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Robert Shelley from Shelley Law discusses physician offer letter negotiation, focusing on the differences between an offer letter and an employment agreement. He explains that an offer letter outlines general terms such as compensation, term length, termination conditions, signing bonuses, relocation assistance, productivity compensation, and restrictive covenants like non-compete clauses. It is typically presented before a formal employment agreement, often by a physician recruiter, whether internal or external. Shelley emphasizes the importance of negotiating these terms either prior to or after receiving the offer letter to ensure favorable conditions for physicians.