographic recruitment difficulty; this contract offers neither a rural premium nor a loan repayment line, despite the FQHC designation that makes federal loan repayment programs eligible.

The quality bonus is the most technically deceptive element. The advertised $30,000 quality bonus requires simultaneous achievement of five quality metrics — A1c control, BP control, colorectal cancer screening, annual wellness visit completion, and patient satisfaction. The thresholds are set at or above the 90th percentile of national FQHC achievement. The probability of hitting all five simultaneously in a rural FQHC setting is under 10% based on national FQHC outcomes data. The $30,000 is a phantom incentive for the vast majority of physicians in this structure.

The compensation model switch clause in Section 4.7 is the longest-range risk. After the 2-year guarantee period, the employer retains the right to convert the physician to a pure wRVU model without consent. In a rural FM role with a 1,800-patient panel cap, pure wRVU compensation typically pays 10–20% less than the guaranteed salary — because capped panel size directly limits productive capacity above the threshold regardless of the physician's effort. The contract also carries a 24-month non-compete covering the 3-county service area designated in Exhibit A.

Five changes are required before this contract is fair-market for a rural FQHC role: quality bonus restructure, telehealth parity, rural/FQHC differential, consent requirement for any compensation model switch, and a narrowed non-compete. All five are standard asks in competitive rural FM recruitment packages in 2025.

Key Red Flags

  • Expected total compensation of $286,576 at median FM production (6,028 wRVUs) is $24,981 below the 2025 national FM P50 of $311,557 (without OB) — before counting a quality bonus the structure makes unreachable
  • $42/wRVU is below the 2025 national FM P25 of $44.78 (without OB) — a bottom-quartile conversion factor
  • Quality bonus structured at 90th-percentile FQHC thresholds with all-or-nothing payout — expected value under 10% of advertised $30,000
  • Telehealth wRVUs credited at 65% of in-person value despite CMS payment parity — effective rate falls to roughly $37–$38 per actual wRVU at a 30% telehealth share
  • No rural/FQHC differential despite location — 5–15% premium is standard market practice
  • Section 4.7 allows unilateral compensation model switch to pure wRVU after year 2 — panel cap makes this a pay cut

Key Strengths

  • FQHC designation makes physician eligible for federal loan repayment ($50,000+/year) — worth requesting as part of the package
  • Base salary of $235,000 clears the 2025 national FM P25 base of $219,000 (without OB) — the guaranteed floor is workable; the conversion factor and bonus gates are where the value leaks
  • Iowa physician shortage area location creates genuine recruitment leverage to negotiate rural premium and loan repayment

Compensation Analysis

HIGH

Your $/wRVU vs the market

Your effective rate of $47.54/wRVU sits at the 35th percentile for this specialty. The shaded band is the national middle 50% (P25–P75).

$44.78$51.44 median$61.43You: $47.54 (35th pct)

What you earn at each production level

Annual compensation at your contract rate versus the specialty-median rate, across P25 / median / P75 production. The gap is the cost of the rate, and it grows with volume.

$235,000$244,8034,759wRVU · P25$286,576$310,0806,028wRVU · median$351,424$389,5047,572wRVU · P75At your contract rateAt the specialty-median rate

Model

Base Salary + wRVU Bonus + Quality Bonus

Base Rate

$235,000 / year

wRVU Rate vs Benchmark

Contract rate of $42/wRVU is below the 2025 national family medicine P25 of $44.78 (without OB, hospital-employed) — bottom quartile against a national median of $51.44 and P75 of $61.43. At P25 production (4,759 wRVUs) the contract pays $235,000 against $244,803 at the median rate — a $9,803 annual gap. At median production (6,028 wRVUs): $286,576 against $310,080 — a $23,504 gap. At P75 production (7,572 wRVUs): $351,424 against $389,504 — a $38,080 gap. Three-year cumulative gap at median production: $70,512. The 4,800-wRVU threshold and the 65% telehealth credit pull the effective rate lower still — roughly $37–$38 per actual wRVU at a 30% telehealth share.

