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How to negotiate like a 5 year old

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Multiethnic business people in meeting

Have you ever noticed how effortless it is for children to negotiate for their wants and needs? It is as if they come into this world with a magic gift of knowing how to get what they want—and better yet, nibble for even more.

As a mother of three small children, I watch in awe as my kids masterfully maneuver these situations and take note of their skills in an effort to learn from them. So I ask myself—why is it that, as we get older, we lose that comfort level with being direct about our needs and wants and negotiating for the same?

As a physician recruiter with more than 15 years of experience negotiating physician employment agreements, there is a palpable change in a candidate’s voice, behavior and even body language when we move from the pleasantries of exploring a particular opportunity to the negotiation phase of the recruitment process.

Why is this? I believe it has much to do with a candidate’s worry about crossing some invisible boundary in the discussion, appearing too greedy, or having a general discomfort with advocating for their needs. Since the fall is the time of year when many senior residents begin to consider job opportunities, it is an optimal time to put forth some tips on negotiating with an employer.

Come prepared for the discussion.

This is fairly obvious, as you cannot expect modifications from an employer if you don’t know what is already in the agreement. You must review the document and become familiar with the obligations of both parties. Employers and their representatives will be well-versed in the language of the employment agreement, and you don’t want to be left behind as they move from paragraph to paragraph. That said, if there is something that requires clarity, be sure to speak up and ask for an explanation in layman terms.


• Enlist an attorney to review the agreement.

As it may be your first time reviewing an employment agreement, I encourage you to select an attorney who is both in the region where you plan to practice and is well-versed in physician agreements. You will be bound by the provisions of the agreement, so it is important that the document be one you can live with for the duration of the term of employment.

• The figures related to compensation may be negotiable, but more often than not, the methodology for payment is non-negotiable.

Compensation structures have simplified over the years, but there can often be multiple components that make up a total compensation plan, including salary, incentives, bonuses for quality and good citizenship, partnership, etc. Employers devote extensive time and resources to developing the best model for a practice and are typically not inclined to make radical modifications related to their methodology. As a general observation, employers tend to be more inclined within reason to readjust dollar amounts for base salaries, sign-on bonuses or retention bonuses before ever delving into changes in the compensation plan.

• It is perfectly acceptable to request data related to historical incentive/bonus payments.

If the employer is offering an incentive or bonus component, you should feel comfortable requesting not only the specific formula used for calculation, but also historical data related to how much has been paid on average to individuals in the group over a period of time (such as the past three or six months). The employer can do this while still protecting the identities of the individual physicians. If an employer is reluctant to do so, you should consider this a red flag.

• Benefit programs offered by employers are usually standard and universal for the group.

Health, dental, vision and retirement plans are typically non-negotiable. CME allowances and paid time off may be more negotiable, but many employers are reluctant to do so in order to avoid inequities within the group. There is also a greater level of complexity for the employer to administer a plan that differs among group members. (more…)

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Anne Fowler

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