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December 16, 2020

Show candidate commitment with a letter of intent

You circulated the job posting, searched candidate databases, scoured your pipeline and sent emails - all in the search for great physicians to join your organization. Then came the prescreenings, interviews and onsite visits. At long last a finalist emerged who is the ideal hire for your physician or advanced practice provider opportunity.

The natural next step is to move directly into contract negotiations and finalize the hire as soon as possible, right? Well, there may be another step - a half-step even - that you should consider first: a letter of intent.

What is a letter of intent?

A letter of intent is a precontract letter stating your organization is ready to stop the job search and enter into good-faith contract negotiations in order to hire the candidate. It may include the reasons why, plus high-level employment details that will be covered fully during negotiations (more on these below).

When done well, a letter of intent demonstrates your organization’s interest in and commitment to a candidate and helps them get excited at the prospect of joining the team.

What a letter of intent is not

A letter of intent is not a legally binding document. It’s simply a formal gesture in which your organization recognizes the candidate as your top choice and invites them to reciprocate the feeling.

Here is what you should include in each letter of intent

Information to include

While there is important information to cover, it’s key to remember a formal contract will come later. Instead of sending a multipage document listing every detail, try summarizing the information to keep your letter of intent to a maximum of two pages.

The details should be stated clearly and in a manner that doesn’t inadvertently pressure the candidate. Some of the items you should consider outlining include:


This is foundational information for any candidate’s consideration and among the information many will look for first. For a letter of intent, list an approximate salary or range, including the salary structure and estimated annual earnings. Also include any sign-on or annual bonus opportunities.

Because the letter is not legally binding, there’s a chance the candidate could attempt to negotiate these numbers when reviewing a contract. In order to minimize the chance of that happening, base any approximate range on traditional factors including median pay for the position, cost of living and your candidate’s experience. Ideally, the expectations you’ve learned as you’ve formed a relationship with the candidate will help prevent any surprises when it comes to salary discussion.


Another staple of offers, your organization’s available benefits should also be outlined. This includes personal care provisions such as health, dental, vision and life insurance, but also introduce offerings like your organization’s retirement contribution program and malpractice coverage. If your candidate would be relocating, you should also include any relocation assistance available.

Contract length

The contract length helps the candidate mentally prepare for their minimum commitment to the organization. You can also share any planned pay increases in subsequent years.

Time off

Work-life balance continues to be an increasingly important factor for all professions, including health care providers. According to a past American Medical Association survey, 92 percent of millennial physicians state it’s important to balance work and personal/family responsibilities. Share with them how your organization provides personal time off, sick days and any additional information on your organization’s commitment to wellness.

Title and reporting structure

List their specific title, within what team they’ll work and the reporting structure. Also include any responsibilities for supervising employees or teams. These types of details will help the candidate better understand the role that’s being created for them and how they’ll fit into the overall structure.

Sending the right message

The information you’re sharing is important, and how it’s interpreted is equally important. This letter is an opportunity to show the candidate your organization is ready to commit to them and invites the candidate to share the sentiment.

While a lot of the information is standard, a letter of intent should still be read as a personal communication written specifically for them.

  • Be sincere  - While all letters of intent contain similar information, each one should avoid dry, corporate jargon in favor of professional-yet-relatable language and tone.
  • Send from a person  - This letter could come from the recruiter who has built a relationship with the candidate or from the department chair hiring the role. In any case, ensure that it’s signed by someone from your organization to emphasize the intent and interest in bringing the candidate onboard.
  • Include the why  - Share with the candidate what makes them the right fit for the role given your organization’s needs, mission and culture. That information helps them see their worth and promise - while also giving them early confidence how they’ll fit within the organization.
  • Remember the community  - If your candidate would be relocating, think back to any local amenities that strongly appealed to them. Including a reminder statement helps further differentiate your organization’s opportunity from others the candidate may be considering.

Once the candidate signs the letter of intent, shift momentum to the offer and contract negotiations.

With a well-crafted letter of intent, you can demonstrate your organization’s commitment to the candidate and share pertinent hiring information - without weighing it down with every detail. Once the physician signs and returns the letter, continue the momentum and look for the first opportunity to begin contract negotiations and finish taking the remaining steps toward welcoming a new physician or APP to your team.

Read PracticeLink articles by Drew Terry

Drew Terry

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