What is the difference between guaranteed base salary and total compensation potential in a physician offer?

Guaranteed base salary is the fixed recurring cash paid on your regular pay cycle regardless of billing volume during the guarantee period. Total compensation potential combines base salary with conditional wRVU productivity bonuses and quality incentives that depend on hitting volume or performance targets; one-time sign-on, relocation, or loan-stipend payments are separate conditional items governed by their own retention schedules.

How does a wRVU productivity threshold work in a physician contract?

An employer sets an annual work Relative Value Unit (wRVU) threshold and a dollar conversion factor per wRVU above that threshold. You should verify whether the threshold is pro-rated for ramp-up, PTO, and CME weeks, which Medicare Physician Fee Schedule year defines the wRVU weights, and when the guaranteed base converts to pure productivity.

What is the difference between a guaranteed salary and an income guarantee draw?

A guaranteed salary is earned compensation with no repayment balance if collections start slowly during ramp-up. An income guarantee draw is an advance against collections where a shortfall between collections and the monthly draw may, depending on whether the draw is recoverable or forgivable, become a balance that you repay or work off over a multi-year forgiveness schedule.

Who pays for malpractice tail coverage when a physician leaves a practice?

If the employer provides an occurrence policy, claims from your tenure remain covered after departure without a tail endorsement. If the employer provides a claims-made policy, continued coverage after departure requires either a reporting endorsement (tail insurance) or prior-acts (nose) coverage from your next employer; the contract specifies whether the physician or the employer pays for tail upon resignation, non-renewal, or termination without cause.

What documents should a physician request before signing a Letter of Intent (LOI)?

Before signing an LOI, request the full Physician Employment Agreement, the Compensation & wRVU Calculation Exhibit, the Sign-On, Relocation & Loan Stipend Promissory Note, the Malpractice Certificate & Tail Coverage Addendum, the written Clinic Hours & Call Schedule, and the Benefits Summary & HPSA eligibility documentation.

Healthcare & Life Sciences · Candidate guide

How to read a physician offer, before you sign

Two offers with the same headline figure can differ by more than $100,000 in guaranteed first-year cash once you separate base salary, wRVU thresholds, income draws, and exit liabilities.

Direct answer

Read every physician offer in four separate buckets before comparing totals: (1) Recurring fixed cash (stated annual base salary plus unconditional stipends, checked against how many months the guarantee lasts), (2) Scheduled Year-1 fixed cash (recurring fixed cash plus Year-1 sign-on payments, checked against early-departure repayment clauses), (3) Conditional production or quality pay (wRVU, collections, or quality bonuses kept in a separate scenario), and (4) Exit costs & non-cash terms (claims-made malpractice tail responsibility, negative-accrual draw recovery, restrictive covenants, relocation caps, and loan stipends).

Prepared by the Colwyn Group Healthcare & Life Sciences Desk · Reviewed 2026-11-06. We recruit physicians for direct-hire and contract mandates nationwide. Use the private 2-offer comparison worksheet to run your own numbers in the browser.

4 physician pay structures
10 LOI questions
6 documents to request
Gross cash arithmetic only · Not legal or tax advice

01 · Compensation structures

Four ways physician pay is built

Most offers use one of these structures, or a blend. Each one puts the risk somewhere different.

Guaranteed base

A fixed salary that doesn’t move with volume.

Where the risk sitsIn how long the guarantee lasts, and whether base can be reset or treated as an advance.

Confirm in writingMonths guaranteed · whether base can be reset · any bonus on top

Base + wRVU threshold

Salary plus a set rate for every wRVU above a threshold. Below the threshold you’re paid base only.

Where the risk sitsThe threshold and the rate decide what the bonus is worth.

Confirm in writingThreshold · rate per wRVU · who credits and audits wRVUs · how often it’s reconciled

Total compensation potential

A headline that adds base and production pay at some level of volume. It’s a target or a ceiling, not a salary.

Where the risk sitsPostings rarely say how much of the headline is guaranteed.

Confirm in writingWhich part is base · what volume reaches the headline · whether any of it is guaranteed

Income guarantee, then production

A minimum income for a set period while you build a panel, then production pay or an ownership buy-in.

Where the risk sitsIn what happens when the floor ends: repayable shortfalls, how production is measured, how a buy-in is priced.

Confirm in writingLength and amount · whether a shortfall is repayable · buy-in method, timing and exit terms

Same band, different promise

A bigger headline can sit on a smaller base. Compare what each offer guarantees before you compare the totals.

