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Sample Report

General Surgery Contract — Sample Analysis

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Contract Analysis · General Surgery

sample-general-surgery-contract.pdf

Moderate Risk

0 = physician-favorable · 100 = extreme risk

MODERATE
4 High2 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

$344,350 – $385,612

Mid-range: $344,350

Gross $485,000 – $543,116 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.

Take-home at median production is an estimated $344,350 on $485,000 gross — identical at P25 production, because the 8,200 wRVU bonus threshold sits above the median production of 6,918 and the base is all this contract pays in a typical year. At P75 production the bonus lifts gross to $543,116 and take-home to $385,612. The single expense line is the 29% combined effective tax rate — federal, employee payroll, and Kentucky's 4% flat income tax. The uncapped malpractice tail ($40,000–$80,000 at exit) is a separate contingent cost not included in this table.

Executive Summary

This contract pays a base salary of $485,000 with a $58/wRVU productivity rate above an 8,200-unit annual threshold. Against the 2025 national general surgery benchmarks, the base is strong — above the median base of $418,754 and just under the P75 of $493,269 — but the conversion factor is not: $58/wRVU sits below the P25 of $61.30 and $15.98 below the median of $73.98. At the median production of 6,918 wRVUs the bonus never triggers, leaving total compensation at $485,000 against a market-median figure of $511,794 — $26,794 behind, with the gap widening to $137,648 per year at P75 production.

Trauma call is the largest single dollar gap. Section 6.1 places the physician in a 1-in-4 trauma rotation with no separate compensation — approximately 91 call shifts per year. Community hospital trauma call market rates run $1,500–$2,500 per 24-hour shift, which values the obligation at $136,500–$227,500 per year, approximately $182,000 at the midpoint — roughly 38% of the base salary delivered without pay.

The subspecialty case problem compounds the call issue. The physician performs bariatric, hepatopancreatobiliary (HPB), and colorectal procedures — all commanding 10–25% premium compensation in market-rate surgical contracts because of higher technical complexity and longer fellowship training. The contract treats a laparoscopic cholecystectomy and a distal pancreatectomy identically on the fee schedule. For a surgeon with HPB fellowship training, this misalignment can represent $25,000–$40,000/year in undercaptured value.

The contract includes a non-compete: 24 months following separation, covering the hospital's "surgical referral service area" with no fixed radius stated. The state-specific enforceability assessment for Kentucky — including the current case law and the negotiating play it supports — appears in the Non-Compete section of this report.

Key Red Flags

  • $58/wRVU conversion factor is below the 2025 national general surgery P25 of $61.30 (median $73.98) — a bottom-quartile rate on every productivity dollar
  • 8,200 wRVU bonus threshold exceeds the national median production of 6,918 — a median-producing surgeon earns zero bonus under this plan
  • Trauma call 1-in-4 with no separate compensation — market rate $1,500–$2,500/24h; $136,500–$227,500/year of market value, approximately $182,000 at the midpoint
  • Subspecialty cases (bariatric, HPB, colorectal) paid at flat general surgery rate — 10–25% premium market standard
  • Non-compete covers an undefined "surgical referral service area" for 24 months — no fixed radius stated in the contract
  • Tail coverage uncapped — Kentucky general surgery tail runs $40,000–$80,000

Key Strengths

  • Base salary of $485,000 exceeds the 2025 national general surgery median base of $418,754 and approaches the P75 of $493,269 — a strong guaranteed floor
  • At P25 production (5,014 wRVUs), the guaranteed base pays $114,064 above the market-median figure of $370,936 — real downside protection in low-volume years
  • 90-day bilateral without-cause notice is symmetric, and call days do not count against the 20-day PTO allowance

Compensation Analysis

HIGH

Your $/wRVU vs the market

Your effective rate of $70.11/wRVU sits at the 42nd percentile for this specialty. The shaded band is the national middle 50% (P25–P75).

$61.30$73.98 median$94.13You: $70.11 (42nd 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.