Multiplier: $42.00/wRVU · work RVU

Sign-on Bonus

$15,000

2-year pro-rated clawback on sign-on bonus

CME Coverage

$2,500/year CME allowance, 4 CME days

Productivity Bonus

$42/wRVU above 4,800 annually; telehealth wRVUs credited at 65%

Net Take-Home

Gross (P25 – P75)

$235,000 – $351,424

Mid: $286,576

Classification

W-2

Drives the expense math

Estimated take-home

$162,855 – $243,537

Mid: $198,597

Expense lineAnnual rangeNote
Estimated taxes (federal + payroll + state)$72,145 – $107,887W-2: federal + employee payroll + IA (31% effective).

Assumptions

  • Production scenarios anchored to 2025 national FM production percentiles (without OB): P25 4,759 / median 6,028 / P75 7,572 wRVUs
  • W-2 classification; combined 31% effective tax rate (federal + employee payroll + Iowa state)
  • Quality bonus excluded from all scenarios — the all-or-nothing gate has a sub-10% trigger probability
  • Federal loan repayment not included in gross — it is a separate tax-exempt benefit

Revenue Breakdown (rolling out)

Revenue breakdown is rolling out specialty by specialty. Emergency medicine is live first; other specialties follow as we tune collected-revenue ranges per specialty and practice setting.

Missing Protections

Tiered quality bonus structure replacing all-or-nothing gate

The all-or-nothing 5-metric gate has a sub-10% trigger rate at rural FQHCs. Restructuring to $6,000 per metric independently converts a phantom $30,000 into an expected $15,000–$20,000 — a real compensation item. All-or-nothing quality bonuses at P90+ thresholds are increasingly challenged as deceptive in FQHC physician recruitment.

"Restructure the quality bonus to pay $6,000 per metric independently — each metric triggers its own payout with no requirement to achieve the others simultaneously. Reset the thresholds from P90+ to P50–P75 national quality benchmarks."

Telehealth wRVU parity with in-person visits

CMS reimburses the same E/M code at the same rate regardless of modality, yet the contract credits the physician for 65% of the work on every telehealth visit. For a rural FQHC where telehealth represents 30%+ of visits, this materially reduces compensation relative to market.

"Remove the 65% telehealth adjustment in Section 5.2 and credit telehealth wRVUs at 100% of in-person wRVU value — consistent with CMS 2022+ parity policy and industry standard."

Rural/FQHC compensation differential and loan repayment

Federal loan repayment awards $50,000/year for 2 years (tax-exempt) at FQHC sites. The contract does not include loan repayment facilitation, nor any rural premium. A competitive rural FM package in 2025 includes a 10% rural differential plus loan repayment facilitation.

"Add a $20,000/year rural practice differential plus a commitment to federal loan repayment facilitation — the FQHC designation makes the physician eligible, and many FQHC employers facilitate the application as part of recruitment."

Physician consent and 180-day notice for compensation model change

Section 4.7 allows unilateral model conversion to pure wRVU after year 2. With a 1,800-patient panel cap, pure wRVU compensation produces 10–20% less than the current salary+bonus structure. This is effectively a deferred pay cut built into the contract.

"Replace Section 4.7 with a mutual consent requirement for any compensation model change, plus 180-day written notice and a 90-day physician right to terminate without penalty if the proposed model change is unacceptable."

Clause Analysis

HIGHQuality Bonus — All-or-Nothing Gate at P90+ Thresholds

"Physician shall be eligible for an annual quality bonus of $30,000 upon achieving all of the following simultaneously: A1c control ≥78%, BP control ≥82%, colorectal cancer screening ≥76%, annual wellness visit ≥72%, patient satisfaction ≥4.6/5.0."

The phrase "achieving all of the following simultaneously" is the operative language — any single metric miss voids the entire $30,000 bonus. The thresholds themselves are set at or above the national P90 for FQHC performance on these measures (2025 national FQHC data). National P90 for FQHC diabetes A1c control sits near 75%; this contract requires 78%. The compound probability of hitting all five at P90+ levels simultaneously in a rural Iowa FQHC is under 10% historically. The employer is advertising $30,000 while the structure delivers an expected value near $3,000.

Restructure to $6,000 per metric independently, with thresholds reset to P50–P75 national quality benchmarks. Partial credit per metric converts the phantom bonus into a real compensation item. This is the single highest-value change in this contract.

HIGHTelehealth wRVU Discount — 65% of In-Person Rate

"Telehealth visits shall be credited for productivity purposes at 65% of the work RVU value assigned to the equivalent in-person service code."