02 · Before you sign

Ten questions to ask before you sign a letter of intent

An LOI sets out the main terms before the full agreement is drafted. Take these to the employer, and ask for every answer in writing.

Exit cost: money you could owe, or have to spend, if you leave.

Which parts of this letter are binding?
An LOI can carry exclusivity or confidentiality terms. Ask what binds you, and for how long.
Terms
What is the base, and for how many months is it guaranteed?
A base with no guarantee period can’t be compared with one that has it. Ask what happens when the period ends.
Scheduled cash
How is variable pay calculated?
Ask for the wRVU threshold, the rate per wRVU or the collections formula, who audits production, and how often it’s paid.
Conditional cash
Is the base an advance against production?
If it is, ask whether a shortfall is carried forward, taken from later pay or reset, and what you owe if you leave.
Exit cost
What are the schedule and call terms?
Clinic days, the hours counted as full time, call frequency (1 in 6 weekends, say), call pay and holidays. Get them in the agreement.
Workload
What are the sign-on and relocation terms?
The amount, when it’s paid, the forgiveness schedule, and which ways of leaving make it repayable.
Exit cost
Which malpractice cover applies, and who pays tail?
Claims-made or occurrence, the limits, the retroactive date, and who pays for tail in each way you might leave.
Exit cost
What restrictive covenants apply?
Radius, duration, scope, and whether they still apply if you’re let go without cause. Have your attorney read the clause.
Restriction
What support and benefits are stated?
Staffing, CME money and time, paid leave, retirement match, when health cover starts, and any loan repayment program.
Listed, not added
What’s the timeline, and which documents will I get?
Ask for the full draft agreement and the compensation exhibit, a named contact, and time for your own attorney to review it.
Documents

Open the 2-offer comparison worksheet

03 · Document checklist

Six documents to request before you sign

A letter of intent summarizes headline numbers, but the schedules and exhibits govern how you are paid and what happens if either side ends the agreement early.

Documents to request from an employer before signing a physician employment agreement
Document	Exact terms to verify in writing
01. Full Draft Physician Employment Agreement	Term length, guarantee duration in months, without-cause notice period (for both physician and employer), and whether base salary can be reduced or converted to a draw during the initial term.
02. Written Compensation & wRVU Exhibit	Exact wRVU threshold, dollar conversion factor per wRVU above threshold, CPT/modifier credit rules for APPs or shared visits, reconciliation frequency (quarterly vs. annual), and whether negative balances carry forward.
03. Sign-On, Relocation & Loan Stipend Promissory Note	Gross payment schedule, pro-rata monthly vs. cliff forgiveness schedule, and whether repayment is waived if the employer terminates without cause or closes the clinic site.
04. Malpractice Certificate & Tail Coverage Addendum	Whether coverage is occurrence or claims-made, policy limits (e.g., $1M/$3M), and who pays for the reporting endorsement (tail insurance) upon expiration, resignation, or termination without cause.
05. Clinic Hours, Call & Coverage Schedule	Scheduled patient contact hours vs. protected administrative time per week, paid weeks worked per year after PTO/CME, weekday and weekend call ratio (1 in N), and separate call stipend rates.
06. Benefits Summary & HPSA / Loan Repayment Eligibility	Health plan effective date, 401(k)/403(b) employer match vesting schedule, CME allowance and paid CME days, and facility HPSA score if applying for NHSC or state loan repayment programs.

04 · Worked arithmetic & formulas

How the arithmetic works

Recurring fixed cash = annual base + other fixed annual cash: Only unconditional recurring cash. Bonuses, production pay and reimbursements stay out.
Scheduled Year-1 fixed cash = recurring fixed cash + Year-1 sign-on: Assumes you stay employed and each payment condition is met. Check what you’d repay if you left early.
Conditional scenario = recurring fixed cash + the conditional amount you type: Kept separate from the fixed-cash lines. The worksheet doesn’t model wRVU thresholds, conversion rates or collections.
Per paid hour = cash ÷ (paid hours a week × paid weeks a year): A unit conversion. For an hourly offer, multiply the rate by paid hours and paid weeks first, then enter the result as annual base.
Listed, not added = relocation, reimbursements, benefits, equity, paid leave inside base: They matter, but they aren’t comparable cash, so they sit beside the totals and never inside them.
Principal after a year = principal − amounts you chose to apply: Never below zero. No interest, fees or capitalization.

