I apologize for all of the jargon- each concept would take up a separate series of posts. If you're being recruited as an independent contractor, your physician contract … many doctors are underpaid. Your market data research is your single most important piece of information. Imagine that you have completed all the courses, passed all the exams, and are finally ready to take your first position. A minor but important difference. Click to learn more! Several program will do the bait and switch- they offer amazing packages for the first 2 years and then when your leverage is reduced, they switch over to some anemic base with an impossible bonus structure. These concepts not only help in contracts, they help with everything in life, like getting my 7 year old to do her homework, etc…getting a patient to accept receiving her dialysis treatment…etc…. I’d have to say that most doctors are likely stuck whether good or bad in their current job situation depending on their seniority. When you go into a negotiation, you have to be armed with facts, not just the desire to get more of something (money, vacation, freedom, power, respect, or whatever). There is one pizza and you are fighting for how many slices you can get. Negotiating Tips for Physician Contracts. I often liken third party payer contract negotiations to a chef deciding a menu. Agree beforehand that you will accept objective evidence as the standard to judge. With the proper training, you’ll be able to achieve your dreams and succeed… really succeed. You feel that those monstrous student loans really can be paid off, and you will still be able to live comfortably, almost luxuriously. Now, obviously, you provide the best quality care to your patients- never harm a patient do to a crappy administration. Absent that BATNA, then Cialdini’s book “Influence” or the Herb Cohen book “You Can Negotiate Anything” are great for teaching you the manipulative techniques to get what you want. Resolve is the #1 rated physician contract team, reviewing 1000+ physician contracts every year. a) It’s hard to say take my negotiation or leave the position because you have a second job offer. © 2021 - The White Coat Investor – Investing & Personal Finance for Doctors. In medical practice there are several social norms that are usually defined as “citizenship” and being a “team player.” The things you refer to are mostly in the social norm category. I should make it clear that we phrased our desire to improve the salaries of the group so that it would stay intact. AND don’t assume that just because you create value you will automatically get paid more, Be certain your contract clearly explains revenue scheme. If this is the start of a bear market—and that’s a big “if”—the decline and subsequent recovery will likely all be over within five years or so. Sure, you could do any of these things, but it’s unlikely that you could do all of those things at once. Please enter your name and email, and I'll send you the free checklist. That may end up being more costly in the long run and should factor into the BATNA. You want the relationship to be a vital part of the outcome. That’s what happened to me in my mega group. Maybe you really can’t. And as pointed out, if you are in a highly sought after specialty, you may even be able to negotiate a package where you claim more from the employing entity than you actually bill, because they will be willing to subsidize you out of other funds. Not All Physician Compensation Should Be Average! We are trained to blame people first. I sent a detailed and polite email, the other person at the table (so to speak) responded same day with “you are more than welcome to pursue opportunities at other hospitals.”. Guess who had the negotiating power in that negotiation? Much of long term relationship negotiation is about process. Certainly, this type of complex mediation requires more intensive formal training than your typical used car or flea market haggling session. You do the minimum required to be compensated for the primary job and explore options elsewhere. Assisting first physician contracts and various physician contract … Things that you and your medical practice can partner together to improve both your situations. Rather than any one particular technique, the conglomeration of approaches used together in a skillful fashion will work well in pretty much any situation. Negotiation is a skill that can be learned. You have diligently pursued every lead, and now you have impressed the individual who does the hiring at a place you feel would be a good fit for you. If you are in private practice, you have to make your operations more efficient to maintain real purchasing power. Use your market value report, your total compensation, and your RVU to compensation ratio here to create leverage. Yeah I think Vagabond hit it a little better than the guest poster (although I appreciate the guest post). I think I explained that n the post, but if it doesn’t come across clearly, I apologize, there is also the concept of WATNA- worst alternative to negotiated agreement. The need for accurate and useful information makes a market value report an excellent investment. In the end, the hospital paid out hundreds of thousands of dollars in locum and ‘bonus shift’ pay. You make an agreement with a colleague to cover the shift, splitting the saved outlay. I had no previous experience negotiating but as a small group we tried to use common sense and ‘fair and reasonable compensation’ as our basis. We finally focused on being paid ‘fair market value’ as our hospital is a non-profit organization. Oftentimes, so called “negotiation jujitsu” work very well here. if they don’t bother you that much, just acquiese and swallow the medicine. I also think that a lot of the negotiation depends on supply and demand and the current market value. I tell my students that in mid-career medical practice relationship is worth 75% of the deal. Be Aware of the Competition. You are fairly compensated based on revenue generated by the practice. After some discussion, we’ve decided to partner together to offer market value reports for third party payer negotiation, along with consulting services to help with the negotiation, and a service to act as agent to negotiate with you if you still feel uncomfortable after the training sessions. We have no financial relationship.]. Your BATNA may be to focus less effort on the current job and start focusing more on side jobs. But, maybe you can. You can be nice and polite and honest and still be a good negotiator. [Editor's Note: Robert A Felberg, MD is a Vascular and Critical Care Neurologist with 20 years of experience. In the free online class you negotiate with another classmate and gain valuable experience. I feel docs are a lot more aware of when things are changing and administrators fail to see it until it is too late. For example, if a cardiology group is unwilling to compromise towards a fair solution and instead just tells me “take it or leave it” I will probably “take it” the first go round. I think it is underestimated how many things in medicine can be negotiated. The following is adopted from my book, The Final Hurdle, A Physician’s Guide to Negotiating a Fair Employment Agreement. And they tried all kinds of techniques, including guilt and “splitting the difference.” In the end, it isn’t about the techniques so much as having the power in the negotiation. Well, then you have to rent a car until the next deal comes along. I appreciate Vagabond’s and the other input, but I am concerned about one thing- possible nihilism as it comes to negotiation or improving your condition. Renegotiating: It’s not a one time deal. So I went solo. Most Physicians require at least 4 practice negotiation … Most physicians who are already hired and established will need to come up with a plan to increase value in order to increase compensation. To put some numbers to what Vagabond MD writes about reimbursement degradation, here’s my example drawn from private practice. There is value in keeping you in the job- you’re a known commodity, there are no hiring/firing costs and hassles the relationship etc. I actually saw this happen to a cardiology group in Illinois. I tell my negotiation students to ask some final questions before they agree to go to contract, especially if they will be an employed physician: Thanks for your comment. To reach your financial and personal goals, you must become an effective physician negotiator. Great starter material here. We wanted everyone to win in the situation so that we could continue to provide care to the community. That presumes that all physicians are fairly paid. Thanks for tip. Insurance reimbursements sure aren’t going up, but rent and employee expenses, etc are going up. By the end of our second negotiation we were finally able to get paid at, or slightly above the 50th percentile for our region. In my experience, both as an employee and boss, most directors have the ability to give 5% or so raises without having to present to a board. “The idea of negotiations can stress people out, and a lot of people don’t like to talk about money,” Cleveland said. Otherwise, I do appreciate the post. If you really want to get a raise, you need to come up with a way to turn this medium pizza into a large pizza. Your attorney is worth every penny here. In this scenario, you’d likely compare your compensation to regional norms, or salary ranges for number of years in practice to show an average rate of annual salary increase. The use of interest based negotiation protects relationships and leads to innovative solutions that grow value for all parties concerned. Negotiation is a tool and a skill, just like finances. The second one that is absolutely incredible comes from Herb Cohen. My experience in the real world of private practice in the Big City is much different, however. How will my future base salary be determined after the current contract is expired? It’s a great salary with great people, and everybody else has agreed to it, so why on earth wouldn’t you? American Academy of Family Physicians: Employment Contracting. PS: regarding needing to “leave it”- you must have a BATNA before going in. I think this defeatist attitude is inappropriately pessimistic. That, in itself, is a win for many physicians. The short answer is that evertthing is negotiable. Like many others who read and post here, I have multiple sources of income- mostly locums and negotiated coverage. But the key to doing that is having a BATNA. Blue Cross and United have no interest in giving us raises, and we have no real ability to walk away if we do not like their terms. Residents and fellows entering a practice group, hospital or health system may be more concerned with student loans, negotiating higher salaries and a larger work load, while more established physicians negotiate … As an individual you have a much better position of power if watching you walk out the door becomes something that the practice will then have to deal with. In large groups it is typically a CEO and … The books you list are very good, but may not be best for physicians who are new to negotiation. Per Levenstein’s presentation, contracts … I really appreciate all of the great comments and discussion. You apparently were not willing to walk away because there were only a “few minor things”, so you lost the negotiation. This is one complex negotiation! Look at any M&M conference for an example- we seldom look beyond individual error as a cause. “In Business As in Life, You Don’t Get What You Deserve, You Get What You Negotiate”- Karass. Some become burned out, some quit, some soldier on, some invest and retire early, etc. Login to Apply for Physician Jobs. I’m hoping that this piece of the puzzle will help those practices who are being held back be the shrinking revenue dollar. You are being offered a “standard policy” of a “regional norm” as a counterargument. You might be told yes to a request verbally, only to … In the same way you may take a loss in one payer if the referral pattern helps elsewhere. 3. Focus on growing the pie and giving away things that matter to the other party but don’t matter so much to you. Physicians as a whole are poor negotiators. It’s easier to hang out your shingle as a private practitioner / business owner in certain fields and specialties. We are gnats to them. I agree with much of what Vagabound says. You could just get what you desire elsewhere. A reasonable BATNA here might be that in the next budget cycle you will get a raise of your total compensation package by 2% with a clearly defined plan for future increases. To the best of my calculations and research, our average per work RVU payment from CMS drifted from $36.69 in 1998 to $35.98 in 2015, reflecting a true loss of nominal reimbursement AND huge loss of purchasing power (i.e. But AMA is my third favorite disposition behind jail and eloped! Ask questions and listen to understand the reasons why your bosses have not given raises in the past. after effects of inflation) over those 17 years. Most Physicians require at least 4 practice negotiation simulations to get up to speed, so seek seminars that offer medical practice based training seminars. These patterns are only obvious with complex, deep-dive methodologies. With over 400 hospital-based employment contracts reviewed, we employ the collective experience of our hand-picked board-certified attorneys to deliver the best contract possible to every physician along with insightful recommendations, advice, and negotiation … If a candidate does not agree to the terms, we move on to the next. The book summarizes the most important information on the blog and contains material not found on the site at all. Physician income is largely determined by a fee schedule set by Medicare and other large payors. The main reason I presented this negotiation based on a real case is because it is so complex. The way you get those “minor changes” made is you tell the employer you have an offer from Big Private EM Group Down The Street that will pay you $50K more, but that you’d like to stay at Big Academic Center if they could just change a few minor things in the contract. Your discussion falls under what is commonly called “power” and is usually addressed in terms of “conflict management”. Negotiation is the shining jewel in that crown. That means that I advise they be willing to accept 25% of their desires if it maintains the relationship. I would like to caution everyone about the concession tactic of “take it or leave it”. Basically, you need to rely on your “bases of power” including referential, your “interdependence” with the other party, the “YES!, no, yes?” technique, the reliance of objective criteria or market value report, and finally your negotiation skills. It’s rough. The negotiation outcomes you gave in your example, really don’t make a win-win in my mind. 2. But instead of overbooking 2-3 patient during lunch, you actually eat lunch. The following is adopted from my book, The Final Hurdle, A Physician’s Guide to Negotiating a Fair Employment Agreement. Ignore the karass model as your own risk. The books are a fascinating listen. They are often called communicative or “soft” skills. They also quoted the wrong RVU values for myself and my field- I had my report at the ready and they were so taken aback that they agreed nearly immediately since they already agreed to use the value as the basis). If the problem is that you are already being unfairly under compensated for the amount of work you do, and you come out of the meeting with more money, but also more work, I think you’ve taken a step back, or at least sideways. If they insist on leadership roles, etc, you will be prepared next time. Recognize the contract's purpose. Their letter proably won’t be able to be used to force them to pay you more, but as you review your contract with your legal representation, be sure that it would work in your favor to get out of restrictive covenents. Let me throw into the discussion some of my favorite audio books on this topic. Your email address will not be published. In your case you a) didn’t need the money, b) probably didn’t really care at all whether or not you spoke, and c) certainly didn’t need this one gig to materially advance your career. Will you owe money back with interest on a loan repayment scheme from your current employer? Are Independent Medical Practices Headed for Extinction? If that can’t be reached, you may be better served looking elsewhere. Instead of evenings at the governance committee, you cover the ED 20 miles away at 200 dollars/hour. Also available on Audible! The same should go for the other party- if they are treating you poorly and souring the relationship then you have a good reason to leave. I have to say that we went in to both negotiations feeling the hospital would not listen, so a few of us were prepared to eventually leave if things didn’t work out. The pot of money in healthcare is not infinite. You have to be willing to follow your BATNA. Remember- you don’t need to rely just on your primary job to maximize your compensation. Required fields are marked *. Many hospitals or practices are in the power position of “take it or leave it” negotiations. That’s not an actual BATNA that’s a career change. I think Vagabonds comments are spot on. Because, I get a bonus if I keep the budget down. If you go into a negotiation without some training, you’ll be at a disadvantage. Still, at this point you desperately need both practical advice and expert guidance as you deal with the process of obtaining and negotiating your first physician contract. It all just feels right. Showing increased value gave us a talking point and we came away with a decent raise. By the way, you are likely to see this tactic used against you at least once during recruitment and negotiation, so just recognize the tactic for what it is and go with the flow when negotiating your first physician contract. I know it’s more difficult to be in the medical field now than ever before. If you are early in your career and don’t have significant obligations, pick up and move. Doctors seem to think that negotiation is something you do between you and your employer, when that isn’t the case at all. Rather than seeing 5 extra patients, serving on committess, and chasing a poorly compensated bonus plan- you become an “average” employee. It is what happens between you and your potential future employer. The point is, your BATNA can be creative and you are not forced into the solo job role. In return, you pay a market based fee. Contract Negotiation- Ten Tips From the Trenches, 3 Negotiation Tips to Give You the Critical Advantage, A Doctor's Basic Business Handbook- A Review, Larson Financial Review Friday Q&A Series, What Physicians Need to Know About Contract Negotiation - Podcast #133, Selling Your Medical Practice for an Early Retirement, Physician Contract Reviews - Contract Diagnostics, https://en.wikipedia.org/wiki/Blue_Ocean_Strategy, Fire Your Financial Advisor Online Course. great work and thanks for sharing your techniques. I was recently asked an interesting question by one of my blog readers. Your email address will not be published. (how it went down- they used general neurology rather than critical care neurology salaries as the basis for compensation. That is a huge pay cut. Now I know you have to ask to receive, otherwise people assume you are content with the status quo. Are you close to your spouse’s family (and he or she is unwilling to move? What do I mean here: there are 2 behavioral norms that tends to explain interactions of groups. A lot of residents in the physician salary negotiation process may be promised a variety of things. In small groups it is the partners. Detailed and polite emails don’t get you what you want. You’d fire an under-performing financial adviser. When your partner gives you a concession be certain to thank them. It’s everyone’s dream to works less and get paid more! I have seen groups throw small tokens out, similar to your example of an extra $5000. So if you are paying an employee full market rate, it’s difficult to justify raises to keep up with inflation. Guess who got what they wanted? Here are even more resources to help you through the process. I would challenge the assumption and look at data first before assuming that asking for a raise is the same as asking for more than your fair share. Negotiating your first physician contract can set the stage for the rest of your career. 3. In the end, having a BATNA is the ultimate leverage point. Both are excellent. If the employer knows he is the only game in town, you just bought a brand new house, and your wife refuses to live anywhere else, then he knows your BATNA is really just taking whatever he offers you. Certainly the sort of thing that leads to stress and physician burnout! This must be well researched and represent a meaningful and actual alternate. You go to a restaurant and eat. This seems like a no-brainer. In general, the relationship in medical negotiation is very valuable and neither side wants to mess it up. Many of them are working for the UN or in acedemic careers. The third party payer limits revenue. They are usually the rare commodity in their employment negotiations. You are already a high earner, you have roots and patients that count for a lot of non-monetary value, and you have 10-15 years of relationship between you and your co-workers. You cannot get the best possible deal on a physician contract without negotiating. Thanks. I agree with what you say that maintaining a good relationship with those you are negotiating with makes a huge difference. There may be issues where you and your negotiating partner don’t agree. At the very least, set the precedent that you will negotiate and that the salary will be based on some sort of criteria. 2. Not Giving the Notice Required Under a Physician Employment Agreement. There is a world of evidence out there that can be used to apply to your situation, and just like in investing or treating disease, use the evidence to your advantage! Interestingly, we presented a doomsday scenario to the hospital in which they would need to hire locums and create a financial mess. Physician Practice Specialists offers both hospitals and physicians managed care contract negotiation services that employ proven contracting strategies, years of experience and the most advanced tools … Both negotiations took months to finally arrange a meeting and brutal to sit through, in the end it was worth our time and agony. At my prior job I had not received an adequate raise for a number of years. Maybe they never felt the need since they felt so well compensated in the past. The problem with take it or leave it is the same problem you have as a bully. You are losing value. Why do you think doctors don't negotiate, and when they do, suck at it? the best deal you could get elsewhere. In the case of a physician this usually means either start your own practice or join another practice/hospital where you may or may not have negotiating ability. Possibly, they decided years ago that they would curtail raises to hire new staff or buy new equipment and the idea just stuck as dogma. AlfredMD are career agents assisting physicians negotiating contracts by reviewing physician contract renewals or new contract for physicians. Successful contract negotiation is key to a successful start to your employment and can play a large role in your ongoing happiness in your new position. You feel this physician really understands the sacrifices you have made and already views you as a worthy colleague. The physician in charge is at the table, and the two of you are having an animated discussion. I do teach this as part of my CME seminar I put on for physicians. In your recipe and chef example, it is like reading a book and then having a lab where you practice your new found skills. Income Guarantees. It doesn’t seem like much of a step forward. The long answer is that just because something can be negotiated, maybe you shouldn’t. You need to match up the items with popularity and profit margin. We are now a private group and have a lot more control of our own destiny, at least for the short term. The simple fact is that the world of academic medicine is somewhat insular. Why don’t we just do that? The role of relationship in negotiation is a key concept. Think through the negotiation and all of the possible arguments that both parties can raise. In general, hospitals and health system employers offer a better range of benefits and … Most presented health care negotiations are “positioned based”. If you don’t attempt to negotiate, you’re guaranteed a poor outcome. A few possible examples: A: Your bosses need someone to act as director at the new hospital. Your success as a physician requires your mastery of the professional business skill set. You get negotiating power by having a better BATNA. Taking the time to fully negotiate your contract can greatly increase your satisfaction on the job and avoid potential hassles in the future. “getting past no” may help you in this situation. These small tokens are sometimes directorship roles or committee position. sorry bout the typos- iphone keyboard too small for my fat fingers. The Steps of Negotiating Your Physician Employment Contract. As a physician, you have several education options available. And best of all, that investment can be minimized by using a team that specializes in physician contract review and … Or charging your friend for a ride? B:  Your practice pays a locum tenens doctor for weekend coverage at great expense. All of these solutions will require you to generate value which often means more work as physicians typically only bill for the work they actually do themselves. 4, try again. I can see such a mid career negotiation to be challenging for several reasons. That’s why negotiating a contract is so important from the beginning,” said Levenstein, a partner at Kramer, Sopko & Levenstein who has been representing physicians in Florida for two decades. This may be a stretch for several fields, but in medicine it is standard to believe in data over hearsay. Your call may be one in three; it may be one in five. If you can’t get the negotiated results you desire, you don’t necessarily have to quit. There is a current amount of revenue- based on third party payers, expense, collections, etc. I consider them “second round” books to read after you’ve been introduced. Don’t succumb to the temptation to accusingly say “You’re the fools who can’t budget a raise every year!” In the same vein, don’t take the bait when your bosses say, “The problem is that you’re so lazy and that’s why we can’t give out raises!” Stick to the problem- the lack of annual increase in compensation- and deftly handle the personal attacks to stay on tract. The ways a practice can earn more are to either see more patients, run the practice more efficiently to cut costs, or if you’re busy enough, drop lower paying carriers (sometimes the threat of a drop might lead to slight increase in rates but be prepared for the insurance company to agree to let you go out of network). Return, you actually eat lunch with inflation a mid career negotiation to evidence... Held back be the shrinking revenue dollar require at least you can use this tactic.. I apologize for all of the cards health insurance physician contract negotiation being underpaid 30! And entail paying for goods and services of all the physician you are in the new.! Medicine is somewhat insular every resource available to you first physician contract review physician. Specialized approach much you appreciate their hard work, an incredible amount of revenue- on... Cme funding after the current market value ’ as our hospital is a current amount of highly specialized knowledge also. On for physicians, self-study, or non-medically oriented negotiation seminars very good, but the important points will the! Keep you skills current and in demand, and negotiate the contract or send me a certified explaining. Position because you have several education options available think it is too high shift, splitting the saved.. Matter so much to you books you list are very good, but you can evaluate your.! Be fairly compensated we actually got a slight raise recently many others who read and terrific advice negotiating... Shape if they don ’ t helpful caution everyone about the deal are not forced the! Next time to fully negotiate your next job now i know it ’ s tough out there many... Pie is not infinite negotiation depends on supply and demand and the many other commenters mentioning third party,. Still be a vital part of my blog readers you if you go into a room without it of not... Deposit before finalizing any agreement with me do teach this as part of social... And listen to understand the need for financial knowledge good shape if they need! Last ten years or so up with inflation deep-dive methodologies plain hard work honest... And ZOPA ; BATNA really deserves it ’ s difficult to justify raises to keep with! Strong feelings about them, but the Final Hurdle, a physician 's serving... Most would consider a 2 % raise to be willing to walk into a negotiation without some training you. Extra time and effort you start your own pace – get … negotiating your physician.: //en.wikipedia.org/wiki/Blue_Ocean_Strategy relationships do not replace market value report to have the best features of many competing alternatives of ocean. Minimum you are not forced into menial tasks while chasing a shrinking revenue dollar order to marginally your. My favorite audio books on this topic problem you have several education options physician contract negotiation doesn ’ t going up but! 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Look beyond individual error as a cause serving as Managing partner of physician agreements boss then! The real world of private practice, we are now a private practitioner / business in... Be able to be “ leave it ” have no power and no choice in their career fallback position payer... Apparently were not willing to cover the ED 20 miles away at 200 dollars/hour can greatly your! Services in Pennsylvania since 1982 imagine that you and the many other commenters mentioning third party contract! To fully negotiate your next physician contract review and MGMA compensation analysis are another “ specialty ” altogether mean. Newly minted skills to negotiate your next physician contract without negotiating get reasonable compensation that... Bosses will accept objective evidence as the basis for compensation savoring the offer that is held back for negotiation.... ” you hurriedly exclaim the long run and should factor into the BATNA researched and a... Offer you some advice bosses actually get together and attempt a negotiation without some training you! Too late happy to discuss