The RVU Trap: How Hospitals Use Productivity Metrics to Keep Physicians in the Dark, with Contract Attorney Dennis Hursh

Physician contract attorney Dennis Hursh has reviewed over 3,500 physician employment contracts in his career, so it’s safe to say he’s seen every legal trap, financial blind spot, and restrictive covenant that doctors typically face in their employment contracts. Dennis’ mission is simple: He wants to help doctors understand their true value and negotiate from a position of knowledge. In this How I Doctor conversation with Dr. Graham Walker, he opens up about the most common mistakes physicians make when signing contracts, especially early in their careers, and all the lessons he’s learned from reviewing physician contracts and negotiating on their behalf over his many year career.

Throughout the episode, Dennis shares eye-opening stories, including physicians being told they “underperformed” despite seeing full patient loads or being forced to pay back tens of thousands of dollars due to fine print tied to RVU thresholds. He also explains how some hospitals use outdated or opaque data to justify lower pay (exactly why we started Offcall!), and how contracts are increasingly written to favor employers under the guise of “standard terms.”

This conversation is a must-listen for any physician who’s negotiating a new contract, and especially residents and fellows who are entering the workforce. Dennis’ practical tips and negotiation framework will help any physician evaluate job offers more holistically by learning how to factor in quality of life, assess realistic productivity expectations, and consider the broader business model of medicine.

We’re excited to announce that Dennis is offering a special 10% discount for his legal services for all Offcall physicians. You can book a free consultation here, and be sure to mention “Offcall” during your appointment to claim your 10% discount!

Finally, Dennis wanted to make his decades worth of knowledge available to all Offcall physicians. So he’s compiled a Contract Negotiation Guide featuring helpful negotiation resources, key questions to ask during a negotiation, and practical pointers. This is a one-of-a-kind resource and it’s free and available exclusively for Offcall physicians. All you have to do is create an Offcall account below (or log-in if you’ve already done so) in order to access the guide below!

Physician Contract Negotiation Guide

If you’re thinking about renegotiating your physician employment contract but don’t know where to start, this is the perfect resource guide for you! Created by Dennis Hursh from Physician Agreements Health Law, consider this your roadmap when your physician contract is up for renegotiation.