$485,000$370,9365,014wRVU · P25$485,000$511,7946,918wRVU · median$543,116$680,7649,202wRVU · P75At your contract rateAt the specialty-median rate

Model

Base Salary + wRVU Bonus

Base Rate

$485,000 / year

Shift differentials: No trauma or emergency call differential defined — all call work at standard wRVU rate

wRVU Rate vs Benchmark

The contract conversion factor of $58/wRVU sits below the 2025 national general surgery P25 of $61.30 — the median is $73.98 and the P75 is $94.13 — a bottom-quartile rate on every productivity dollar. The high base masks it at low volume: at P25 production (5,014 wRVUs) the contract pays $485,000 against a market-median $370,936 — $114,064 ahead. At median production (6,918 wRVUs) the contract pays $485,000 against $511,794 — $26,794 behind. At P75 production (9,202 wRVUs) it pays $543,116 against $680,764 — $137,648 behind. The 3-year cumulative gap at median production is $80,382. The 8,200 threshold compounds the rate problem: it sits above the national median production of 6,918, so a typical year produces zero bonus.

Multiplier: $58.00/wRVU · work RVU

Sign-on Bonus

$30,000

3-year pro-rated clawback — $20,000 owed before year 1, $10,000 before year 2, $3,333 before year 3

CME Coverage

$3,500/year CME allowance, 5 CME days — consistent with professional-society guidance for surgical CME funding

Productivity Bonus

$58/wRVU on all wRVUs above 8,200 annually (quarterly reconciliation)

Net Take-Home

Gross (P25 – P75)

$485,000 – $543,116

Mid: $485,000

Classification

W-2

Drives the expense math

Estimated take-home

$344,350 – $385,612

Mid: $344,350

Expense lineAnnual rangeNote
Estimated taxes (federal + payroll + state)$140,650 – $157,504W-2: federal + employee payroll + KY (29% effective).

Assumptions

  • Gross scenarios anchored to the 2025 national general surgery production percentiles — 5,014 (P25), 6,918 (median), 9,202 (P75) wRVUs; the bonus pays only above the 8,200 threshold
  • W-2 effective tax rate of 29%: federal + employee payroll + Kentucky 4% flat
  • Employer-provided health plan and malpractice coverage during employment; the uncapped tail is excluded here and covered in the Malpractice section
  • No employer retirement match assumed — not specified in contract

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

Trauma call compensation — per-shift stipend or annual guarantee

Section 6.1 mandates 1-in-4 trauma call with no separate pay. Community hospital trauma call market is $1,500–$2,500/24-hour shift. At approximately 91 call shifts annually, the uncompensated market value ranges from $136,500 to $227,500. This is the largest single gap in the contract.

"Add a trauma call stipend of $2,000 per 24-hour shift, paid monthly, for all trauma call coverage. Alternatively, a $60,000 annual trauma call stipend paid quarterly provides a defined alternative."

Subspecialty fee schedule for bariatric, HPB, and colorectal procedures

Subspecialty procedures require fellowship training, carry higher wRVU values per case, and command 10–25% premium rates in market-rate contracts. Treating a distal pancreatectomy the same as a hernia repair misallocates the value delivered.

"Add a subspecialty tier: bariatric, HPB, and colorectal procedures credited at 1.15× the standard wRVU rate, or a separate fee schedule for subspecialty cases with a minimum 15% premium above the base rate."

OR time guarantee or compensation floor for hospital-side under-delivery

The contract sets an 8,200 wRVU threshold — above the 2025 national median production of 6,918 — but does not commit the hospital to provide adequate OR access. Without guaranteed block time, wRVU production is structurally dependent on hospital scheduling — a variable outside the physician's control.

"Add a guaranteed minimum of 1.5 days/week OR block time, or a compensation floor guarantee that does not reduce below base salary if hospital-controlled OR unavailability limits production below the 8,200 threshold."

Fixed non-compete geographic definition

The "surgical referral service area" language is undefined — neither the physician nor the hospital can map the restriction's scope at signing. Kentucky treats reasonable physician non-competes as binding (see the Non-Compete section for the state assessment), and an undefined area leaves the physician unable to plan a compliant exit.

"Replace 'surgical referral service area' with a specific radius (e.g., 20 miles from Riverbend's main campus) and confirm no secondary or affiliate campuses are included in the measurement."

Clause Analysis

HIGHTrauma Call — Required Without Compensation

"Physician shall participate in the trauma call rotation as assigned by the Chief of Surgery. The standard rotation schedule is one in four call assignments. Trauma call participation is included within Physician's compensation as described herein."