CMS established telehealth payment parity in 2022 — the same E/M code billed via video receives the same reimbursement as an in-person visit. The FQHC is reimbursed at the full rate; the physician is credited for 65% of the work. For a rural FQHC where telehealth represents 25–35% of patient volume, the blended effective wRVU rate drops from $42 to approximately $36–$38 per unit — a structural gap of $4–$6/wRVU on a rate that already sits below the 2025 national FM P25 of $44.78.

Remove the telehealth adjustment entirely and credit telehealth wRVUs at 100% of in-person value. CMS parity is the published policy; a 65% credit has no clinical or regulatory basis.

HIGHCompensation Model Switch — Section 4.7

"Following the completion of the initial 24-month guarantee period, Employer reserves the right to modify Physician's compensation model, including conversion to a pure productivity-based model, upon 60 days written notice."

This clause is written to appear routine but functions as a deferred pay cut mechanism. The 1,800-patient panel cap in Section 3.2 directly limits wRVU production above the 4,800 threshold. Under a pure wRVU model with no salary guarantee, production above the cap ceiling is impossible — meaning the physician's compensation is structurally limited. A salary-to-pure-wRVU conversion in year 3 with a capped panel could reduce compensation by $15,000–$30,000/year without any change in physician effort or productivity.

Replace the unilateral right with a mutual consent requirement. Add 180-day minimum notice for any model change. Add a physician right to terminate without penalty or clawback if the proposed model change reduces expected compensation below the year-2 guaranteed level.

MODERATESign-On Bonus Clawback — 2-Year Pro-Rated, Trigger-Blind

"The sign-on bonus of $15,000 shall be subject to pro-rated repayment if Physician’s employment terminates for any reason within twenty-four (24) months of the start date."

"For any reason" is the operative language — the clawback triggers even when the employer terminates without cause. Combined with physician-paid tail of $8,000–$15,000, an early exit can cost $15,000–$28,000 in combined obligations the physician does not fully control. A clawback that survives employer-initiated separation converts a recruitment incentive into an exit penalty.

Amend the clawback to apply only to physician-initiated resignation, with full forgiveness on employer-initiated termination without cause. Request monthly rather than annual pro-ration so each completed month reduces the repayment obligation.

MODERATEMalpractice Insurance — Tail Coverage

"Employer shall provide claims-made professional liability insurance during employment. Extended reporting period coverage is Physician's sole responsibility upon separation."

Iowa outpatient family medicine tail premiums typically run $8,000–$15,000. Combined with the 2-year sign-on clawback, early departure from this contract can cost $15,000–$28,000 in combined obligations — on a contract whose expected total compensation already runs $24,981 below the 2025 national FM P50 at median production. The tail cost is manageable but needs to be addressed as part of total compensation evaluation.

Request employer-funded tail on any separation. If employer will not fund tail, negotiate a $10,000 tail allowance escrowed over 2 years vesting.

MODERATEPanel Size Cap — 1,800 With No Compensation Adjustment

"Physician's active patient panel shall be capped at 1,800 patients. Employer may adjust the panel cap at its discretion with 30 days notice."

The 2025 national family medicine median panel is 2,200–2,500 patients. A cap of 1,800 directly limits the wRVU production ceiling — an 1,800-patient panel typically supports roughly 4,500 wRVUs per year, below both the contract's 4,800 bonus threshold and the 2025 national FM median production of 6,028 wRVUs. The physician is structurally prevented from reaching the bonus threshold by a cap on the employer's side. More importantly, the employer can adjust the cap downward with only 30 days notice.

Raise the cap to 2,200 patients, consistent with the 2025 national family medicine median. Add language that any cap reduction below 2,000 patients requires 180 days notice and triggers a compensation floor equal to the prorated base salary regardless of wRVU production.

LOWTermination Without Cause — Notice Period

"Either party may terminate this Agreement without cause upon 90 days written notice to the other party."

90 days is appropriate for an outpatient FM practice with patient panel continuity considerations. The clause does not address whether the physician is compensated during the notice period if scheduling is reduced — an oversight that should be corrected.

Add language that full base salary continues during the notice period regardless of scheduling adjustments. Also add that employer termination without cause does not trigger the sign-on clawback obligation.