Hypothetical example$200,000 annual base + $20,000 first-year sign-on = $220,000 scheduled first-year cash, then $200,000 a year if the terms continue. An optional $50,000 productivity scenario stays separate.

Hypothetical example$100 an hour × 32 paid hours a week × 48 paid weeks = $153,600 at those assumptions. Different guarantee periods aren’t like for like: if one offer guarantees base for 12 months and the other for 24, note it before you read the two columns as equals.

Gross cash arithmetic only. Not tax, legal or financial advice. Everything on this page is the figures you typed, added and divided. It isn’t market data, a comparison across specialties or a recommendation, and it leaves out taxes, benefits, equity and contract terms such as repayment, tail coverage and restrictive covenants. Have an attorney who represents physicians review any agreement before you sign.

05 · Live mandates

What current Colwyn physician postings state

Individual advertised ranges and extracted terms on currently published Colwyn Group physician mandates (18 active postings in this build). These are individual employer postings — not a national salary survey, market average, or statistical benchmark.

Current advertised Colwyn Group physician mandates
ID	Mandate & Location	Advertised Compensation & Basis	Stated Schedule, Call & Incentives
COL-2026-005	Clinical Psychiatrist – Interventional & Neuropsychiatry (open for relocation) Laguna Beach, CA · Full-time · Closes December 31, 2026	$450,000–$500,000 per year (total compensation potential; includes ~$200,000 base + productivity incentives)	Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain · Incentives & support: RVU / productivity incentives
COL-2026-006	Primary Care Physician – Pod Leader (open for relocation) - San Jose/ North Hollywood, CA North Hollywood, CA · Full-time · Closes December 31, 2026	$300,000–$360,000 per year	Credentials: Active state license required · Incentives & support: Relocation assistance
COL-2026-007	Medical Director I (Geriatric medicine Physician) - Elk Grove, CA (open for relocation) Elk Grove, CA · Full-time · Closes December 31, 2026	$300,000–$370,000 per year	Credentials: Active state license required · Incentives & support: Relocation assistance
COL-2026-008	Orthopedic Extremity Surgeon – Inpatient / Acute Care (open for relocation) - Houston, TX Houston, TX · Full-time · Closes December 31, 2026	$700,000–$750,000 per year (total compensation potential)	Credentials: Board Certified / Board Eligible (BC/BE) · Active state license required · Incentives & support: Relocation assistance
COL-2026-014	Chief Medical Officer (CMO) – Bilingual Chinese Monterey Park, CA · Full-time · Closes December 31, 2026	$255,000–$345,000 per year	Credentials: MD or DO degree · Active state license or eligibility to obtain
COL-2026-017	Medical Doctor – Medical Cannabis Evaluations Bonita Springs, FL · Full-time · Closes December 31, 2026	$100–$125 per hour	Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license required
COL-2026-019	Anesthesiologist — Outpatient Ambulatory Surgery Center (On‑Site) Jefferson City, MO · Full-time · Closes December 31, 2026	$370,000–$520,000 per year	Schedule & call: No on-call · Monday–Friday · Incentives & support: Sign-on bonus
COL-2026-020	Pulmonologist Prescott, AZ · Full-time · Closes December 31, 2026	$325,000–$450,000 per year	Credentials: MD or DO degree · Active state license or eligibility to obtain
COL-2026-034	Orthopedic Surgeon – Sports Medicine Bergen County, NJ · Full-time · Closes December 31, 2026	$500,000–$600,000 per year	Credentials: Board Certified / Board Eligible (BC/BE)
COL-2026-043	Primary Care Physician (Internal Medicine / Family Medicine) Buffalo, NY · Full-time · Closes December 31, 2026	$209,000–$225,000 per year	Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain · Incentives & support: Sign-on bonus · Loan repayment / forgiveness
COL-2026-051	Outpatient Telehealth Staff Psychiatrist (Adults 18+) 100% Remote Albany, NY · Full-time · Closes December 31, 2026	$260,000–$290,000 per year	Tax classification: W-2 · Schedule & call: Monday–Friday · Telehealth / remote delivery · Credentials: Board Certified / Board Eligible (BC/BE)
COL-2026-052	Outpatient Telehealth Staff Psychiatrist – Hybrid (Adults 18+) Manhattan, NY · Full-time · Closes December 31, 2026	$260,000–$290,000 per year	Tax classification: W-2 · Schedule & call: Telehealth / remote delivery · Credentials: Board Certified / Board Eligible (BC/BE)
COL-2026-055	Obstetrician-Gynecologist (OB/GYN) Central Valley, CA · Full-time · Closes December 31, 2026	$500,000–$650,000 per year	Tax classification: W-2 or 1099 · Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Incentives & support: Sign-on bonus · Relocation assistance · Loan repayment / forgiveness · RVU / productivity incentives · Visa sponsorship: H-1B / J-1 visa sponsorship mentioned
COL-2026-057	Interventional Pain Physician Scottsdale, AZ · Full-time · Closes December 31, 2026	$450,000–$550,000 per year	Schedule & call: Monday–Friday · Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain
COL-2026-066	Internal Medicine Primary Care Suwanee, GA · Full-time · Closes December 31, 2026	$350,000–$350,000 per year	Schedule & call: Monday–Friday · Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain · Incentives & support: Sign-on bonus · Relocation assistance · Loan repayment / forgiveness · RVU / productivity incentives
COL-2026-067	Family Medicine Primary Care Metro Atlanta, GA · Full-time · Closes December 31, 2026	$350,000–$350,000 per year	Schedule & call: Monday–Friday · Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain · Incentives & support: Sign-on bonus · Relocation assistance · Loan repayment / forgiveness · RVU / productivity incentives
COL-2026-068	Dermatologist Metro Atlanta, GA · Full-time · Closes December 31, 2026	$350,000–$400,000 per year (total compensation potential)	Credentials: Board Certified / Board Eligible (BC/BE) · MD or DO degree · Active state license or eligibility to obtain · Incentives & support: Sign-on bonus · Relocation assistance · RVU / productivity incentives
COL-2026-069	Radiologist (Remote) Houston, TX · Full-time · Closes December 31, 2026	$450,000–$550,000 per year	Schedule & call: Telehealth / remote delivery · Credentials: Board Certified · MD or DO degree · Active state license required · Incentives & support: RVU / productivity incentives

