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The Art of Physician Contract Negotiations

Hopefully, your soon-to-be boss is tickled to have you, but you owe it to yourself to negotiate for the best deal possible. We all hear how it’s just business, not personal.

 

REALITY CHECK: All contract negotiations are personal.

 

My contract lawyers taught me the finesse of aggressively negotiating my contracts without ruffling my boss’ feathers or placing them on the defensive. Companies advertise “excellence,” but here’s the truth: they don’t want excellent; they want mediocre. No company wants the new hire to come in and radically change things – unless they hire you to do exactly that.

In general, men typically negotiate more consistently, which is one of the many reasons why male physicians overall have higher salaries than women. To my fellow female physicians, harken! Read on to learn softer ways of delivering strong negotiating language. You deserve it.

If your employer gets a bad feeling about you early on in your relationship, you will be labeled as a “problem.” This will follow you for the rest of your employment. Some may call me negative; I call it wisdom from experience. Don’t shoot yourself in the foot. Use the following negotiating language for fair compensation instead.

 

Start positive.

Give love by saying,

  • I’m so honored and excited…
  • Thanks so much for talking today, I have a sense of how busy you are…
  • I was so excited to speak with you and hear your enthusiasm.

Transition from the easy to the hard things. They’ll be anxious. If you place them on the defensive, then their ability to listen decreases exponentially. Start by saying, “95% of my questions are just clarifications, to help me exceed your expectations.”

If your contract lawyer edits some grammar or technical things in the contract, you can mention it to your employer, but clarify that, “I don’t want to waste your time reviewing these.”

 

Never put them on the defensive.

Save the biggest things for last, which inevitably surround money. If they get loud, you get soft and speak slowly. If they give considerable push back, or you detect any agitation, move onto the next item by saying, “Well, let’s move on, and we’ll come back to that.” This gives them the feeling that the conversation is moving forward, that you’re negotiable, and provides buffer time to settle down. Like I said, never put them on the defensive.

Don’t nickel and dime your employer. When discussing salary or vacation time, say things like:

  • I hate talking about money, but I want us both to feel good.
  • In residency, we were educated on burnout, the importance of mental health, and taking quarterly breaks. This is for your benefit, so I can stay sharp and productive 100% of the time.
  • This is really important to me and to you. You’ve spent a lot of time working on this. I would really appreciate it if you gave this more thought, as will I.
  • Let’s each give this more thought. If you have a better idea, then I’m happy to compromise.

People will ask you the same question in different ways to get their desired answer. This is exactly where soft people feel worn down and ultimately accept a contract they aren’t thrilled to sign.

Keep repeating the same answer.

 

Negotiation Examples

BOSS: Are you giving me an ultimatum?

YOU: I respect you too much in this practice to do that. I trust you; I wouldn’t be moving if I didn’t, but in section XYZ it states XYZ. My contract lawyer has urged me not to sign, but I know that’s unreasonable. I’m making sacrifices, and I’m appreciative of the opportunity. I want to protect your business without…

  • Uprooting my life (if you’re negotiating the noncompete years or miles)
  • Being involuntarily uprooted (if you’re negotiating length of notice that must be given for you to be let go).
  • It’s hard for me to get involved, make connections, and then be uprooted at any time.

 

BOSS: Well, what if we compromised and settled on…. XYZ?

YOU: That’s an interesting question. Let me give it the thought it deserves before I answer.

 

YOU: (Regarding salary) While that’s a nice offer, the national average for an XYZ physician with # years of experience is $320,000. Is that something you can match?

 

YOU: Unfortunately, for as much as I would like to work here, I’m not able to accept a salary that is $50,000 below the national average. Is it within your budget to match the national average salary?

 

Take your time to think.

You do not have to answer or agree to anything in the moment. If they push you after you ask for some time to think about it, see that as a massive red flag and reconsider signing the contract.

Keep in mind, during these negotiations, you are interviewing them just as much as they are interviewing you. Perhaps this is a dream job or the prime location. If the conversation gives you a sinking feeling in the pit of your stomach, listen to that. Trust yourself and be willing to walk.

Finally, end on a positive note. Even if you’ve realized with a resounding NO, I am not accepting this job, leave the conversation on good terms. Don’t accidentally blackball yourself from a hospital system.

End with:

  • I’m so appreciative of your time, thank you.
  • I feel really good after our conversation, and I’m confident we can find some middle ground.
  • Would it be helpful if I emailed my suggestions?

 

By using the aforementioned language, any reasonable human will respond positively. If they don’t, seriously reconsider the job. As a healthcare provider, you will surely have much harder conversations down the line. Contract discussions form the collaborative cornerstone for the rest of your employment. Best of luck!

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About Danielle Kelvas, MD

Dr. Danielle Kelvas, MD earned her allopathic medical degree from Quillen College of Medicine at East Tennessee State University in Johnson City, TN. She served a term as the National Chair of Global Health for the American Medical Student Association (AMSA), regularly speaking to legislators on Capitol Hill (USA) to advocate for healthcare reform in the US, and published a global health program for medical students that is used by New York Medical College and AMSA. She also served as Co-Chair of the Medical Education Committee for an anti-sex trafficking agency, traveling the United States giving lectures to medical professionals on how to identify and rescue these victims. She began residency training in Emergency Medicine and later switched to Family Medicine, wishing to return to the art of medicine. Dr. Kelvas has traveled, lived, and volunteered medically in over 40 countries, equipping her to collaborate with professionals and companies from all backgrounds. She has 15 years of global collaborative experience, having led multiple medical volunteer trips internationally, working with groups like Health Talents International, Kenya Relief, and Mission Lazarus. Dr. Kelvas is widely published and currently funded to write a novel on PTSD in healthcare providers.

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