"Included within Physician's compensation" is the operative language confirming zero incremental pay. The 2025 national practice-management data shows community hospital trauma call rates of $1,500–$2,500 per 24-hour shift, and a 1-in-4 rotation produces approximately 91 call shifts per year — an uncompensated market value of $136,500–$227,500 annually, approximately $182,000 at the midpoint, roughly 38% of the base salary. This is the largest single economic gap in this contract.

Add a trauma call stipend of $2,000 per 24-hour shift, paid monthly based on actual shifts worked. If employer will not pay per-shift, request a $60,000 annual trauma stipend. Either amount is below market but creates a defined compensation element for a material work obligation.

HIGHSubspecialty Cases — Flat Fee Schedule

"All surgical procedures performed by Physician shall be compensated at the wRVU rate specified in this Agreement, regardless of procedure type or complexity."

"Regardless of procedure type or complexity" is the contractual confirmation that bariatric, HPB, and colorectal cases are paid identically to routine general surgery. Subspecialty procedures carry higher wRVU values per case (CMS assigns higher work RVU values to complex procedures) and command premium rates in market contracts because of training requirements, case duration, and billing complexity. For a surgeon performing 10–15 HPB or bariatric cases per month, the flat-rate structure underpays by $25,000–$40,000/year compared to a tiered fee schedule.

Request a subspecialty tier: bariatric, HPB (distal pancreatectomy, hepatic resection, bile duct reconstruction), and colorectal cases credited at 1.15× the standard wRVU rate. Frame as compensation for the fellowship investment and higher per-case value delivered to the group.

HIGHOR Time — No Guarantee or Compensation Floor

"Physician shall maintain a level of surgical activity consistent with Employer's expectations and patient volume. Employer shall endeavor to provide reasonable OR access."

"Shall endeavor to provide reasonable OR access" is not a commitment — it is an aspirational statement with no enforcement mechanism. The contract sets an 8,200 wRVU production expectation but makes no commitment to provide the scheduling infrastructure required to achieve it. If the hospital cannot staff sufficient OR technicians, OR suites are blocked for other service lines, or elective scheduling is closed due to census, the physician's production — and bonus — is reduced through no fault of their own.

Add one of two protections: (a) guaranteed minimum of 1.5 days/week OR block time with a written scheduling commitment, or (b) a compensation floor that holds the physician harmless if hospital-controlled OR unavailability prevents reaching the 8,200 threshold — e.g., if OR availability drops below 1.5 days/week for any rolling 90-day period, the threshold is pro-rated accordingly.

HIGHwRVU Bonus Threshold — Set Above Typical Production

"Physician shall receive a productivity bonus of $58.00 per work RVU for all work RVUs in excess of 8,200 during each contract year."

The 8,200 trigger exceeds the 2025 national general surgery median production of 6,918 wRVUs and approaches the P75 of 9,202 — a median-producing surgeon earns zero bonus under this plan. The marginal rate compounds the problem: $58/wRVU sits below the national P25 of $61.30, so even the production that does clear the threshold is paid at a bottom-quartile rate. At P75 production the bonus is worth $58,116, yet total contract pay of $543,116 still runs $137,648 below the market-median figure of $680,764 at that volume.

Lower the threshold to 6,900 wRVUs — in line with national median production — or raise the conversion factor to at least the P25 of $61.30, preferably toward the median of $73.98, so the productivity component pays at market.

MODERATEMalpractice Insurance — Uncapped Tail Liability

"Employer shall provide claims-made professional liability coverage during employment. Physician shall be responsible for all extended reporting period coverage costs upon any separation."

Kentucky general surgery tail premiums typically run $40,000–$80,000 at major carriers. Combined with the 3-year sign-on clawback, early departure from this contract can produce $50,000–$110,000 in combined exit obligations — a material constraint on the physician's ability to leave if circumstances change.

Request employer-funded tail on any separation. If employer will not provide full coverage, negotiate a $25,000 cap on physician responsibility. Escrow the physician's portion over 3 years of employment.

MODERATEFirst Assist Fees — Undefined

"The Agreement does not address compensation for first-assisting services provided by Physician on cases performed by other surgeons."