Physicians & Medical Directors Psychiatry & Behavioral Health Dental, NP/PA & Allied Health Optics, Photonics & Engineering Executive & Corporate California New York Texas Georgia All Open Mandates

06 · Offer Evaluation FAQ

Frequently asked questions when reading a physician offer

Plain-English definitions of contract mechanics to review with your physician employment attorney before signing.

What is the difference between guaranteed base salary and total compensation potential in a physician offer?: Guaranteed base salary is the fixed recurring cash paid on your regular pay cycle regardless of billing volume during the guarantee period. Total compensation potential combines base salary with conditional wRVU productivity bonuses and quality incentives that depend on hitting volume or performance targets; one-time sign-on, relocation, or loan-stipend payments are separate conditional items governed by their own retention schedules.
How does a wRVU productivity threshold work in a physician contract?: An employer sets an annual work Relative Value Unit (wRVU) threshold and a dollar conversion factor per wRVU above that threshold. You should verify whether the threshold is pro-rated for ramp-up, PTO, and CME weeks, which Medicare Physician Fee Schedule year defines the wRVU weights, and when the guaranteed base converts to pure productivity.
What is the difference between a guaranteed salary and an income guarantee draw?: A guaranteed salary is earned compensation with no repayment balance if collections start slowly during ramp-up. An income guarantee draw is an advance against collections where a shortfall between collections and the monthly draw may, depending on whether the draw is recoverable or forgivable, become a balance that you repay or work off over a multi-year forgiveness schedule.
Who pays for malpractice tail coverage when a physician leaves a practice?: If the employer provides an occurrence policy, claims from your tenure remain covered after departure without a tail endorsement. If the employer provides a claims-made policy, continued coverage after departure requires either a reporting endorsement (tail insurance) or prior-acts (nose) coverage from your next employer; the contract specifies whether the physician or the employer pays for tail upon resignation, non-renewal, or termination without cause.
What documents should a physician request before signing a Letter of Intent (LOI)?: Before signing an LOI, request the full Physician Employment Agreement, the Compensation & wRVU Calculation Exhibit, the Sign-On, Relocation & Loan Stipend Promissory Note, the Malpractice Certificate & Tail Coverage Addendum, the written Clinic Hours & Call Schedule, and the Benefits Summary & HPSA eligibility documentation.

Comparing real offers?

Lay both offers side by side in the private worksheet, or ask our healthcare desk to review an offer in confidence. A Colwyn recruiter reads every request, and nothing about you goes to an employer until we have spoken and you have agreed.

Open the 2-offer comparison worksheet Request a confidential offer review

Browse 18 open physician mandates on the Physicians Hub