Attorney Dennis Hursh has reviewed more than 3,500 physician contracts and has seen the same patterns again and again - doctors being underpaid, overworked, and legally trapped by language they didn’t know to question.

In this episode, Dr. Graham Walker talks with Dennis about how RVUs and non-competes are often used against physicians, and how to push back. They dive into the structural imbalance between hospitals and physicians, the myths of “standard contracts,” and the silent clauses that could cost you tens of thousands of dollars.

From shocking stories of RVU misreporting to seven-figure locums arbitrage, this episode unpacks how the business of medicine quietly undermines doctors’ financial stability and career flexibility. Dennis brings clarity and tactical advice for any doctor negotiating a contract. Whether you’re fresh out of residency, or already practicing and unsure if you’re getting a fair deal, there’s something in this episode for everyone.

If you’ve ever felt like your compensation didn’t reflect your work. Or if you’ve been told “this is just how it’s done”. This episode will show you how to reclaim your leverage and ask the right questions before you sign.

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.

Create an Offcall account (or log-in if you’ve already done so) in order to access the guide at https://www.offcall.com/learn/podcast/the-rvu-trap-physician-contract-red-flags-rvu-pitfalls-and-negotiation-tips-with-dennis-hursh

• Why “standard contracts” are a trap — and how to spot the clauses that limit your freedom or earnings
• How malpractice tail coverage can destroy your savings if you’re not careful
• The truth about RVU compensation and why most physicians never get the full picture
• How locums companies profit on your labor — and how to negotiate like a free agent
• The Stark Law loopholes and myths that employers use to shut down fair pay discussions

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!

🩺 Offcall is more than a platform — it’s a community. Join today!

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky

Dr. Jay Parkinson is a pediatrician and founder who’s been reinventing healthcare from the outside in for nearly two decades. From launching one of the first tech-enabled house call services in Brooklyn to pioneering virtual primary care with Sherpaa, Jay has always believed that doctors can design better systems. Now he’s back with Automate Clinic, a new venture training physicians to fine-tune clinical AI models with real-world judgment and insight.

In this episode of How I Doctor, Dr. Graham Walker talks with Jay about bucking the traditional medical career path, designing more human-centered systems, and what most startups (and health systems) still don’t get about primary care. They also dive into Jay’s new work building AI you can actually trust, and why the doctors best positioned to shape its future are the ones curious enough to break stuff and ask better questions. If you’ve ever wanted more freedom, more creativity, or more control in medicine then this one’s for you.

What You’ll Learn in This Episode:

• Why Jay bet on the iPhone, and not the EMR, as the future of medicine
• 
  
• What healthcare can learn from previous startups like Uber and Google
• 
  
• Why most doctor visits don’t need to happen in person and how to rethink the “front door” of care
• 
  
• How AI can surface consensus, not just “the right answer” and why that’s so powerful in medicine
• 
  
• Why design is a form of protest, and every patient deserves a more beautiful experience
• 
  

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky https://bsky.app/profile/drgrahamwalker.com

✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe

🟧 Follow Offcall on

LinkedIn https://www.linkedin.com/company/joinoffcall/

IG https://www.instagram.com/offcalldotcom/

TikTok https://www.tiktok.com/@offcalldotcom

Dr. Ami DeWaters is a hospitalist, medical educator, and one of the leading voices reimagining how we prepare residents for the realities of modern medicine. She’s an associate professor at Penn State College of Medicine that’s known for her sharp insights and deep commitment to building physicians who are not just clinically excellent, but also financially, professionally, and systemically fluent.

In this episode of How I Doctor, Dr. Graham Walker talks with Ami about the disconnect between what doctors are taught and what they actually need to succeed. From FTEs and RVUs to PSLF and prior auths, they unpack the hidden curriculum of becoming a practicing physician - and why not understanding how the system works is no longer an option. If you’ve ever felt like medicine handed you the keys without teaching you to drive, this episode will tell you how to take back control.

What You’ll Learn in This Episode:

• Why understanding FTEs is essential for your contract, your income, and your loan forgiveness
• How to negotiate your first job like a pro and the surprising reason your desk might be the first red flag
• The hidden power of residents to drive change and how one radiology resident helped redesign their entire overnight workflow
• Why every doctor needs to speak the language of RVUs, billing, and insurance regulation if they want to lead and not just survive
• The one lesson every intern should learn by the end of their first year

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky https://bsky.app/profile/drgrahamwalker.com

✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe

🟧 Follow Offcall on

LinkedIn https://www.linkedin.com/company/joinoffcall/

IG https://www.instagram.com/offcalldotcom/

TikTok https://www.tiktok.com/@offcalldotcom

Article Display Title (Social)