Contract Negotiation Tips for Resident Physicians

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Little to no time is devoted to helping resident physicians understand the complexity and tactics of negotiating their first job. As resident doctors, the salary is etched in stone, and there is nothing to negotiate.

Don't expect your residency faculty will happily divulge their compensation package. Although this is a natural tendency for most when discussing their work, it is only one career satisfaction element as relationships, appreciation, work-life balance, and equality rank at the top.

Having sat on both sides of the table, the following are a few thoughts from 20 plus years of interesting career discussions. The ideas may not all resonate but focus on mindset over money.

Know Your Non-negotiables

It may be tempting to sell your soul to get the perceived dream job, but there are always costs to bear. Agreeing to work more night and weekend shifts to land in your favorite city may sound good at first, but trust others who have gone before that this will create a sour attitude quickly. Life changes, and your family will grow tired of your absence.

Decision making for one is exponentially easier than long-range planning involving a significant other, kids, or aging parents. Pause and look into the future five years and overlay the expectations of the current job offering on those plans and dreams.

Listen More

Remember that, more likely than not, a number has already been inked before you entered the room. Listen carefully for clues, as there may be room to ask for more. It's also critical to do your market research and network with others who can share valuable information. During the negotiation process, you will find that information is a powerful ally.

The opportunity to discover clues will present itself depending on the skill of the interviewer. You can find the specific needs of the organization or group.
-We lost one of our dedicated night physicians due to health reasons, and our group is planning an expansion to another location
-Our group presented a well-received EMR study at the medical informatics conference last month
-We plan to add wound care in-home care services to our clinical offerings

You may note an area of particular interest where you can add previous experience or expertise and solve their problem and secure additional perks in the process. You might find yourself heading up a new program or project.

Honest Humility

Although a certain competency level is assumed after completion of residency, you will be unlikely to be the group's new rock star. After meeting several of the other physicians in the group, you should understand whether mentorship is available. There is still a lot to learn. Having a professional mentor will smooth out the inevitable rough areas as a new attending.

Breathe Into Resistance

Doctors interrupt patients in 11 seconds on average. Resist this tendency. Take a slow breath, pause, and focus on what is being communicated. A lot can be learned by listening to the gaps. Let the interviewer fill in the gaps, and you may be surprised at what's on the negotiating table.

Refuse the Golden Handcuffs

A plethora of retirement options exist but be wary of those requiring a specific time commitment. Many professionals have found themselves tied to a job they despise due to vesting requirements for specific financial plans.

Don't guess. Ask pointed questions and consult a financial advisor if you're unclear what you were looking at. (link to my article of 60k flush)

Not a Zero-Sum Game

Ideally, both parties leave the table satisfied. Chances are this will not be your final position, and negotiations are not winner take all.  Resist the zero-sum fallacy.

Concessions

Unless the group is desperate to fill a position, you may find yourself making certain concessions. Resist the temptation to accept these as permanent and be sure to negotiate a timeframe to review certain aspects of your contract. According to a Medicus study, 20% of physicians plan a job change in the next 12 months. Someday this will likely be you.

Good Luck

Trust in your knowledge and skills. Enjoy the process but never forget your non-negotiables.

Editor's note: The author is neither an attorney nor a financial planner, and it is expected the reader will consult their own professionals on making decisions or reviewing contracts.