Many community general surgery practices involve first-assisting on partners' or specialists' cases. The contract is silent on whether first-assist wRVUs are credited to the physician's productivity total or compensated separately. Without this language, the hospital or group can request first-assist services with no compensation obligation.

Add explicit language: first-assist services are credited to the physician's wRVU total at the applicable CMS wRVU value for the assistant's professional component, or alternatively, a per-case first-assist stipend of $X is paid for each case where the physician assists.

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 a surgical practice with ongoing patient care commitments. The contract does not specify whether the physician continues to be scheduled during the notice period or whether compensation continues if scheduling is reduced. In a scenario where the hospital decides to end the relationship, the physician's schedule could be reduced during the 90-day window.

Add language that full compensation continues during the notice period regardless of OR scheduling adjustments. Employer may not reduce scheduling below 50% of baseline during the notice period without paying compensation through the full 90-day window.

Non-Compete

MODERATE

Exists

Yes

Radius

not specified

Duration

24 months

Governing State

Kentucky

Enforceability

Moderately Enforceable

Landmark cases: Charles T. Creech, Inc. v. Brown (2014, Supreme Court of Kentucky): Held continued at-will employment alone is not adequate consideration for a non-compete and that Kentucky courts will not blue-pencil/reform overbroad covenants, voiding the agreement. Citation confirmed 433 S.W.3d 345 (Ky. 2014).

Kentucky enforces reasonable physician non-competes (Enforceable; common-law reasonableness, physician/employee-favorable). Treat this as binding and negotiate the scope down now. Your not specified / 24 months terms sit within the range Kentucky courts have upheld, so a court would likely enforce them — your leverage is to narrow them before signing.

Malpractice Insurance

HIGH

Type

claims-made

Coverage Limits

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

Tail Coverage

Not provided — physician sole responsibility with no dollar cap

Tail Cost Estimate

$40,000–$80,000 (Kentucky general surgery, major carriers, 2025 pricing)

Request employer-funded tail on any separation. Also negotiate a consent-to-settle clause — surgical malpractice settlements without physician consent carry significant NPDB and credentialing consequences.

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, (6) loss of surgical privileges at Riverbend facilities.

Physician Rights

90 days written notice to terminate without cause. No physician right to terminate for cause if employer fails to pay compensation or fails to provide OR access. The OR-access gap and the 3-year sign-on clawback create significant economic barriers to exit during the first three years.

Add a physician right to terminate immediately for cause if employer fails to pay compensation within 15 days of the due date or fails to provide minimum OR access (as defined in a new OR guarantee provision). Add that employer-initiated termination without cause does not trigger the sign-on clawback.

Benefits & Leave

MODERATE

Health Insurance

Group health plan available — employee contribution applies; employer contribution not specified

CME

$3,500/year CME allowance, 5 paid CME days — consistent with professional-society guidance for surgical CME funding

PTO

20 days PTO per year; does not include CME days; call days do not count against PTO

Retirement

403(b) through Riverbend Health Network; employer match not specified

Disability

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

Malpractice

Claims-made coverage provided during employment; tail uncapped on physician (see Malpractice section)

Negotiation Approach

The trauma call gap is the highest-value item — $136,500–$227,500/year of uncompensated market-rate work, approximately $182,000 at the midpoint. Lead with it. The conversion factor is the second lever: $58/wRVU sits below the national P25 of $61.30 and the 8,200 threshold sits above the median production of 6,918, so the productivity plan pays below market at every realistic volume — bring the three-scenario numbers. Kentucky treats reasonable physician non-competes as binding, and the 24-month term sits within the range Kentucky courts have upheld — so trade definition for dollars: offer the fixed radius the hospital wants in exchange for call pay and the rate correction. The subspecialty premium and OR guarantee reinforce the value-for-value argument: you are delivering more value than a general surgery generalist, and the contract does not account for that.

Opening Move

"Section 6.1 puts me in a 1-in-4 trauma call rotation with no separate compensation. The 2025 national general surgery data shows community hospital trauma call at $1,500–$2,500 per 24-hour shift — that values the rotation at $136,500–$227,500 per year. Before I can accept the overall package, I need a defined trauma call stipend. I am prepared to discuss the amount and structure."

