Physicians Stuck in Bad Contracts & Non-Competes
Hospital employees, particularly physicians and specialists, are experiencing frustration and powerlessness when negotiating contracts. They face externally imposed 'fair market value' calculations, restrictive non-compete agreements, and a system where executive compensation appears prioritized over frontline staff compensation. This creates a sense of unfairness and limited agency in their professional lives.
SOURCES (60)
“I got a job offer from an in person outpatient psych facility 25 minutes away from me! I rotated with this office during my clinicals and loved every aspect of this place!! This is my dream job! They would have me be a 1099 independent…”
“Hey guys, I have been a PA in Arizona for 7 years and have been working for pain management practice for approximately 3 years. I have what I think is a pretty good job with great pay but I am struggling lately because we hired another midlevel practitioner about 10 months ago who's schedule continues to be significantly lighter than mine. This afternoon, for instance, I have 10 patient encounters (2 of them being new patients) ending with my last patient visit at 4:30pm.. The newer mid-leve”
“Is anyone willing to share their salary/experience at memorial Sloan Kettering NYC? For both inpatient and surgical? Is it based off years of experience? There is very little information online and the salary ranges on the job postings aren’t helpful. Thank you! submitted by /u/TinyUmpire9664 [link] [comments]”
“The agency contract will probably be the annoying part, not the specialty change. If L&D is still your goal after that keep applying even if you hear no a few times. It only takes one manager to say yes.”
“Between the metrics micro-management and corporate group fatigue, I’m getting close to my breaking point. I’m thinking about making the jump to locums or independent community shops, but I honestly do not have the time or energy to fight off traditional recruiters or comb through standard job boards after a brutal night shift. A colleague of mine said they just uploaded their CV to an automated app physician copilot job agent that text-matches and aggregates openings quietly in the background so”
“we should be thinking about this exam in the context of the past decade, as people are becoming more supportive of socialism and unions. especially as it relates to medical residents who we know work absurdly dangerous hours for basically minimum wage. and more recently repression of speech at universities and by professional organizations some of these practice scenarios about being overworked/burnt out, being treated poorly by programs, are so MIND BOGGLING to me. this exam pretends that advoc”
“i’m at a group private practice now and i do think my end goal is to have my own private practice, but i want to get a few more years and some experience under my belt. and a better understanding of insurance lol. i’d love to hear peoples stories of how they got into private practice, what the process was like, is it worth it? it seems so intimidating but so many people do it, so i know it’s not impossible submitted by /u/Sensitive-Fly-7110 [link] [comments]”
“How have you guys been negotiating pay increases? Our teams raises this year were not great (inpatient clinical). Any strategies? Competetors are paying a minimum, entry level RD roughly $2000 more than what our team is getting paid (i am 5 years tenured, colleagues are about 1-3 years tenured). Central FL if that helps submitted by /u/Puzzleheaded-Test572 [link] [comments]”
“Hi everyone, I searched the sub but didn’t find anything recent. I am considering leaving my current position (ortho surgery/urgent care) for an ortho trauma position; wondering about anyone’s experiences as an ortho trauma PA. Currently, I get maybe 1 OR day every 1-2 months (all arthroscopic shoulder and knee). Main role is ortho urgent care, practicing autonomously with surgeon available for questions as needed. Occasional outpatient clinic. Schedule 4 days/week ranging from 8 hr to 12 hr shi”
“It’s really industry specific. I am a dentist and that shit doesn’t seems to work at all for dentistry”
“This is the old car mechanic right out of High School vs Surgeon earnings story. Not until their 50’s does the surgeon blow the doors off the mechanic. But then it’s truly significant. Not sure that the graph plots hold true in today’s day and age.”
“Facility practicing outpatient heme/onc in Hawaii is offering $130/hr w2 plus covered flights, rental car, and housing which they will pay directly (not available as stipend. In an 8 hour day, they want me to see 11 patients for follow up, 1 bone marrow biopsy, and 3-4 telephone follow up calls. I think the schedule is pretty crazy for an 8 hour day, but just want to get your thoughts on the compensation and the work load. What would be a reasonable work load and compensation these days? s”
“I live in NJ which is a HCOL area. $300k or less seems low for a specialist in my area. Do you think those salaries are higher in NJ?”
“As an NP (depending on the state you live in) you can absolutely create a plan and execute it and not just follow orders. BUT OP will need to move if he wants to go that route, take the time to learn his specialty and then open a practice. It won’t take 10 years though. California is a restricted NP practice authority state. However, OP, you’re surrounded by full practice authority states and would only need to move the next state over after you finish your NP.”
