Most physicians put significant thought and effort into reviewing and negotiating their employment contracts before signing. But what happens when you’ve started your new position, and now you’re noticing red flags: the call schedule is heavier than promised, your bonus formula doesn’t match what you understood, or the support staff and resources you were promised aren’t materializing? What can you do when your employer doesn’t seem to be living up to its obligations?
Step One: Go Back to the Contract
The first place to start is simple: take a look at the contract that you signed. Many employment agreements contain language that’s more nuanced than you may remember.
For example, here are some items that you should consider and review in your original agreement:
- Compensation: Is there a written formula for productivity bonuses, or was it left vague and open-ended?
- Call Duties: Does the contract set a maximum call frequency, or did it leave scheduling in the employer’s discretion?
- Support and Resources: Were staffing or facility resources described as a binding obligation or framed simply as expectations?
Understanding whether the issue is a true contractual breach versus a misunderstanding or miscommunication is critical before you escalate.
Step Two: Document What’s Happening
Start keeping detailed notes. If you were promised a call rotation of one week per month but are consistently on the schedule for two or more, write it down. If your wRVU reports don’t match what you expected, keep copies. Having a clear, factual record is critical, both for internal discussions and, if necessary, legal review later.
Step Three: Raise Concerns Professionally
Many problems can be easily resolved simply by communicating where you believe the employer is falling short of what’s obligated in the employment agreement. Approach your medical director, practice manager, or HR department with specifics. Keep the conversation professional and focused on patient care and fairness.
Some examples of how you could approach the conversation:
- “I understood the call coverage would be 1:4, but I’ve been consistently scheduled 1:2. Can we revisit this expectation?”
- “The bonus formula in my agreement specifies X. The calculation I received seems different than what’s in the agreement. Could we go over the numbers together?”
Often, employers will address these issues if they’re presented clearly and early. It’s important to remember that employers can make mistakes too; if the issue is the result of the employer’s honest mistake, it will likely be resolved quickly and cordially.
Step Four: Know Your Options if Problems Persist
If the employer resists or disputes your concerns, you may need to escalate:
- Contractual Remedies: If the employer is in breach, you may have legal remedies.
- Negotiation: Sometimes a mid-course renegotiation is possible, especially if both sides want the relationship to succeed.
- Exit Strategy: Review your termination provisions carefully. Most contracts require advance written notice (often 60–120 days), and if the employer is in breach, they will likely have a set period of time (often 30 days) to cure or fix the issue. Keep in mind that many employers may impose restrictive covenants, such as non-competes. Knowing these terms in advance allows you to plan your next steps strategically.
Step Five: Get Legal Support Early
It’s easy to think of contract review as something that happens only before you sign. In reality, many physicians benefit from counsel after employment begins. An attorney familiar with physician contracts can:
- Clarify whether the employer’s conduct is a breach.
- Help you frame communications with administration.
- Advise you on negotiation leverage and exit risks.
If the employer truly is in breach of the employment agreement, it is critical that you follow the process set forth in the employment agreement for a breach by the employer. Without doing so, you may jeopardize your rights for exiting the employment relationship or resolving the issue. Working with an attorney early can help ensure you follow the correct procedures.
Key Take Away
Signing your contract isn’t the end of the story but is only the beginning. If your new job isn’t aligning with what you believed was promised, you’re not powerless. By revisiting the contract, documenting your concerns, addressing issues professionally, and seeking legal counsel early, you can protect your practice, your career, and ultimately your patients.
