Bo Wang 王波, MD, PhD (Class-80)
Dallas, TX

Who Should Negotiate?

Most of the medical residents or physicians shy away from negotiations during their physician job search and would want their lawyers to negotiate with the employer. But remember not all lawyers may negotiate for you. Most of the lawyers will review your physician employment contract and tell you about the potential pitfalls. Then it is up to you to bring it to the employer. If you want your lawyer to do the contract negotiations, make sure it is clear in the beginning before you sign an attorney client relationship.

There is a trade off as to who should negotiate with the employer. If it is the attorney then the process is usually slow, out of your control and can be expensive. But it is professional work, saves you from the pain of negotiating and may benefit you especially if your negotiating skills are poor. On the other hand you can decide to negotiate yourself. It also can be worth the experience as well as effective, educational, and free.

How To Negotiate Your Own Contract

You can negotiate with your employer. There should be no stigma attached to it. Here is one of the ways to do it:

STEP 1. Ask the prospective employer to send you the contract. Do not start negotiating until you receive the contract.

STEP 2. Review the physician employment contract at least three to four times word to word yourself. Make a list of sentences or conditions that bother you.

STEP 3. Get the contract reviewed by the attorney. He will give you a list of conditions that you may need to address with the employer. