Think back to your childhood when you were an expert at getting that extra chocolate chip cookie, or staying up an extra five minutes before bed time. It was easy, almost effortless, then to get what you wanted. You’d ask for five cookies knowing you’d never get that many, but confident your mom or dad would give you two instead of the original one. And you’d ask after you had eaten dinner, never before.
Physician employment contract negotiation is similar, but with a whole lot more at stake. Knowing when, how and what to ask for in negotiations is important – as is having the same unwavering confidence you had as a child, when being direct about your needs and wants was natural.
Unfortunately, as we get older, negotiating can be intimidating and many new physicians are hesitant to negotiate employment contracts. However, it’s important for physicians to be satisfied with their new positions and to be compensated and incentivized in ways that they believe are fair and equitable. Here are a few guidelines to follow when the time comes to negotiate:
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First and foremost, know what’s reasonable to ask for. Some things are fairly standard across the board, and other aspects of the employment contract are negotiable. Here are some general rules to follow:
- The figures related to compensation may be negotiable, but typically the methodology for payment is not. Although more simplified than in years past, compensation structures often include multiple aspects including, salary, incentives, bonuses for quality, partnership, etc. and radical modifications to these models are rare. However, they are more open to adjusting base salary amounts, and sign-on or retention bonuses.
- Benefit programs, such as health, dental, vision, retirement plans are typically non-negotiable. CME allowances and paid time-off may be more negotiable, even though many employers prefer to remain consistent.
- In some specialties and certain arrangements, an employer may alter a non-compete/non-solicitation clause to entice a physician to join, but larger physician groups are less likely in order to avoid setting precedents for the future.
- Do your research on your market. Understand the physician salary norms for your specific location, population, specialty, position and any other relevant factors, and make sure you are comparing apples to apples. According to a recent MGMA survey, the mean annual compensation between some regions across the country varied by as much as $44,000. So, if you are considering a job offer in Atlanta, referencing a much more competitive offer you received in New York is irrelevant.
- Know the ins and outs of your physician employment contract. The employer will be well-versed in the language and terms of the employment agreement, so you may want to consider enlisting the help of an attorney to review the contract on your behalf and provide further explanations or clarity where needed. Physician attorneys who are familiar with your geographic location are ideal, as they are familiar with regional norms, and can spot clauses you might miss on your own.
- Keep the negotiation process moving, don’t prolong it. It’s important to be cognizant of everyone’s time. Be as responsive and prompt as possible in your correspondence, and don’t delay the process.
- Be assertive, not aggressive or arrogant. The way you handle yourself during the negotiation process is telling of how you will be perceived within the organization. The key is to be confident, but never make demands or be argumentative.
Generally speaking, a physician’s flexibility in negotiating depends on a number of factors, including specialty and how much it is in-demand, the market you are looking in, the supply and demand of that particular location, your type of training, and your track record, and board certification.
Signing an employment contract is an important financial decision, but also will impact your personal and professional life for years to come. When done well, the negotiation process ends with both physicians and employers excited about the future.