“Is there any true value is traditional private practices taking commercial insurance & medicare, Not DPC or concierge. That down the line you could sell the practice for profit? For example a practice with 2 MD & 2 midlevels? submitted by /u/sunnypurplepetunia [link] [comments]”
“What things should a new PA keep in mind/look for when considering that first job? Any specific questions to ask? submitted by /u/Training-Watch-3299 [link] [comments]”
“Has anyone bought their clinic from corporate when corporate was going to close down the clinic? submitted by /u/Temperature-Savings [link] [comments]”
“Does anyone know for certain if 96127 is wRVU value for physicians to be reimbursed or just the practice? I’ve gotten mixed feedback looking into online and the coding department is worthless where I work. It would make more sense that physicians get reimbursed since I document the scores, talk about follow up, etc when I use it, but if anyone has a firm answer I’d appreciate it! submitted by /u/IncreaseStriking8805 [link] [comments]”
“Hey Reddit. I’m a PA-C in the midwest. For two years I’ve been at an FQHC Urgent Care. I’m fully autonomous, and oftentimes I am the only provider staffing the clinic (due to FQHC turnover, constant budget cuts, among other factors). The loan repayment incentive to work here has been nothing short of amazing, but it is not what I envisioned for my career. I am good at Urgent Care medicine. But, I am bored in Urgent Care medicine. The constant influx of patients, getting yelled at for not having”
“Hi, has anyone worked for DMC in Michigan? Sinani Grace, Harper, or any of the other locations and care to share their experience? Was offered a hospitalist job with the group. submitted by /u/ShoppingObjective666 [link] [comments]”
“I just noticed I still have people I haven’t worked with since covid times. Do they get contacted every time I get credentialed with a new job? My jobs have alternated between charging insurance and not, I’d be embarrassed if they’ve been contacted years after I asked them to be references just because I needed to get re-credentialed for a job submitted by /u/ThickTelevision2536 [link] [comments]”
“any MDs in this sub who were PAs first and can offer advice or insight? I work hard, I self study, I am always asking my attendings a million questions or looking things up and trying to understand the underlying cellular structure/pathophys/mechanisms of disease states. I enjoy the nuances of medicine, I enjoy understanding things at the cellular level, and I don’t like to think of things in the binaries of “prescribe x for y”. I love learning, and I am very frustrated by the limitations of my”
“Considering leaving a big hospital system to work for a FQHC. Anything I should know? Pros and cons? submitted by /u/Ok_Cause9057 [link] [comments]”
“Hello all. I am a FM trained hospitalist. I do home hospice on the side and have been doing so for around 2 years. My question is to those in a similar position or PCPs. I have been getting MARs from facilities for my patients asking me to sign off on every page. Is this standard practice? I review each patients meds in my EMR every 2 weeks when we meet for our interdisciplinary groups. I think this practice redundant and more appropriately a responsibility of the facility doctor. Thanks in adva”
“Looking to make the transition from Neurosurgery for a better work-life balance. Currently at a private practice neurosurgery group, been here almost 5 years. Received a verbal offer for an inpatient surgical oncology rounding role at a tertiary care center. I enjoy neuro and being first assist in surgery, but not a fan of clinic or being on call and having to go in in the middle of the night. These night cases don’t happen regularly, but I’ve had a fair share of 15-16hr days and weeks working 7”
“I’m a new graduate PA currently working in pain management, and I’ve been here for about six months. I recently received an offer for an outpatient GI position that I’m seriously considering accepting. How would you recommend I approach telling my supervising physicians that I’m leaving? I can’t imagine they’ll be very happy about it, and I want to handle the conversation as professionally and respectfully as possible. submitted by /u/nbell1998 [link] [comments]”
“I've been living in NYC for over a decade, and I'm facing the music that being here is an awful financial decision- between the high cost of living, my student loan burden, taxes, and just the uniquely awful work culture here, its difficult to justify. The only problem is I have a great community of friends that I've built up through the years, and I don't want to start from scratch by moving somewhere more affordable. I also really love this place. I've looked into "tra”
“I'm in the process of starting my own PP and I'm excited/worried about how much upside this path has. Can you share 1. Revenue 2. How long you've been working in your PP 3. How much of your income comes through insurance vs. private pay, and 4. (if you're willing to share) what your average insurance payout is? (Specifically asking for florida in this last one). Thanks in advance! submitted by /u/Thetree33 [link] [comments]”
