What is leverage? How is it used in Physician Contract Negotiation?

What is leverage? How is it used in Physician Contract Negotiation?

How can use you use Leverage to get better than the Average Doctor Salary?

Leverage- It’s probably the single most misunderstood term in negotiation. When people think of the term leverage they usually imagine one of two vivid images- someone threatening someone else with a lever or crow bar or somebody being squeezed into compliance. The real practice is far less antagonizing, but also much more useful in advancing your career

So where does the concept of “leverage” comes from?          

Well, imagine a playing field with a goal line at either end. And then imagine a large, heavy rock in the middle- Sort of like the superdome with a 2000 pound bowling ball at the 50-yard line. Now, your intent is to move that heavy object to your goal on the far side of the field. Next, imagine you had a giant plank and a fulcrum- together forming a lever– and you can use this lever to move the rock closer to your goal. That’s “leverage”, anything available in a negotiation you can use to “lever” or “move” the agreement closer to your goal.

Now that you know the meaning of leverage, what are the things that can act as leverage?

Time is the most common leverage tool. You need to sell your house by the end of the month. I have no urgent requirement to purchase. I can use your desperation to leverage down the final price. Scarcity is an another leverage point. You are down to the big red “E” in your gas tank and pull off the highway where you find the stations all charge 30 cents per gallon more than the average station. Your need to full the tank immediately is used as leverage to charge you more.

The most well-known negotiation tactic taking advantage of leverage is the “walk-away”.  You give the impression you don’t want that new car after all and you get up and leave. The seller, eager for the sale, will then come back with a much better price to keep the hope of a final agreement alive.

How can you gain more leverage?

1.    Do your legwork. Truly understand your desires, priorities, weaknesses, and strengths. Think about your negotiating partner. What are their concerns and needs? What are their strengths?   For example, you may be joining a practice that is having trouble finding doctors to take call in a hospital on the northern suburb of town. You have no real issues taking call there, but you know that the current partners all live south of the city and it’s a burden for them.   You use this knowledge to leverage a higher call reimbursement in agreement to take the majority of your call at this “burdensome location”.  You think even more about the situation and negotiate an extra $60,000 annually to be the medical director at that site.

2. Form Coalitions. Sometimes you are the weaker party and you lack leverage against a more powerful negotiating party. This is where your skill in “Office Politics” comes in (Note: Office Politics is not the bastion of evil portrayed in movies- It’s the ability to use the resources within an organization to effectively achieve your goals).  Find other like-minded people in your sphere of influence and get them on-board. If done properly, a few well-placed calls or recommendations will change the power in the negotiation significantly.

3.  Time is mentioned above and needs to be considered as you plan your negotiation. Make a deal to sign up for a seminar early for a 10% discount.  Leverage your willingness to commit to a certain region of the country to obtain a training stipend. Slow down the negotiation when you are aware of pressing needs from your partner. Being willing to speed up agreement for a meaningful concession. Always be aware which party is under the bigger time constraint.

There are several factors you should take into account when as you negotiate your Physician contract.    Plan ahead, survey the terrain, and use leverage to obtain the best Doctor Salary. And remember, these skills can be useful in other aspect of your professional and personal life- from buying your first house to managing professional disagreement.  Negotiation remains the single most important Medical Professional and Business skill required by all physicians to succeed.

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Bless you-thanks-Any chance you will expand this?


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I’m uncertain about this post. Your initial thoughts are spot on, but unfortunately it’s dangerous to count upon whatever strangers might think. Please expand this, because I think you are a worthy blogger and I want to read more from you!



    Interesting thought
    Are referring more to the ability of others to deceive you? or trusting the other people within your coalition?


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