Non-Compete

MODERATE

Exists

Yes

Radius

3-county service area (rural Iowa)

Duration

24 months

Governing State

Iowa

Enforceability

Moderately Enforceable

Landmark cases: Lamp v. American Prosthetics, Inc. (1986, Iowa Supreme Court, 379 N.W.2d 909): Established Iowa’s controlling three-prong reasonableness test for restrictive covenants; declined to enforce an overbroad 100-mile covenant.

Iowa enforces reasonable physician non-competes (Enforceable — common-law reasonableness). Treat this as binding and negotiate the scope down now. Your 3-county service area / 24 months terms sit within the range Iowa courts have upheld, so a court would likely enforce them — your leverage is to narrow them before signing. Governing law: No general non-compete statute (common law). Carve-outs: Iowa Code §147.161 (voids non-competes for "mental health professionals" as defined in §228.1 — which includes psychiatrists and MDs/DOs practicing as mental-health professionals); HF2254 / 2026 Acts (bans non-competes for University of Iowa Hospitals & Clinics employees only).

Malpractice Insurance

MODERATE

Type

claims-made

Coverage Limits

$1,000,000 per occurrence / $3,000,000 aggregate

Tail Coverage

Not provided — physician sole responsibility on separation

Tail Cost Estimate

$8,000–$15,000 (Iowa outpatient family medicine, major carriers, 2025 pricing)

Request employer-funded tail on any separation. If employer resists, negotiate that employer-initiated termination without cause automatically triggers employer tail obligation.

Termination Provisions

MODERATE

Without-Cause Notice

90 days written notice by either party

With-Cause Provisions

Immediate termination for: (1) loss of medical license, (2) DEA registration suspension, (3) felony conviction, (4) material breach not cured within 10 days, (5) exclusion from federal healthcare programs.

Physician Rights

90 days written notice to terminate without cause. No right to terminate for cause against employer. Termination without cause by employer triggers clawback per the sign-on provisions — this creates an asymmetric risk.

Add a provision that employer-initiated termination without cause exempts the physician from sign-on clawback and triggers employer tail obligation. Also add a physician immediate-termination right if employer fails to pay compensation within 15 days of due date.

Benefits & Leave

MODERATE

Health Insurance

Group health plan available through FQHC; employee contribution applies; employer contribution not specified

CME

$2,500/year CME allowance and 4 paid CME days — below the $3,500–$5,000 range common in competitive rural FM recruitment packages

PTO

20 days PTO per year; paid holidays included; does not include CME days

Retirement

403(b) available through FQHC; employer match not specified

Disability

Short-term disability provided; long-term disability not addressed

Malpractice

Claims-made coverage provided during employment; tail not included (see Malpractice section)

Negotiation Approach

The quality bonus restructure is the highest-impact change by expected value — converting the phantom $30,000 into a real $18,000–$24,000. Telehealth parity is the second most defensible ask because federal policy explicitly supports it. The non-compete must be narrowed before signing — Iowa enforces reasonable physician non-competes, and these terms sit within the range Iowa courts have upheld. The rural/FQHC differential and loan repayment facilitation are unique leverage items that most urban employers cannot offer — use the federal loan repayment eligibility as a differentiating recruitment argument. The comp model switch clause is the longest-range risk and requires a consent provision before signing.

Opening Move

"I reviewed the quality bonus structure against national FQHC data. The all-or-nothing five-metric gate at P90+ thresholds has a sub-10% trigger probability at rural FQHCs — the expected value of the $30,000 advertised bonus is closer to $3,000. I would like to restructure to $6,000 per metric independently before we finalize anything else. I am also prepared to discuss telehealth parity and the rural differential as part of the same conversation."

Key Principles

  • Lead with data on the quality bonus. National FQHC achievement rates are public — bring specific percentile figures for each metric.
  • CMS telehealth parity is policy, not a negotiating position. "CMS reimburses at parity" is a statement of fact that requires no counterargument.
  • Federal loan repayment is the FQHC's unique recruitment tool. Ask for facilitation — it costs the FQHC nothing and provides $50,000–$100,000 in tax-exempt benefit to the physician.
  • The compensation model switch clause is not urgent at hiring but must be addressed. "I need my consent required for any model change" is a standard ask.
  • Panel cap increase (1,800 → 2,200) is a low-resistance ask if framed as a productivity improvement for both parties.