Key Principles

  • Lead with the 2025 national trauma call data — bring the percentile figures, not feelings. $1,500–$2,500/24-hour shift is a published market rate.
  • Frame subspecialty premium as compensation for fellowship investment, not as a demand for more money. "I trained for HPB specifically" is more effective than "I want more per case."
  • The OR guarantee is a recruitment leverage point — before hire, the hospital needs you. After hire, they can deprioritize OR time. Secure the OR commitment now.
  • Treat the non-compete as binding — Kentucky enforces reasonable physician non-competes and the 24-month term sits within the upheld range. The undefined "surgical referral service area" is the negotiable part: offer a defined 20-mile radius, which the hospital wants for certainty, in exchange for trauma call compensation.
  • Tail coverage is a manageable item — negotiate the cap, but do not let it block agreement on call pay and the conversion factor.

Sequencing

  1. 1Submit written counter-proposal on trauma call compensation as a standalone first ask
  2. 2Present the conversion-factor and threshold correction in writing, with the dollar gap at P25, median, and P75 production
  3. 3Raise subspecialty premium in the same conversation or the following meeting
  4. 4OR guarantee is a natural companion to the wRVU threshold — raise together
  5. 5Offer the defined non-compete radius as a trade for call pay — a fixed, enforceable boundary is something the hospital wants and you can concede
  6. 6Tail coverage and first-assist are final redline items

Negotiation Priorities

1Trauma call compensation — $2,000/24h or $60,000 annual stipend

Financial Impact

Approximately $182,000/year of market-rate call work uncompensated at the midpoint ($136,500–$227,500 range) — roughly $546,000 over a 3-year term. A $60,000 annual stipend recovers about one-third of market value, a defensible starting position.

Current Terms

Trauma call 1-in-4 included in standard compensation — no separate pay

The Ask

$2,000/24-hour shift trauma call stipend OR $60,000/year annual call guarantee

Fallback

A $1,500 per 24-hour shift stipend — the bottom of the published $1,500–$2,500 market range, roughly $136,500/year at 91 shifts — or a $40,000 annual stipend with a written 12-month review to revisit per-shift pay.

Walk-Away Point

$40,000 annual trauma stipend minimum. Below this, the uncompensated call burden erases the value of the above-median base salary.

Say this

Section 6.1 places me in a 1-in-4 trauma rotation — approximately 91 call shifts a year — with no separate compensation. The 2025 national general surgery data puts community hospital trauma call at $1,500 to $2,500 per 24-hour shift, which values that obligation at $136,500 to $227,500 a year. I need a defined trauma call stipend of $2,000 per shift, or a $60,000 annual guarantee, before the rest of this package works. I am prepared to discuss the structure.

2Conversion factor and bonus threshold — below-P25 rate, above-median trigger

Financial Impact

At median production the contract runs $26,794/year below the market-median rate — $80,382 over 3 years. At P75 production the annual gap is $137,648.

Current Terms

$58/wRVU on production above 8,200 wRVUs — rate below the 2025 national P25 of $61.30, threshold above the national median production of 6,918

The Ask

Conversion factor at $62/wRVU minimum (above the P25 of $61.30) and bonus threshold lowered to 6,900 wRVUs

Fallback

Threshold at 7,400 wRVUs with the rate unchanged, or the rate at $61.30 (P25) with the threshold unchanged — either materially improves bonus economics at realistic volumes.

Walk-Away Point

Threshold no higher than 7,800 wRVUs, or rate no lower than $61.30. Below both, the bonus is decorative.

Say this

The 2025 national general surgery median is $73.98 per wRVU, and this contract's $58 sits below the P25 of $61.30. The 8,200 threshold also sits above the national median production of 6,918 wRVUs, so at typical volume the productivity component never pays. I am asking for the conversion factor at $62 and the threshold at 6,900 — that aligns the plan with national production data.

3Non-compete — fixed 20-mile radius, 12-month term, single campus

Financial Impact

Contingent rather than annual: if enforced at separation, a 24-month exclusion from the local market puts up to two years of median general surgery earnings at relocation risk — $502,947/year, roughly $1,005,894 over the restriction period. Cutting the term to 12 months halves that exposure.

