How I Doctor with Dr. Graham Walker The RVU Trap: How Hospitals Use Productivity Metrics to Keep Physicians in the Dark, with Contract Attorney Dennis Hursh
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
What You’ll Learn in This Episode:
- 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 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/