Before signing a physician assistant contract, a PA should understand the financial, clinical, and legal terms that will govern the employment relationship. The agreement may determine compensation, supervision and delegation requirements, malpractice exposure, scheduling obligations, termination rights, and post-employment restrictions. These provisions can affect both day-to-day practice and future career options.
Many physician assistant contracts use employer-favorable language or incorporate policies that are not included with the agreement. That can create unexpected income risk, regulatory concerns, or limits on professional mobility. A complete review should examine how the written terms operate in practice, not merely whether the salary appears competitive.
The questions below address the major provisions a PA should evaluate before accepting an employment or independent contractor position. They can be used alongside a detailed physician assistant employment agreement checklist to identify missing information, unclear obligations, and terms that may warrant negotiation or attorney review.
Questions About the Position, Scope, and Supervision
Are the Duties and Clinical Scope Clearly Defined?
The written job description should identify patient populations, procedures, practice settings, required certifications, administrative duties, and any expectations to work at multiple locations. Broad language such as “other duties as assigned” may allow responsibilities to expand beyond the role discussed during recruitment. Ask whether the employer can modify the job description unilaterally and whether a material increase in duties will affect compensation.
The agreement should also explain expected hours, call coverage, weekends, holidays, scheduling procedures, and floating requirements. Ambiguous scheduling language can permit an employer to increase workload or change locations without additional pay. Hospital-based PAs should confirm how call is assigned, whether response time or on-site coverage is required, and how call work is compensated.
How Will Supervision, Delegation, and Prescribing Be Managed?
Ask who will provide required supervision or collaboration and how availability, communication, chart review, and clinical escalation will work. The contract and incorporated policies should be consistent with the state rules governing the PA’s practice. Undefined supervision language can create problems when the arrangement described in the agreement does not match the employer’s actual clinical workflow.
Delegation and prescriptive authority should also be documented clearly. Confirm any controlled-substance limitations, co-signature requirements, internal approval procedures, or credentialing conditions. If the contract incorporates a handbook or clinical policy by reference, ask whether the employer can change those materials without the PA’s consent and how a change in scope will affect duties, productivity expectations, or liability.
Before accepting the position, the PA should compare the written role with what was represented in interviews and offer materials. The American Academy of Physician Associates also identifies practical questions to ask when assessing a PA job offer.
Questions About Compensation, Bonuses, and Benefits
How Is Compensation Calculated and Reconciled?
Physician assistant compensation may consist of a base salary, RVU production, collections, or a hybrid formula. For salary-based arrangements, ask whether the stated amount covers all clinical, administrative, and call responsibilities. For productivity arrangements, the contract should define the applicable metric, threshold, conversion factor, measurement period, payment schedule, and access to supporting reports. A focused PA compensation and productivity review can help determine whether those mechanics are complete and internally consistent.
RVU provisions should identify the type of RVU being measured and explain how coding changes, denials, or adjustments affect credited production. Collections-based formulas should define which receipts count, how payer delays and refunds are handled, and whether the PA receives post-termination collections. Under any model, ask whether the employer can audit or retroactively adjust pay, whether negative balances carry forward, and what happens when the employer’s staffing or scheduling decisions prevent the PA from meeting a target.
What Conditions Apply to Incentives and Benefits?
Signing bonuses, relocation assistance, loan repayment, and retention incentives often include service requirements and repayment provisions. Ask when each payment is earned, whether the obligation is prorated over time, and which termination events trigger repayment. The agreement should also clarify whether repayment is due immediately and whether the employer may deduct the amount from final compensation where permitted.
Benefits should be evaluated as part of total compensation. Confirm health insurance eligibility, retirement contributions, paid time off accrual and carryover, continuing medical education support, and reimbursement for licensing, DEA registration, professional dues, and credentialing expenses. If benefits appear only in a handbook, determine whether the employer may change them during the contract term and whether the employment agreement guarantees any specific contribution or allowance.
Questions About Malpractice Coverage and Liability
Ask whether the employer provides claims-made or occurrence malpractice insurance, who pays the premium, and what policy limits apply. Claims-made coverage generally requires protection to remain in place when a claim is reported, while occurrence coverage applies to covered incidents occurring during the policy period. The contract should identify the insured parties and explain whether coverage extends to all assigned locations and duties.
If the policy is claims-made, determine whether tail coverage will be required when employment ends and who must purchase it. Because that responsibility can create a significant post-employment expense, the allocation should be stated expressly rather than left to employer policy. PAs can review the practical differences in this guide to tail insurance obligations for physician assistants.
Indemnification language also deserves careful review. Ask whether the PA must reimburse the employer for claims, defense costs, billing issues, regulatory matters, or alleged contractual breaches. Broad provisions may shift liability even when the conduct occurred within assigned duties, so the agreement should be evaluated together with the malpractice policy and any separate defense or repayment obligations.
