Family Physician Contracts in BC: Checklist

A family physician contract checklist in BC should do more than confirm a percentage split or start date. A useful agreement explains the working relationship, payment flow, clinic overhead, scheduling, professional responsibilities, medical-record access, termination and patient continuity. Those details matter to both the physician and the clinic because an unclear agreement can turn an otherwise strong match into an operational, financial or medico-legal problem.

This guide is for family physicians reviewing a clinic opportunity and for clinic owners preparing an offer. It is general information, not legal, tax, accounting or employment advice. The final agreement should be reviewed by qualified advisers who understand British Columbia medical practice.

Why a written family physician agreement matters

Community family practice combines two separate systems. The first is the physician's method of payment for insured clinical services, such as fee-for-service, the Longitudinal Family Physician payment model or an eligible service contract. The second is the business arrangement between the physician and the clinic that supplies space, staff, technology and administrative support.

One does not automatically define the other. A physician may receive clinical payments directly and still owe a clinic management fee, fixed rent or percentage contribution. Doctors of BC also notes that a New-to-Practice family physician contract requires a Practice Agreement with the clinic and that the physician contributes to overhead at the rate stated in that agreement.

The contract should therefore describe the complete relationship in plain language. A verbal promise about "the usual split" is not a substitute for a written family physician service agreement.

Start by identifying the parties and the relationship

The first page should name every legal party correctly. Confirm whether the agreement is with the individual physician, the physician's professional corporation, the clinic company, a partnership or another entity. The signature blocks should match those names.

The agreement should also state whether the physician is intended to be an employee or an independent contractor. A label alone is not decisive. The Canada Revenue Agency explains that the real working relationship, including direction and control, opportunity for profit or loss, tools and integration, determines employment status. A worker or payer who is uncertain can request a CPP/EI ruling.

For a family physician employment versus independent contractor arrangement in Canada, review practical facts such as:

Who sets the physician's schedule and controls how services are delivered?
Who supplies the workspace, staff, equipment and electronic medical record?
Can the physician work at other clinics?
Who bears operating expenses and financial risk?
Does the physician invoice through a professional corporation?
Are vacation, benefits, payroll deductions or statutory entitlements involved?

The contract and day-to-day practice should tell the same story. Clinics should not use an independent contractor agreement as a shortcut when the actual relationship functions as employment.

Define the clinical scope and payment flow

A BC family physician job offer letter may be concise, but the final agreement needs more detail. It should identify the services expected, the practice location, any virtual-care component, anticipated patient population and whether the role is longitudinal, walk-in, locum, after-hours or mixed.

Clarify which payment model is expected and what happens if the physician changes models. State:

Who submits claims or payment records?
Which payee number and bank account receive funds?
Who can correct rejected claims?
Who owns responsibility for billing compliance?
How are uninsured services, forms and third-party reports handled?
Are bonuses, premiums or incentives included in the clinic calculation?
How and when does the clinic provide statements and reconcile adjustments?

Do not rely on a headline gross amount. The clinic split model for family physicians in Canada must be read together with the exact services included, the physician's payment model and the costs excluded from the management fee.

Compare percentage split, fixed rent and hybrid arrangements

There is no universal family practice overhead percentage in BC that makes every agreement fair. Costs vary with location, staffing, hours, equipment, technology, service level and patient complexity. Doctors of BC describes common overhead categories such as rent, utilities, staff, equipment, insurance, information technology and electronic medical records.

Three common structures are:

Percentage split. The clinic retains an agreed percentage of defined receipts. This can align cost with revenue, but the agreement must define which receipts enter the calculation.
Fixed rent or management fee. The physician pays a set amount for an agreed package of space and services. This provides predictability but can be harder for a new or part-time practice if volume is uncertain.
Hybrid model. The physician pays a base amount plus variable charges for selected services, hours or volume.

When comparing clinic rent versus a split for a family doctor in Canada, calculate the likely annual cost under more than one realistic workload scenario. A lower percentage is not necessarily better if essential staffing, billing or technology is excluded.