“Background: FM + addiction Field: Pain/Addiction in mental health at VA M-F with occasional walk-in coverage, seeing 6-8 patients per day max with 1-3+ no-shows per day. I don’t prescribe opiates Compensation: around 236k with EDRP (40k per year for 5 years reimbursed non-taxed + 20k sign-on Pros: Chill schedule, VA benefits, VA insurance/pension/retirement Experience: 1 year out of fellowship I bill for counseling, psychotherapy, and I supervise students/residents/fellows, I present at IOP. HCO”
“Hello friends! I’m a new grad PA currently looking & interviewing for jobs. This one job I interviewed for sounds enticing, but idk if it’s actually a good deal. Here’s the breakdown: - base salary of $90k - monthly bonus of around $1k - $1,300 - offers 401k but no health or dental insurance - 2 wks pto/yr - student loan repayment thru HRSA ~ $68k over 2 years - covers relocating costs & license fees - sign a 3-4 yr contract I think what’s throwing me off the most is that the base salary”
“EEP (Eugene Emergency Physicians) here - we just made it through an attempted CMG takeover and came out the other side intact, still an independent democratic group, but short a few docs and PAs. We’re in the process of hiring back up, but it’s tricky doing so in the middle of the year since most new grads have already figured out their plans. So I wanted to ask the EM subreddit: how do other small democratic groups recruit physicians and PAs? Word of mouth? Ads on the EM Docs Jobs Facebook grou”
“Hey. I need to run this by other PAs to see if this is normal. I started with my current practice in jan 2026 (first job). They hired me on with another PA who has sadly left since we started. They hired both of us and trained us for about 3 months, then we were slated to be on our own. We had a meeting before going live because they didnt hire a MA to help us now the owner of the company assured us someone would help us. our MAs are not the best to be honest, but everyone was busy. So, that mad”
“Hi everyone! I’m in the early stages of opening a practice and would really appreciate advice from anyone who’s been through this especially in Texas. Right now, I’m leaning toward opening a psychiatry/wellness telehealth practice. Because of Texas ownership laws, the plan is for my supervising physician to own 51% of the practice, with me owning the remaining 49%. I have meetings scheduled with healthcare attorneys over the next few days, but I’d love to hear from people with real world experie”
“I love psych. My job isn’t that bad, but I couldn’t stay here more than a couple years honestly. It’s been 9 months and I have learned a lot but did not get really any training and feel like I just got cut loose early on am constantly filled with self-doubt. Other than the times I get an opportunity to talk with colleagues or my MD, it feels like I have been entirely self taught with textbooks, podcasts, CME, etc. I also feel mislead about compensation and will not see any RVU bonuses, maybe eve”
“Voluntarily surrendering a license usually means you agree to never practice again in exchange for the board dropping their investigation. That document you found is the sanitized board summary, a trial would have aired way worse details.”
“Learned my lesson and want to provide insight so people think deeply before considering joining Ivy Sounded good during the negotiating process but quickly went sideways upon starting… - 3 month ramp to full caseload for a new grad turned into “your caseload is to small and we need you to see more patients” by Week 3 - clinic director coincidently texting me to complete notes on my PTO days - PTO being denied due to “lack of coverage” despite having several float PTs - Regional director requesti”
“Hi everyone, does anyone currently work as a PCP around the major hospitals in the Philadelphia area, including suburban or rural locations? I’d really appreciate your advice on what base pay and RVU targets family medicine physicians should negotiate, what contract terms or situations to avoid or not accept, and whether it’s possible to decline being on call. How many patients per day are you seeing and do you have inbox coverage? Any other important tips or “watch outs” would be greatly apprec”
“I’m a UK GP planning to move to Canada in the next few months and I’m looking into how family practices are usually run, particularly in Ontario. I’m hoping to join a FHO+ model. I really dislike admin, so I’m interested in a model where the MOA handles the admin side (phones, booking patients, referrals, paperwork with supervision, forms etc.) and a nurse helps with clinical tasks such as vaccinations, chronic disease reviews, and preventative care. I was also wondering if nurses commonly help”
“I manage anoutpatient tertiary hospital based oncology infusion center and we got a new CFO within the last year. The push for the CFO has been reduce drug costs. Month over month, we are above budget because 1) our patient volume increased and 2) we add new drugs to formulary for new lines of therapy that cost a lot. He doesn't really care about the reasoning, or the thought that this is outpatient with insurance auth and will have revenue. He just wants us to spend less. The only we can sp”
