What Physicians Wish They Had Known Before Signing Their First Contract

By DR Advisors | Physician's Trusted Advisor

We've reviewed contracts for physicians at every stage of their careers — fresh out of residency, mid-career and renegotiating, and a few who called us after a difficult exit, wishing they'd called sooner. Across all of those conversations, certain regrets come up again and again.

This post is a composite of what we hear most. Not one physician's story, but the pattern across hundreds of them — the things physicians consistently say they wish they'd understood before they signed their first contract.

"I Wish I Had Modeled Year 2"

This is the most common regret we hear. Physicians focus intensely on the Year 1 number and don't model what happens when the draw period ends and the productivity formula takes over. As we covered in our post on the Year 2 trap, the gap between expectation and reality at that transition is one of the most frequent sources of financial disappointment in physician contracting.

The fix is simple in hindsight: model Year 2 before you sign, using realistic productivity assumptions for your specialty and panel size. It's one of the easiest things to get right — and one of the most commonly skipped.

"I Wish I Had Understood My Non-Compete Before I Needed to Leave"

Almost every physician who calls us about a non-compete issue says some version of the same thing: they didn't think carefully about it when they signed, because they weren't planning to leave. Then circumstances changed — the position wasn't the right fit, family needs shifted, an opportunity came along — and the non-compete became a real constraint instead of a hypothetical one.

Map your non-compete against your actual life before you sign, not after you need to use it.

Use the Physician Contract Review Worksheet to think through these provisions before you're in the position of needing them. Download the Worksheet → Physician Contract Review Worksheet

"I Wish I Had Asked About Tail Coverage Explicitly"

Tail insurance comes up as a regret almost as often as Year 2 compensation. Physicians frequently assume their malpractice coverage works a certain way, only to discover the actual arrangement when they're calculating the cost of leaving. As we've covered in detail, this is one of the most financially significant provisions in any physician contract — and one of the easiest to clarify in writing before you sign.

"I Wish I Hadn't Been Afraid to Ask Questions"

Many physicians describe feeling like asking detailed questions about their contract would seem unprofessional, or would signal distrust of their new employer. In our experience, the opposite is almost always true. Thoughtful, specific questions about compensation structure, termination terms, and exit provisions are standard professional behavior — not a red flag to the employer. Employers who have a problem with a physician asking informed questions are, in most cases, telling you something important about how they operate.

"I Wish I Had Known What Was Actually Negotiable"

As we covered in our post on negotiation, one of the most consistent patterns is physicians either negotiating provisions that weren't going to move, or leaving genuinely negotiable provisions untouched because they assumed they couldn't be changed. Knowing the difference — what's a fixed policy versus what's a starting position — changes the entire negotiation.

"I Wish I Had Gotten a Professional Review Instead of Asking a Family Member or Friend"

This one is gentler but common. Physicians often have a friend, family member, or acquaintance who's "good with contracts" take a look before signing. The intention is good, but general legal or business experience doesn't translate to physician contract expertise. The provisions that matter most in a physician agreement — wRVU formulas, tail coverage structures, non-compete norms for medical practice — are specific to this field. A well-meaning general review often misses exactly the things that matter most.

Expert Advice: What's striking about these regrets is how preventable nearly all of them are. None of them required physicians to be contract experts themselves — they just required someone with the right expertise involved before signing rather than after a problem surfaced. That's the entire premise behind what we do.

Don't add your story to this list. Get a professional review before you sign. Book Your Physician Contract Review → Physician Contract Review

The Bottom Line

These regrets share a common thread: they're all about information that was available before signing but wasn't fully understood or acted on. Every one of them is preventable with the right review at the right time. If any of these sound familiar as you're evaluating your own offer, that's worth addressing now — not after you've signed.

Related reading: [The Year 2 Trap: Why Physicians Earn Less Than They Expected] | [What Is Tail Insurance — And Who Should Pay For It?] | [Non-Competes Are Negotiable — But Only Before You Sign]