Make clinic overhead auditable

A clinic overhead clause should define both the charge and the service package. At minimum, list:

exam-room and office access;
medical office assistant coverage and supervision;
appointment booking, phones and patient messaging;
billing submission, rejection management and reporting;
electronic medical record licences, interfaces and technical support;
clinical supplies and ordinary office supplies;
utilities, cleaning, maintenance and security;
equipment available to the physician;
privacy, cybersecurity and records-management support;
insurance carried by the clinic;
marketing or recruitment costs, if any;
after-hours access and on-call administration.

The agreement should identify costs that remain the physician's responsibility, such as professional licensing, continuing education, professional liability protection, personal tax filings or disability coverage.

Also define the calculation base. If a clinic management fee is a percentage, does it apply to all gross receipts, only specified clinical payments, or payments received during the term? How are retroactive adjustments, Business Cost Premium payments, panel-related payments, incentives and refunds treated? Doctors of BC states that the Business Cost Premium is an MSP payment for physicians and cannot automatically be retained in full by a facility owner; sharing should follow the parties' overhead agreement unless they agree otherwise.

Require regular statements and a process to question discrepancies. Transparency protects both parties and makes clinic economics easier to manage.

Cover schedules, leave and operational expectations

The agreement should turn a general promise of "flexibility" into workable rules. Define expected clinic sessions, start and end times, administrative time, virtual sessions, weekend or evening coverage and the process for changing a schedule.

Address:

vacation and planned leave notice;
illness and unexpected absence;
locum coverage and who recruits or approves a locum;
responsibility for results, referrals and inbox work during absences;
clinic closures and statutory holidays;
minimum or maximum commitments, if any;
meeting, quality-improvement or teaching expectations;
response times for patient and staff messages.

These terms should support safe continuity rather than impose unrealistic availability. If a clinic is recruiting for a permanent role, it can also use Careviv's clinic partnership and physician recruitment pathway to define the opportunity before candidate matching.

Clarify staffing, equipment and technology

A doctor clinic contract should state what will be ready on the first day. List the room, workstation, telephone, dictation tools, medical equipment and supplies provided. Explain who trains the physician on the electronic medical record and local workflows.

For staff, define which services are included and who manages performance, scheduling and payroll. If the physician can direct an assistant's daily work, clarify the boundary between clinical instruction and employment supervision.

Technology clauses should cover account ownership, access controls, acceptable use, downtime procedures, cybersecurity incidents, data export and the return or disabling of credentials at departure. Avoid giving one party unrestricted access to the other's systems merely for convenience.

Put medical-record custody and access in writing

Medical records are not an ordinary clinic asset. The College of Physicians and Surgeons of BC requires safe storage, enduring access and compliant retention. Its Medical Records Management standard was revised in April 2026 and states that records generally must be retained for at least 16 years from the date of the last entry or from the age of majority, whichever is later, unless law requires otherwise.

The Canadian Medical Protective Association recommends that a physician joining a group practice identify the records custodian and secure continued access to the parts of the record related to care the physician provided. A written agreement should address:

who is the records custodian;
each party's access during the relationship;
reasonable access after the physician leaves;
how patients are notified about a departure or transfer;
whether and how records can be transferred;
the format and cost of any permitted export;
retention, security and destruction responsibilities;
management of privacy incidents;
responsibility for outstanding results, referrals and follow-up.

Do not postpone this discussion until someone resigns. Record custody is a core patient-safety and business-continuity term.

Review restrictive clauses with care

Some agreements contain non-solicitation, exclusivity or non-compete language. These clauses can affect where a physician works, whether a clinic can recruit and how patients experience continuity. Their validity and effect depend on wording, context and applicable law.

The federal Competition Bureau also distinguishes legitimate contractual restraints from agreements that may harm competition and has specific enforcement guidance on wage-fixing and no-poaching agreements between unaffiliated employers. A generic clause copied from another industry may be inappropriate for a medical practice.

Ask qualified counsel to review the duration, geography, restricted activities, affected people, patient-choice implications and available remedies. The contract should never suggest that a clinic owns a patient's choice of physician.

Build a safe termination and handover process

Every agreement eventually ends, even when the relationship is successful. Define termination with cause, termination without cause, notice periods, cure periods and any immediate suspension needed for patient or workplace safety.

