Top 5 Mistakes NPs Make with their Employment Contracts

By Guest Blogger Leigh Ann O’Neill for Lauth O’Neill Physician Agency

When it comes time to take your first job, many nurse practitioners are excited to begin working, and start getting paid for what they’ve been trained to do.  Additionally, most folks have student loans to pay off, so getting some money in the bank seems like priority number one.  Don’t be mistaken, though.  When it comes to accepting your first nurse practitioner job, there are several key mistakes you want to avoid.

And spending the extra time and money to make sure your bases are covered will go a long way in avoiding costly set-backs down the road.  Finally, doing your homework with respect to your employment contract has the potential to pay off in spades, setting you up for financial and professional success in your new job.

Here are the top 5 mistakes you want to avoid as you enter your next nurse practitioner employment contract.

1. Don’t fall victim to the “this is all just standard language” line.

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The health care field is full of generous and well-intentioned people.  Many health care providers have spent so much time in their education and training that they become accustomed to having individuals who are in their employer role also serving primarily as their mentors.  These mentor/ mentee relationships make it difficult to imagine that any employer would ever want anything other than the very best for you and your future.  That is why it is hard to be skeptical of a potential employer who tells you that you probably don’t need to have your employment contract reviewed by a lawyer, because “it’s all just the standard contract language that everyone agrees to”.

The tricky part here comes in the fact that your potential employer is not only your mentor for now, in fact legally speaking, they are somewhat of an adversary.  By definition, when two parties enter into an agreement with one another, they are thereby protecting their own respective rights under that agreement.  Therefore, your potential employer can’t protect your best interests while they are also protecting their own.  You owe it to yourself to make sure your best interests are also protected to the full extent possible.

2. Be sure your production or bonus compensation structure is well-defined, and is as favorable as possible.

More and more, nurse practitioners are being offered compensation structures that are based somewhat, if not entirely, on their production.  In some cases compensation is based on Relative Value Units (“RVU’s”), in others it is based on some other metric of billings or collection.  In all cases, the compensation language in the contract you sign must be specific enough that should you ever need to make an argument as to why you were not paid enough during a particular time frame, you would be able to concretely do so.  Often, compensation language is left very vague in writing, and is somewhat better explained verbally in contract negotiation discussions.  It is important to remember that no matter how satisfied you are that the potential employer explained the compensation structure adequately, if it’s not all in writing in the agreement, it technically means nothing.

3. Don’t agree to vague contract language that may require you to fulfill certain administrative or other non-clinical duties you don’t intend to be responsible for.

In the same vein as vague compensation language is vague contract language when it comes to what is expected of you on a day-to-day basis.  Every NP employment agreement will contain a specific section outlining what the employer expects you to do under the contract.  This may be purely limited to the clinical duties, or it may include administrative and marketing responsibilities.  Whatever your expectation is of the duties required of you, make sure they are clearly spelled out in your employment agreement.  This level of clarity will allow you to point back to your contract if ever necessary in the future to deflect from taking on additional work responsibilities without provision for additional compensation.

4. Make sure your employment contract’s termination language suits your circumstances well and allows you flexibility should you need it down the road.

Every NP employment agreement will also contain some section or provision on termination rights, such as your ability and the employer’s ability to terminate the contract under certain circumstances.  Often, the agreements will include a “without cause” termination provision.  It is important to make sure this is a mutual provision, enabling both the employer and you to terminate the agreement without cause.  This type of provision requires that the terminating party give the other party a certain number of days prior written notice.  It is important to be sure the termination notice period is one you are comfortable with.  For example, you may feel that 30 days is too short of an amount of time to find a new job if your employer terminates; on the other hand, you might feel like 180 days is too long of an amount of time to stay in a job you’re no longer happy with.

5. Ensure your daily work hours and on-call responsibilities are clearly set-out in your agreement.

Finally, it is critical that your weekly work hour minimum and on-call responsibilities are clearly outlined in your NP employment agreement.  The potential employer may have told you that a typical workweek includes 40 hours, and NPs in your same situation are typically on call once per month.  Again, bear in mind that these verbal representations hold no meaning once you sign your employment contract.  If you wish to hold your employer to any specific promise, it must be clearly established in your employment contract.

While this list illustrates many issues you should be aware of before you sign your NP employment agreement, it is by no means exhaustive.  Every contract is different and presents its own set of unique circumstances.  Only a thorough review of your contract by your own lawyer can ensure your best interests have been looked after.


Married to a physician, Leigh Ann O’Neill founded Lauth O’Neill Physician Agency when she recognised the importance of healthcare providers having someone in their corner who will guard their legal and financial interests.  Leigh Ann is an expert at helping NPs and PAs negotiate employment contracts.  If you are looking for help negotiating your employment agreement, reach out to her at or 317-989-4833.


You Might Also Like: 7 Things You Should Consider in a Nurse Practitioner Employment Contract


1 thought on “Top 5 Mistakes NPs Make with their Employment Contracts”

  1. Hi,

    I am an AGNP interviewing with a Neurology practice tomorrow, and I have a question, the practice I am interviewing with wants me to pay for my training with them. I am not sure what this means, I am only attending the interview for experience; however, is this a common practice?

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