Electronic Health Reporter

Getting out of residency and into private practice can be an exciting time full of expectations and opportunities. Nonetheless, some doctors feel some apprehension and even show some diffidence when it comes to discussing terms of employment.

Some of the best negotiation training is in NYC. Physicians can graduate equipped to face the challenge of setting up new contracts with confidence. Recognizing that the terms you start with set the pace for your relationship with your employer or partners, here are six key points to keep in mind during your contract negotiation process.

Be prepared

In most instances, you already know the role you’re interviewing and negotiating for. Conduct some research, including financial due diligence, on the position applied for. Keep abreast of best practices, work titles, organizational hierarchies, salaries, and perks.

When it comes to compensation, doctors often enjoy perks and incentives over and above their salaries. Some of the financial terms and conditions a physician contract negotiation course can familiarize you with include:

• 401K
• Partner buy-in and buy-out
• Malpractice coverage
• Income distribution
• Disability plan
• Overhead: Revenue ratios
• Payer mix (government insurance, private insurance, co-pay, and self-pay)

Be strategic

Too many physicians make the mistake of dwelling on the base salary during negotiations. An intense focus on base salary may be misconstrued by the employer as a sign that you’re too self-focused and not thinking about the mutual long-term relationship.

Negotiation workshops help you discuss terms showing a clear intention to meet and exceed productivity goals and to earn bonus incentives. While asking about your base salary, expand your focus to other financial considerations such as bonuses, incentives, paid vacations, retirement packages, and training opportunities.

A negotiation class or simulation may prepare you to talk to your recruiter and prospective employer/partners about any special circumstances that may influence your decision. Special circumstances may include:

• Schooling for your kids
• Employment opportunities for your spouse
• Moving costs if you’re from out of state or a different region
• Licenses or certifications to meet specialist requirements

Being strategic works to secure your long-term career goals and personal comfort rather than just fulfill your current salary goals.

Don’t consider too many offers

You may receive multiple offers from different recruiters or get a positive response by sending out multiple job applications. Negotiation training experience shows that having multiple offers can turn an exciting prospect into an overwhelming and challenging scenario.

You could express enthusiasm about each prospect and attend all interviews. However, too many offers may cause further confusion and can be a time suck. Alternatively, a negotiation class can help you develop a decision matrix to narrow down on your options, enabling you to invest your precious time and energy in your most attractive positions.

A simple decision matrix could go like this:

• Create a list of all the factors you like about each offer. For instance, work-life balance, career trajectory, work flexibility, learning potential, commute, benefits, etc.
• Assign a weight scale between one and 10, with one as least important and 10 as most important
• Using the weight scale, assign each job offer a value indicating how many factors the offer satisfies
• Add up the totals for your decision factors for each job offer
• Use the totals plus your intuitive feeling to pick two or three prospects and consider only those
• Reserve the rest just in case none of your top picks works out

Get everything in writing

During the interview period, a lot of promises may be made. You may agree on your on-call being one in four, or be promised a new office. Physicians who attend negotiation seminars often report how promises made during the physician contract negotiation process are generally made in good faith. However, if said promises are not put in writing, the promises may become difficult to enforce. By having your agreed terms formalized in writing and signed by both sides, you enjoy the following benefits:

Certainty

Verbal agreements can be vague and leave too much room for contentious translation. Well-written agreements typically leave very little room for miscommunication.

Greater consideration

Some details may seem trivial when only discussed verbally. When put in writing, both sides typically give the issue more thought, weight, and serious treatment.

Less disputable

Sometimes people genuinely remember events differently. It’s not always an indication of malicious intent if one side doesn’t remember an agreement in the same way as the other. Putting in writing ensures terms are more difficult to dispute later.

Develop a BATNA

Career decisions may affect your long-term professional development and personal growth, so they are not to be taken lightly. Before entering physician contract negotiations, develop a fallback position, also known as your Best Alternative to Negotiated Agreement (BATNA).

Be candid and expressive about your compensation needs, and be ready to compromise on some issues. Accept that you’re not going to get everything you want, but have a set of what you really need out of the relationship. Your BATNA should typically include a list of your deal-breakers and deal-makers.

Your BATNA should be based on easily achievable alternatives, like the list you made in your decision matrix. Your BATNA should resonate with your professional and personal goals.

Verify before you sign

Your most important point of negotiation is normally just before you append your signature. In negotiation training discourse, this is the make-or-break moment where you reflect on the upcoming opportunities and the associated risks. Double check on the terms of your agreement and don’t be afraid to ask where you’re unsure. Consult a healthcare attorney, even if you’re joining your parents’ practice or starting one with your best friend from college.

Be sure to cross-check on important issues such as licensing, insurance coverage, malpractice coverage, and student loans. When you contract a healthcare attorney, pick one from the same region as laws differ from state to state, county to county.