When Doctor Contract Negotiations Go Bad (Part One): Usually it’s a Good Thing

When Doctor Contract Negotiations Go Bad (Part One): Usually it’s a Good Thing

You worry that negotiating your doctor contract for higher salary may go badly. The reality is that it may be the best thing that could happen for your career.

Author: Robert A Felberg MD

Topic: Negotiation, Professional and Business Skills

Keywords: Physician soft skills, negotiating for a higher doctor salary, doctor negotiation mistakes, difficult negotiations

[Editor’s note: THANKS to White Coat Investor for naming this post of one the “Best of the Web” for November 2017! Welcome White Coat Investor readers- We Love the WCI Blog. Thanks again for visiting!]

It’s a common fear. You want to get a fair compensation package, but you worry that by bargaining you will upset your future boss and they will withdraw the offer. This anxiety may prevent applicants from even attempting to get a better deal.  You realize that you are expected to negotiate and that if you don’t, you’ll lose respect and be branded as a pushover. You just don’t want to sour the deal and lose the job offer altogether.

[Editor’s Note: To truly succeed in your medical career you’ll need three complementary skill sets.  Of course, you need to be skilled in the practice of medicine.  Secondly, you’ll also need to understand finance.   Finally, you need Professional and Medical Business skills.   Of all the professional skills, negotiation is the most important.  This is one of an ongoing series from Physician Advocates introducing the science and practice of negotiation to healthcare professionals.  Sign up for our newsletter to be kept up to date.]

The simple fact is, sometimes a negotiation going badly is the best thing that could ever happen to your career.

When you negotiate, you are “interviewing” your future bosses. Think about it this way. When you are looking at a new job, you are brought in for an interview.   The job interview process is purposefully designed to be a bit stressful. They question you all day, maybe ask you to give grand rounds, and then have you go out to dinner.  It is all designed to see how you respond. Will you breakdown? Become unable to function like a “deer in the headlights”?  Perhaps, you start getting angry or defensive? Your future organization is observing you closely during the visit. If you can hold it together and come across as cool, competent, confident, and charismatic under the wilting pressure of a 12-hour interview, it’s a pretty good indication that you’ll be able to handle the strains of the job.

But, when do you get to interview your bosses?  Before you commit, you’ll want to know how they respond and what are their true core values? Do they treat their staff with respect or do they place monetary concerns first? Do they value fairness? Will they reward hard work and excellence with monetary compensation, recognition, and increased voice in decision making? How do they handle conflict? Do they look for solutions with collaboration, create new value, use recognized national standards, or just coerce? Are they open and transparent?

How your future bosses act during the negotiation will be a very strong indicator on how they will act as your employer.

For this reason alone, it is absolutely vital that you negotiate your physician contract. Consider this- you wouldn’t get married without some sort of vetting process. In many cultures, that involves courtship, dating, and engagement prior to actual marriage. It’s a pretty good sign that how your future spouse treats you during this time is how they will act after marriage.   And, as painful as it may seem at the time, it is worlds better to realize your match is less than perfect before you get married than afterwards.

Your negotiation is the ideal time to examine your future employer. Closely watch how they act and reflect thoughtfully about whether their style is right for you.


Here are some tips to consider as you enter your negotiation

  • Do they act respectfully when negotiating? Do they get angry, use hard tactics, bully you or threaten you? Chances are, they’ll act even worse when they are no longer trying to entice you. Remember, you can always treat others with respect and courtesy, even when you disagree. Accept nothing less.
  • Do they use recognized standards? The trait of reaching for a recognized external or third-party standard, like using a market value report as a base for salary disagreement, is a desired characteristic in a negotiating party. It generally means they value fairness and compromise. It also sets an excellent precedent for future collaborations.
  • Do they try to over-reach on items like restrictive covenant, malpractice tails, or lengths of contracts to pay-off signing bonuses or student loan assistance? Many employers are aware of the naivety of freshly minted doctors and will try to take advantage of them through the more complex aspects of contract design. Although, these types of ploys are usually easily reversed after a high-quality legal review, you do need to think about whether your wish to work with a group that considers such tactics acceptable.
  • Are they open with data and information about the practice? Will they willingly turn over billing or patient care metrics? If they quote salary norms from an obscure database, will they freely give you access to confirm? Negotiations that are data or information rich require a fair exchange of information. Not sharing this type of information suggests a lack of trustworthiness.
  • Determine their negotiating style. Do they create mutually beneficial solutions, compromise readily, accommodate when appropriate? Or is their thought processes rigid and their solutions one-sided or interest based. Do they value relationship over short-term solution? Are they able to work effectively within the organization to obtain resources and agreement?
  • Remember: there are much worse things than having a negotiation coming to deadlock (note: I will write about the concept of deadlock in a future post. Please sign up for our newsletter) Walking away now is far more desirable than signing a contract, buying a house, and then dealing with the monetary, stress, health, and reputational hits that comes from learning too late that your dream job has become a nightmare.

Approach your negotiation as an unparalleled opportunity to observe your future employers in a high-stake relationship based interaction. Of course, you’ll can’t expect perfection, but you should be able to get a good idea of their core values, styles of management, and conflict resolution skills. Don’t worry unnecessarily that your attempt to obtain a better physician salary will sour the job offer. This is unlikely to happen and if it does it was probably a good thing- who wants to work for a boss who doesn’t offer you a fair package?

Learning how to negotiate in respectful manner with emphasis on the relationship will be the subject of part two of this post. In the meanwhile, think about negotiations you’ve had in the past where the other party gave you warnings you just didn’t pay enough attention to at the time. As you prepare your next negotiation, be sure to obtain a solidly researched market value report, upgrade your skill set, work on your brand to present yourself in the best light, and consider taking a CME approved course designed for doctors. The great thing about negotiation, like all professional skillsets, is that they can be mastered with study and practice. With proper educational and training you’ll be able to reach your dreams and succeed… really succeed. 

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What do you think? I am crazy to suggest risking your job over trying to get a better deal? Have you ever missed the warning signs during a negotiation and signed anyway only to be left with expensive regret? Do you have any advice for newly minted doctors entering into this situation? Please share your thoughts in the comment section.







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