A doctor signs on for one clinic and later learns the employer can reassign them across town, legally, because of one clause they skimmed. Jillian Vestal, who specializes in doctor contracts, joins Dr. Michael Jerkins to break down the terms that quietly decide where you work, when you work, and where you're allowed to go next.
She starts with the phrase that appears in nearly every agreement and protects almost nothing: "at the discretion of the employer." It can hand over your location, your schedule, your call, and even your pay. Jillian separates a real salary review, where both sides revisit the number against survey data, from a vague clause that just lets the employer decide. She also dismantles the fear that hiring an attorney turns the negotiation combative, and the belief that a doctor can read the contract themselves. The work isn't reading the words; it's catching how provisions cross-reference and cancel each other out.
On money, she demystifies MGMA: why employers depend on it to justify pay as fair market value, and how an internal cap like a 60th percentile ceiling can be more conservative than the market supports. Her reframe is that "I want more" goes nowhere, while differentiation moves offers, whether that's bilingual ability, niche training, or a skill that opens a service line. She also flags that anesthesiology has climbed the most over four years, and that pay is rising while productivity expectations largely aren't.
Should doctor non-competes exist at all? Should doctors be using AI to review and negotiate their contracts? Are doctors negotiating the right pieces of their contract?
One theme anchors the conversation: the parts of a contract that shape a doctor's life the most are rarely the parts they negotiate. Verbal promises don't survive a dispute; the MGMA median isn't the right target for a new attending, and the first contract is the cheapest one to get right.
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