Current Terms

24 months covering the undefined "surgical referral service area" — no fixed radius stated

The Ask

20-mile radius from the main Riverbend campus only, 12-month duration

Fallback

A 20-mile radius at 18 months, or 25 miles at 12 months — either way a defined restriction measured from the main Riverbend campus only, with no affiliate or secondary campuses included.

Walk-Away Point

25-mile radius and 18-month duration maximum, measured from a single named campus.

Say this

Kentucky enforces reasonable physician non-competes, and a 24-month term sits within the range Kentucky courts have upheld — so I am treating this clause as binding. As written, it covers an undefined surgical referral service area that neither of us can map. I will agree to a defined 20-mile radius from the main campus for 12 months — a restriction you can actually rely on — if we can reach agreement on trauma call compensation.

4Subspecialty premium — 15% tier on bariatric, HPB, colorectal wRVUs

Financial Impact

On 1,500 subspecialty wRVUs per year, a 15% premium adds $13,050/year — $39,150 over 3 years. The figure scales with subspecialty case mix.

Current Terms

All surgical wRVUs credited at flat $58/wRVU regardless of procedure complexity

The Ask

Subspecialty procedures (bariatric, HPB, colorectal) credited at $66.70/wRVU (1.15×)

Fallback

A 10% subspecialty premium — $63.80/wRVU on bariatric, HPB, and colorectal cases — or the full 1.15× tier applied to HPB cases only, with bariatric and colorectal added at the first annual review.

Walk-Away Point

10% subspecialty premium minimum. Below this, the rate differential does not compensate for the fellowship training premium.

Say this

I trained in HPB specifically, and this contract credits a distal pancreatectomy at the same $58 per wRVU as a hernia repair. Market-rate surgical contracts carry a 10 to 25 percent premium for bariatric, HPB, and colorectal work. I am asking for those cases to be credited at 1.15 times the standard rate — $66.70 per wRVU — which adds roughly $13,050 a year at my current case mix.

5OR time guarantee — 1.5 days/week block or wRVU threshold adjustment

Financial Impact

Protects the bonus trigger. At P75 production the wRVU bonus is worth $58,116/year — $174,348 over 3 years — and none of it is payable if hospital scheduling holds production below the 8,200 threshold.

Current Terms

No OR time commitment; 8,200 wRVU threshold with no hospital-side delivery guarantee

The Ask

1.5 days/week minimum OR block time, OR wRVU threshold pro-rated if OR availability drops below minimum

Fallback

A scheduling side letter naming 1.5 days/week of OR block time as the operating target, paired with automatic pro-rating of the 8,200 wRVU threshold for any rolling 90-day period where availability falls below that level.

Walk-Away Point

Pro-rated threshold adjustment is the minimum — if OR is unavailable, bonus threshold must be reduced proportionally.

Say this

The contract sets an 8,200 wRVU threshold but only says the hospital will endeavor to provide reasonable OR access — that is not a commitment. My bonus production depends entirely on scheduling I do not control. I need either a guaranteed 1.5 days per week of OR block time in writing, or language that pro-rates the 8,200 threshold whenever hospital-controlled availability falls below that level.

6Tail coverage — cap physician responsibility at $25,000One-time

Financial Impact

One-time exposure of $40,000–$80,000 at separation; a $25,000 cap removes $15,000–$55,000 of contingent cost — roughly $5,000–$18,000/year if reserved over a 3-year horizon. Combined with the sign-on clawback, year-1 exit costs currently exceed $60,000.

Current Terms

Physician solely responsible for all tail costs — no cap

The Ask

Employer provides tail on any separation, OR physician responsibility capped at $25,000

Fallback

Physician responsibility capped at $30,000, or employer-funded tail whenever the employer terminates without cause — either converts the open-ended $40,000–$80,000 exposure into a known number.

Walk-Away Point

$30,000 physician cap maximum. Above this, combined exit costs (tail + clawback) exceed $60,000 in year 1.

Say this

Kentucky general surgery tail runs $40,000 to $80,000, and this contract leaves all of it on me with no cap. Combined with the 3-year sign-on clawback, a year-one exit could cost more than $60,000. I am asking for employer-funded tail on any separation, or at minimum a $25,000 cap on my share, escrowed over three years.

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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