A notice period for a family physician contract in BC should be considered together with professional obligations. CPSBC's Leaving Practice guidance expects physicians to plan for patient communication, ongoing care, medical-record arrangements and contingency coverage. The College has explained that it recommends at least three months' patient notice where feasible, while recognizing that circumstances vary. That professional expectation is not automatically the same as the contractual notice period, so the two timelines must be coordinated.

The exit schedule should assign responsibility for:

notifying patients, staff, hospitals, pharmacies and referral partners;
completing or transferring open referrals and investigations;
handling results received after the last clinic day;
reconciling billings, refunds and clinic charges;
returning keys, devices and confidential information;
preserving post-departure medical-record access;
removing the physician from websites, directories and payer records;
communicating the new practice location when appropriate.

If a physician is moving from abroad, contractual timing should also align with licensing and work authorization. Careviv's UK GP relocation and Canadian practice pathway provides a starting point, but official regulator and immigration requirements remain controlling.

Red flags for physicians and clinics

Pause and investigate when an agreement has:

an undefined "standard" split with no schedule of included services;
unilateral fee changes without notice or a termination right;
no billing statement or reconciliation process;
an employee label or contractor label that conflicts with actual operations;
no medical-record custodian or post-departure access clause;
broad restrictions unrelated to a legitimate business need;
no plan for results, referrals or patient communication after departure;
verbal promises that do not appear in the written agreement;
a long commitment with no workable exit;
clinic services, equipment or staffing that are not described;
personal guarantees or indemnities that have not been independently reviewed.

The right response is not always to reject the opportunity. It is to identify the issue, obtain evidence, price the risk and revise the language before signing.

A practical negotiation process

Clinics can make offers easier to compare by providing a written information package before the final contract. Include the role description, schedule, payment flow, overhead schedule, staffing model, technology, patient population and proposed start process.

Physicians should review the offer in three passes:

Commercial review: estimate gross receipts, clinic charges and costs under realistic scenarios.
Operational review: walk through a typical clinic day, absence and departure.
Professional review: confirm licensing, liability protection, records, privacy and continuity obligations.

Both parties should maintain a short issue list that records the clause, concern, proposed wording and final decision. The signed agreement should include every material schedule and amendment; do not rely on a separate email trail.

Final family physician contract checklist for BC

Before signing, confirm that the agreement clearly covers:

correct legal parties and authority to sign;
employee or independent contractor structure;
clinical services, location and schedule;
payment model and payment flow;
overhead formula and included clinic services;
billing statements, adjustments and audit questions;
staff, equipment, supplies and technology;
privacy, cybersecurity and medical-record custody;
licensing and professional liability protection;
leave, locum and unexpected absence;
patient communication and continuity of care;
restrictive covenants and conflict resolution;
termination, notice and post-departure access;
amendments, renewal and complete schedules.

A clear family physician contract does not eliminate every risk. It gives the physician and clinic a shared operating model, exposes disagreements early and supports a safer transition for patients.

What should a family physician contract in BC include?

It should identify the parties, working relationship, clinical scope, payment flow, overhead, staffing, technology, records custody, scheduling, leave, restrictive clauses, termination and patient handover. The exact terms depend on the clinic and payment model.

Is a clinic split the same as physician overhead?

Not necessarily. A percentage split is one method of collecting a clinic contribution. The agreement must state which services the percentage buys, which receipts are included and which expenses remain the physician's responsibility.

Is a family physician automatically an independent contractor?

No. The contract label is only one factor. The CRA looks at the actual relationship, including control, financial risk, tools and integration. Either party can request a CPP/EI ruling when status is uncertain.

Who owns patient medical records in a group clinic?

The answer depends on the custody arrangement and applicable law. The agreement should identify the custodian and preserve appropriate access, retention, security and transfer rights. Physicians should review CPSBC and CMPA guidance.

How much notice should a physician give before leaving a BC clinic?

The contract may specify a notice period, but physicians must also meet professional continuity and records obligations. CPSBC recommends advance patient notice where feasible and expects a workable plan for outstanding care and records.

Should a physician obtain legal advice before signing?

Yes, particularly when the agreement includes a long commitment, personal guarantees, employment-status uncertainty, restrictive covenants, ownership terms or complex records provisions. The clinic should also obtain its own advice.

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