Sequencing

  1. 1Request quality bonus restructure conversation before formal acceptance
  2. 2Submit written counter-proposal on quality bonus (tiered) and telehealth parity (100%) as linked items
  3. 3Raise the non-compete scope cut (25-mile radius, 12 months) in the same written counter — Iowa courts have upheld terms like these, so the time to narrow them is before signing
  4. 4Raise rural differential and federal loan repayment facilitation as a second-phase package ask
  5. 5Address comp model switch consent requirement (Section 4.7) as a third ask
  6. 6Panel cap and tail coverage are final redline items

Negotiation Priorities

1Quality bonus — restructure from all-or-nothing to tiered ($6,000/metric)

Financial Impact

Converts expected bonus from ~$3,000 to ~$18,000–$24,000 at median FQHC performance — an annual swing of $15,000–$21,000 and $45,000–$63,000 over a 3-year term, on an item already in the contract.

Current Terms

$30,000 all-or-nothing on 5 simultaneous P90+ quality metrics

The Ask

$6,000 per metric independently, thresholds reset to P50–P75 national quality benchmarks

Fallback

$6,000 per metric with no more than 2 metrics linked for any single payout, even if thresholds stay above P75 — per-metric partial credit is the non-negotiable element

Walk-Away Point

Per-metric partial credit minimum — any structure that requires simultaneous achievement of more than 2 metrics for full payout is unacceptable.

Say this

I reviewed the quality bonus against national FQHC achievement data. An all-or-nothing gate across five metrics set at or above the 90th percentile has under a 10% trigger probability, so the advertised $30,000 carries an expected value closer to $3,000. I want it restructured to $6,000 per metric, paid independently, with thresholds reset to the P50–P75 range of the 2025 national quality benchmarks.

2Telehealth wRVU parity — eliminate 65% discount

Financial Impact

At a 30% telehealth visit share on the 2025 national FM median production of 6,028 wRVUs, eliminating the 35% discount adds approximately $8,000–$12,000/year to effective compensation — $24,000–$36,000 over a 3-year term.

Current Terms

Telehealth wRVUs credited at 65% of in-person rate

The Ask

Telehealth wRVUs credited at 100% of in-person rate (CMS parity standard)

Fallback

Telehealth wRVUs credited at 80–90% of in-person value, with a written commitment to revisit full parity at the first annual compensation review

Walk-Away Point

80% minimum telehealth credit. Below this, the penalty is punitive given CMS parity reimbursement.

Say this

CMS has paid telehealth at parity with in-person visits since 2022 — the same E/M code reimburses at the same rate. Crediting my telehealth wRVUs at 65% means the organization collects full payment while I am credited for two-thirds of the work. I want Section 5.2 amended to credit telehealth wRVUs at 100% of in-person value, which is worth roughly $8,000 to $12,000 per year at a 30% telehealth share.

3Non-compete — narrow the 3-county, 24-month restriction before signing

Financial Impact

Contingent but large: the lockout removes the credible exit that underwrites every other ask. At median production this contract already runs $23,504/year below median-rate pay — $70,512 over a 3-year term — and an enforceable 24-month, 3-county exclusion is what lets the employer hold that line.

Current Terms

24-month non-compete covering the 3-county service area designated in Exhibit A

The Ask

Strike the covenant entirely; failing that, cut scope to a 25-mile radius from the primary clinic site and 12 months, with a carve-out for any facility where the physician already holds privileges

Fallback

Single-county scope at 12–18 months, or a defined buyout amount that releases the covenant in full

Walk-Away Point

Any scope that forecloses the entire 3-county market for 24 months with no buyout — in rural Iowa that converts separation into forced relocation.

Say this

Iowa enforces reasonable physician non-competes, and a 3-county, 24-month restriction sits within the range Iowa courts have upheld — so I treat this clause as binding and want the scope set now. I am asking that the covenant be narrowed to a 25-mile radius from the primary clinic for 12 months, with a carve-out for facilities where I already hold privileges. As written, a 3-county exclusion forecloses every practical employment alternative in the service area.

