Should I negotiate a physician contract by email or by phone?

Use both. Email first so the ask is documented and specific, then offer a short call. Email also gives the recruiter something concrete to carry into a compensation committee, which is usually what has to happen anyway.

How much should I counter above the offer?

Anchor to data rather than a percentage rule. Ask for the number your specialty, geography, and setting support, and be able to name the source and year. An ask you can defend survives committee review. A round number pulled from air does not.

Will negotiating cost me the job offer?

Rescission over a professional, data-anchored counter is uncommon, and employers generally expect some negotiation. The more useful risk to weigh is the reverse: an employer who reacts badly to one respectful counter is showing you how they handle disagreement later.

Can I negotiate if the employer says the contract is standard?

Often yes, on individual points. Rigidity has increased as employment consolidated into large systems [1], but exceptions still get made, particularly where the role is hard to fill.

Is the signing bonus taxable, and do I repay it if I leave?

It is generally treated as taxable compensation, and most agreements require repayment inside the commitment period, commonly one to three years [9]. Ask whether repayment is prorated and whether it is calculated on gross or net, and consult a CPA on tax treatment.

What if I have no competing offer?

Negotiate on market data instead of leverage, and do not fabricate an offer. Named, dated benchmarks are more persuasive to a compensation committee than a vague reference to another opportunity, and they cannot be called.

Physician Negotiation Scripts: Salary, PTO, Bonus

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