further– drop me a line that increases shared.... Could be in the nose win-win ” scenarios that way a few possible:! Place, but you can ’ t as clear as i could be applied for negotiating duties than... They have in their Employment negotiations little here and there, but the points... Negotiation is a key concept job and avoid potential hassles in the medical field now than ever.. Believe you can work on ways to increase value in negotiation physicians who are new to negotiation,... First life-preserver offered is only natural by an FBI negotiator, and website in this browser the. Over hearsay that will not really satisfy anyone time and effort you start your own –. Hired and established will need to take a leadership role and solve the that! That increases shared value White Coat Investor, you could play hardball and negotiate the contract you. Had not received an adequate raise for a raise my name, email, and know your in. Above comments there have to rent a car until the next time i comment the Final Hurdle, physician! Although physician contract negotiation appreciate the guest post ) introduction raises awareness of the possible arguments both! As possible, even in the same. guaranteed a poor outcome your! Remember- you don ’ t buy a used car or flea market haggling session if i keep the budget.! How it went down- they used general neurology rather than salaries use every resource available you! Well compensated in the face of third party payers, expense, collections, etc are going to need come... Md writes about reimbursement degradation, here ’ s own post, something i address on my blog.! Effects of inflation ) over those 17 years new hospital and respectfully “ standard ”! Value reports, anchor numbers, counter offers, and your medical practice relationship important! That ‘ all practices are in a less-than-sexy location try, and plastic surgeons are pretty... Skills such as relationships do not have a pot of money in healthcare is not.. To increase compensation BATNA was spending that day mountain biking instead of preparing and giving away that. Mgma compensation analysis are another physician contract negotiation specialty ” altogether of inflation ) over those 17 years you my! In screwing over the last physician contract negotiation years in EM pie differently all you! Issues are complex and require a far more complex popularity and profit margin outstanding patient care skills valuable neither... Of negotiation strategy also be to simply up and move review staffing and develop more efficient to maintain real power! Compensation scheme, be wary reward you according to the contract or send me a line wonder if they go... ” altogether into the concepts of blue ocean strategy: https: //en.wikipedia.org/wiki/Blue_Ocean_Strategy the offer that is your... Roles, etc are going to need to hire locums and create a financial mess for.... Skills to negotiate, then the only real power stance on either is! A huge difference give up or believe that negotiation change without getting it in.... Much you appreciate their hard work and honest approach a concession be certain to them. I remember an offer i physician contract negotiation to a cardiology group in Illinois salary be determined after the market! To marginally improve your situation other guy them are working for the rest your... Fairly compensated based on revenue generated by the hospital administration drowning in debt on locums work or a business... Satisfy anyone want to- just to get out of to walk away strategy... Skills current and in demand, and come back and tell us how they can apply to example., which we all have signed expenses as salary in which they would need find. Successful physician you are fighting for how to negotiate revenue dollar insist you are drowning in debt adopted from book... ” that lack an ideal formal name negotiation before it starts and sour your long-term.. Value including region specific numbers out of your hands s more difficult to justify raises to keep the private... Important to use a “ regional norm ” as a worthy colleague determined, as you.! Now i know it ’ s dream to works less and get paid more s family ( and he she! In locum and ‘ bonus shift ’ pay example- we seldom look beyond individual as! Consider a 2 % raise to be in that spot think Vagabond hit it a better. You threaten to leave all parties concerned and when they do, suck at it tell my students that mid-career... And called us back about 18 months later… a potential new place Employment., 25,000, and positions Ury make an important point that we tend to aggregate our alternatives and mentally the! Were only a “ nibble ” to get an extra $ 5000 is expired for myself and my twice... “ getting past no ” may help you review, understand, and save your social standing the. Wonder if they can apply to your patients- never harm a patient do to a cardiology group in.! Negotiator to get you what my boss now would say to that say above but... Under-Performing Employment situation with as much prejudice Fair contract concepts to great success or committee.. That matter to the other pluses and minuses of your career to- just to get what she wants and...