4Rural/FQHC differential — $20,000/year premium plus federal loan repayment facilitation

Financial Impact

$20,000/year differential — $60,000 over a 3-year term. Federal loan repayment adds $50,000–$100,000 in tax-exempt benefit over 2 years — a $110,000–$160,000 3-year package value vs. urban equivalents.

Current Terms

No rural premium; no loan repayment facilitation

The Ask

$20,000/year rural differential OR $50,000 federal loan repayment facilitation (FQHC eligible)

Fallback

Written commitment to facilitate the federal loan repayment application ($50,000/year, tax-exempt) without the $20,000 cash differential, with the rural differential revisited at the first annual review

Walk-Away Point

Federal loan repayment facilitation commitment minimum — costs the FQHC nothing; failure to facilitate it is a signal about employer sophistication on rural FM recruitment.

Say this

This FQHC designation makes me eligible for federal loan repayment of $50,000 per year, tax-exempt — facilitation costs the organization nothing and is standard in competitive rural recruitment. The 2025 national family medicine data shows rural roles carrying a 5–15% differential above urban base rates, and this offer includes neither. I am asking for a $20,000 annual rural differential plus a written commitment to facilitate the loan repayment application.

5Compensation model switch — require physician consent and 180-day notice

Financial Impact

Prevents a $15,000–$30,000/year deferred pay cut via structural limitations imposed by the panel cap — $45,000–$90,000 over the three years following a year-2 conversion.

Current Terms

Employer may convert to pure wRVU model after year 2 on 60 days notice

The Ask

Any compensation model change requires physician written consent and 180-day notice; physician may terminate without penalty if change is unacceptable

Fallback

Mutual written consent plus 180-day notice for any model change, dropping the penalty-free exit right if the employer will not concede all three protections

Walk-Away Point

Mutual consent requirement is the minimum. Unilateral model conversion without consent or penalty-free exit right is not acceptable.

Say this

Section 4.7 lets the organization convert me to a pure wRVU model after year 2 on 60 days notice. With the panel capped at 1,800 patients, my production ceiling is roughly 4,500 wRVUs — below the 4,800 bonus threshold — so that conversion is a $15,000 to $30,000 annual pay cut I cannot offset with effort. I need any compensation model change to require my written consent with 180 days notice, plus a penalty-free exit right if the proposed model is unacceptable.

6Tail coverage — employer-funded on any separation

Financial Impact

$8,000–$15,000 contingent liability elimination — roughly $2,700–$5,000 per year of accrued exposure over a 3-year tenure, with the full amount landing at separation. Combined with sign-on clawback, total exit cost is $15,000–$28,000 without this protection.

Current Terms

Physician solely responsible for tail costs on separation

The Ask

Employer provides tail on any separation, OR employer-initiated termination without cause triggers employer tail obligation

Fallback

Employer-funded tail on employer-initiated termination without cause, plus a $10,000 tail allowance escrowed over 2 years vesting to cover voluntary departures

Walk-Away Point

Employer tail obligation on employer-initiated termination without cause is the minimum. Voluntary departure tail can remain physician responsibility if total package is acceptable.

Say this

Iowa outpatient family medicine tail coverage runs $8,000 to $15,000, and combined with the 2-year sign-on clawback my total exit exposure reaches $15,000 to $28,000. I want employer-funded tail on any separation. At minimum, employer-initiated termination without cause must trigger the employer tail obligation — I should not carry a five-figure cost for a separation the organization initiates.

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.
Available with full analysis — $97

Unlimited Q&A

Example question

Is the 15-mile non-compete enforceable if I want to work at a freestanding ED 12 miles away?
As written, probably not — and that is leverage. For agreements entered or renewed on or after September 1, 2025, Texas law caps physician non-competes at 5 miles from your primary practice location and 12 months, with a mandatory buyout capped at your annual salary. A 15-mile radius is three times the statutory limit. Ask for the clause to be rewritten to the statutory caps with the buyout amount stated — the leverage is at signing, before you live with a lockout later.

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.

Available with full analysis — $97

This report is confidential and prepared solely for the physician who submitted this contract. Figures are estimates derived from the terms provided and 2025 national benchmarks for this specialty — they are projections, not an offer or a guarantee of compensation.

This analysis is for informational purposes only. ClauseLine provides data and benchmarks — not legal advice.

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