Questions About Termination and Post-Employment Restrictions
The agreement should define its initial term, any automatic renewal process, and the circumstances under which either party may end the relationship. Ask whether without-cause termination is available, how much advance notice is required, and whether the PA must continue working throughout the notice period. For-cause provisions should use specific standards and explain whether the PA receives notice and an opportunity to cure an alleged breach.
Termination may affect more than the final work date. Confirm how earned bonuses, unused paid time off, outstanding collections, malpractice tail coverage, and benefit eligibility are handled. Repayment obligations for signing bonuses, relocation assistance, or loan benefits should identify the triggering events and whether the amount decreases over time. A separate guide to terminating a physician assistant contract explains additional notice and exit issues.
Restrictive covenants can limit future employment after the relationship ends. Review the duration, geographic area, prohibited activities, covered locations, and events that trigger a non-compete. Non-solicitation clauses may apply to patients, employees, or referral sources, while confidentiality provisions can restrict the use of employer information. The practical impact should be assessed in light of the PA’s specialty and local employment market; this resource on physician assistant non-compete agreements provides a more detailed framework.
Questions About Workload, Performance, and Credentialing
Performance expectations should be objective and measurable. Ask how patient volume, quality measures, documentation, coding, attendance, and productivity are evaluated, as well as who controls the resources needed to meet those standards. If compensation or continued employment depends on a target, the agreement should explain the measurement period, reporting process, and consequences of a shortfall.
Administrative obligations can also affect productivity. Confirm documentation deadlines, electronic medical record requirements, inbox coverage, meetings, training, and other nonclinical duties. If these tasks are substantial, determine whether they are included in scheduled hours and whether they count toward productivity expectations.
The contract should assign responsibility for licensing, credentialing, payer enrollment, and privileges, including application costs and deadlines. Ask whether compensation begins on a fixed date or only after credentialing is complete, and what happens if a delay is outside the PA’s control. These concerns are examined further in the guide to PA credentialing delays and contract risks.
Questions About Contract Review and Dispute Terms
Before signing, obtain the complete agreement and every document incorporated by reference. That may include the compensation plan, job description, benefit materials, malpractice policy information, bonus terms, restrictive covenant exhibits, handbook provisions, and prior offer letter. Verbal assurances should be compared with the final written terms because the signed agreement may state that it replaces earlier discussions.
Governing law, venue, and dispute resolution provisions determine how future disagreements will be handled. An arbitration clause may require disputes to be resolved outside court, while a forum-selection clause may require proceedings in a particular jurisdiction. Ask who pays arbitration or legal costs, whether remedies are limited, and whether the agreement includes notice or internal dispute procedures.
An attorney-led physician assistant contract review can evaluate how the provisions interact and identify language that may create financial, regulatory, or post-employment risk. Review is most useful before the agreement is signed, when unclear terms can still be addressed and proposed revisions can be considered.
Frequently Asked Questions
What documents should a PA review besides the main employment agreement?
A PA should request every document incorporated into the contract, including the compensation plan, job description, benefit materials, bonus terms, malpractice coverage information, handbook provisions, and restrictive covenant exhibits. Prior offer letters and written recruitment promises should also be compared with the final agreement.
How can a physician assistant verify a productivity compensation formula?
The contract should identify the productivity metric, threshold, conversion factor, measurement period, payment schedule, and reporting rights. The PA should also ask how coding changes, denied claims, refunds, employer-controlled scheduling, and post-termination production affect the calculation.
When might a physician assistant need malpractice tail coverage?
Tail coverage may be needed when a claims-made malpractice policy ends and protection is required for later-reported claims arising from prior work. The contract should state whether tail is required, who must purchase it, and what coverage limits apply.
What happens to a signing bonus if the PA leaves early?
The answer depends on the repayment clause. A PA should confirm which termination events trigger repayment, whether the obligation is prorated as service is completed, when payment becomes due, and whether the employer may seek repayment from final compensation where permitted.
How should a PA evaluate a non-compete before signing?
The PA should review the restriction’s duration, geographic scope, prohibited activities, covered locations, and triggering events. Its practical effect should be considered in relation to the PA’s specialty, local employment options, and any related non-solicitation or confidentiality obligations.
Why seek attorney review before signing a physician assistant contract?
Attorney review can identify unclear compensation mechanics, repayment exposure, malpractice obligations, termination risks, and restrictions affecting future employment. Completing the review before signing gives the PA an opportunity to understand the agreement and consider proposed revisions before becoming bound by its terms.
Understand Your PA Contract Before You Sign
Chelle Law reviews physician assistant agreements for compensation, scope, malpractice, termination, repayment, and restrictive covenant risks.
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