Dear Dr. Goodhook,

I’m about to do in-person interviews with several different hospitals. I’ve completed phone interviews with each, and they all seemed very, very interested.

I’m stressed about making the right choice, especially when it comes to negotiating a contract I’m comfortable with. Frankly, I’ve never felt confident about negotiating or standing up for myself, but if several hospitals are fighting over me, I think I should get what I deserve.

Do you have any negotiation tips for me? As I said earlier, I’m anticipating several offers, and I want to get the best package I can.


Anxious in Arkansas

Dear Anxious,

To be quite frank, you don’t sound anxious at all. In fact, you sound rather cocky, and I assure you that your assuredness may be your worst enemy in this situation.

Don’t count your chickens (or your hundred dollar bills) before they hatch. It is often the case that many employers express interest, especially with extreme physician shortages. However, interest doesn’t guarantee an offer.

You haven’t even completed in-person interviews yet. I’m afraid you may be setting yourself up for disappointment.

Whether you receive several offers or not, the following advice will provide veteran insight into the tumultuous waters of physician contract negotiation.

Mind Your Market

Always, always know the market for the area in which you intend to practice. Comparing your colleague’s offer from Upstate New York to your own is a horrid idea.

There are major fluctuations in pay from region to region, and rural hospitals will almost always give heftier paychecks than metropolitan ones.

Your letter indicates that you’re located in Arkansas. If you’re intending to practice there, learn the playing field. Here are some rudimentary questions to ask yourself:

  • Is your specialty or expertise in demand?
  • Is your region in demand?
  • Is your community in demand?
  • What are similar opportunities in similar communities paying?

You’ll be in no position for negotiation if you don’t understand your market.

Imagine trying to sell copper for gold prices! You’ll get the same look if you try to negotiate anything and everything you want just because “you deserve it.” Be wise.

Don’t Jump the Gun

In other words, don’t make promises you can’t keep.

If you’re unsure as to whether or not you would like to accept an opportunity, you are not ready to negotiate.

Negotiating just to “see what you can get” from an employer is a sure way to burn bridges. Indicating that you will accept an opportunity, working through negotiation and then jumping ship is a waste of the employer’s time and yours. It also wastes other candidates’ time.

Finally, remember that the time for negotiation is when you receive the offer letter, not after the formal contract is sent to you to be finalized.

Don’t Get Carried Away

Say you’re confident about accepting an offer and are genuinely ready for the negotiation process. Hold your horses — stop and think before you make demands.

I once knew a young physician just out of residency who had his attorney rewrite the hospital’s agreement in its entirety. Needless to say, the hospital rescinded the offer.

Do seek legal counsel when it comes to negotiation, and don’t get carried away. You’ll find that negotiation is a trade-off process; if you really want something, you may have to forfeit something else.

As a last word of advice, never, ever base your negotiations on your colleagues’ offers. Base them on things like your specific circumstances (medical school debt, experience, specialty, etc.) and market conditions.

It would serve you well to visit the Contract Negotiation Stage in the Adventures in Medicine Resource Library. There, you’ll find priceless wisdom regarding contract terms, negotiation timelines and how to select an attorney.

-Dr. Goodhook

Has physician contract negotiation ever backfired on you?

Have you ever successfully negotiated a physician contract to your advantage? If so, what tactics did you use?

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