“Depending on how large or small is her family GP practice. Every clinic, hospitals, etc is required by law to conduct its audit every quarterly I think. However, in reality, onyl large clinics or facilities hire independent entity to audit their employees. Small private practice with only a handful of employees, usually the lead physician or the owner who does the audit just to satisfy the requirement. They are not as strict in doing their own practice audit for obvious conflict of interest reas”
“I wanted to repost this individual’s post here in an effort to inform and educate those to what/who is “killing” our profession. submitted by /u/Ok_Profile_1086 [link] [comments]”
“I have been in ED/UC for 12 years. Living in Tuscaloosa and its not a very good city for opportunities/ decent pay. Looking to possibly move into a new specialty specifically GI with the hope its a better setting then my current UC. It appears to be just outpatient. Any GI PAs give some info about day to day, number of patients, bread and butter diagnoses, usual hours that sort of thing. I'm sure pay greatly differs between cities and no idea what the starting would be here. Also if I do int”
“I'm residing in a foreign country with my daughter for the past 2.5 years. I work in the medical field. My first contract was a private owned clinic and it was horrible, got out of it with a labor lawsuit (that I filed) . Second was a big chain hospital and I only stayed 3 months probation after which I got a better offer from another private clinic , more money, flexible hours .. all the stuff I wanted. I took the offer and it was a 1 year contract, nearing its end now. This company is tank”
“And what is that plan? and at what age? multiple practice package sell to private equity? practice and invest in sp500? never own and be an associate paying things down? it feels like with today’s debt load- that retirement is very far away. submitted by /u/Ok-Many-7443 [link] [comments]”
“Please specify if you’re in a HCOL area, how many certifications/specializations you have and years of experience. submitted by /u/Accomplished-Sign-31 [link] [comments]”
“Just got my first PA offer in private practice neurosurgery. Did a rotation with the group and loved it, 25 pt a day (PA goes in for history and exam and reviews imaging with patients, doc comes in after PA presents pt and finalize/ plan)Monday Tuesday, with scribes writing notes, 5-6 OR cases Wednesday and Thursday, Friday left open for any add on cases (1-2 during my rotation). Curious what everyone thinks. Position Neurosurgery private practice Indiana/Kentucky 1.0 FTE First assist in the OR,”
“Wondering if my EM brethren have any insight. Currently have the option of working a 3 x 12 schedule in a very cushy West coast resort town ER. Historically it’s very seasonal and we have months where it is low volume. I would be able to work only day shift 8a-8p and can stack my shifts to get the same4 days off every week. The rub is that’s it’s several hours from my family and they don’t want to relocate. So, I would have to commute up, work my shifts and then come back. Hospital provides hous”
“Would anyone be willing to share wRVU compensation structures they’ve encountered? Total cash comp right now is about 145K with 10 years of Cards experience. No current RVU structure. submitted by /u/mistamooo [link] [comments]”
“of those, 16 years I have been in interventional spine and pain management. Joined the owner of the practice right after he started it in 2010 as he was drowning (NC). Since then we have grown to five locations and I have been in a managerial clinical coordinator role for the last eight years or so. I screen, interview, negotiate and hire the APP‘s as well as train them. I deal with clinical managing situations. Perform pretty much any non-flouro injections as well as EMG/NCV’s. He is sole Physi”
“Has anyone used some type of professional company to get their own private practice set up? Either taking care of or walking you through more of the finer detail things - like setting up g-suite/website/social media, necessary permits/licenses, getting EMR set up, etc. Any recommendations would be great! submitted by /u/AdventurousOnion1234 [link] [comments]”
“My job doesn’t require BCPS and I’ve been out of residency for 4 years practicing at an academic medical center on overnights. I’m planning on leaving to go elsewhere and figured I’d take BCPS now to make myself more competitive. I have a comprehensive BCPS review from 2020 but does anyone have any suggestions on free or cheap BCPS guides or prep work? I’m taking it in 2 months and originally I was just going to wing it but I think I should review a little bit of the more recent changes at least”
“I graduated 5 years ago and was one of the last to get credentialed with just a BS. I can’t pick where to live due to my husband, and I have to use the military medical system to get my prescription every month. So living apart for school would be very challenging. like many, I got burnt out from outpt counseling which is what I’ve done since graduating. I really loved foodservice in college but I can’t find a decent paying job in that field. Some of my classmates got jobs with food/beverage com”