The Truth About “Non-Negotiable” Physician Contracts

Hospitals often claim their physician contracts are set in stone—but is that really the case? Before you sign, it’s crucial to know which terms might be negotiable and which could lock you into unexpected obligations.

This is our standard contract. Unfortunately, we can’t make any changes.

If you’ve ever been handed an employment contract—especially by a hospital or large health system—you may have heard this phrase. You might have asked whether you could redline the agreement or have time to let an attorney review it, only to be met with a firm response: No, we can’t negotiate. Please send us a signed copy this week.

But is this really true? And if it is, does that mean that understanding the contract—or having an attorney review it—is pointless?

Can a Hospital Employment Contract Be Negotiated?

When a hospital says its contract is non-negotiable, it may be telling the truth—sort of. In many cases, the hospital can negotiate the contract but doesn’t want to. Whether a contract is actually up for negotiation depends on two main factors:

1. How much does the hospital want you to work there?
2. How much do you want to work there?

A hospital that urgently needs to fill a position may be more open to discussions—even if it initially insists otherwise. Meanwhile, smaller hospitals tend to negotiate more often than bigger health systems. Large health systems often take a firmer stance against negotiation because they have a large volume of employees, a vast candidate pool, and contracts meticulously drafted by in-house attorneys. Thus, they prefer standardization over making case-by-case adjustments. Smaller hospitals, in contrast, tend to be more flexible. That said, even in a large health system, there may be some wiggle room—especially for certain contract provisions.

What Should You Focus On?

Even if the contract isn’t negotiable, it’s still important to understand what you’re signing. Some provisions will have a direct impact on your day-to-day job and long-term career.

Term Provisions: How Long Are You Committing?

The contract’s term provision dictates how long your agreement lasts. Many physicians assume this is just standard language, but the difference between a one-year, three-year, or indefinite contract matters. Knowing your commitment upfront can prevent surprises down the road.

The Termination Provisions: How Can You Leave?

A termination provision explains how you or your employer can end the agreement. Some questions to consider:

• What notice do you need to give if you want to quit?
• Can your employer terminate you without cause?
• If you leave, will you owe money back, such as signing or retention bonuses?

While an employer may be inflexible about the notice period, there may be room to negotiate exit terms—especially regarding financial obligations after resignation.

Restrictive Covenants: What Will Limit You?

Restrictive covenants— such as non-competition, non-solicitation, or non-disparagement clauses— aim to prevent you from taking certain actions during and after your employment. These provisions are common in physician employment contracts and may be hidden amongst other clauses. 

Employers may refuse to remove all of the restrictive covenants, but they might compromise on:  

• The geographic scope (e.g., “10 miles from the practice location)
• The services covered (e.g., limiting only certain medical specialties instead of all medical work) 

Indemnification and Liability: Who Is Responsible?

Even if your employer provides malpractice insurance, your contract may push certain liabilities onto you. These provisions are often buried in boilerplate language, but that doesn’t mean they’re unimportant. While a hospital may refuse changes, you should at least know what risks you’re assuming.

Final Takeaway: Understanding Is Just as Important as Negotiating

Whether you can negotiate your contract depends on how much the hospital wants you—and how much you want the job. Some terms may be flexible, while others are truly non-negotiable.

But understanding what you’re signing is critical, even if nothing can be changed. A contract isn’t just a formality—it shapes your career, financial obligations, and future opportunities. Physician agreements often contain legal nuances with long-term implications. A healthcare attorney can identify red flags, clarify complex terms, and ensure you fully understand key provisions like restrictive covenants, liability clauses, and termination terms. Even without negotiation, an informed decision protects your interests and gives you confidence in your next step.

See our related videos about contract reviews.

Reviewing a physician contract requires careful attention to detail and an understanding of healthcare law. Our attorneys help physicians assess their contracts, negotiate when possible, and make informed decisions. If you’re in one of the states where we have licensed attorneys, schedule a consultation with a member of our team.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.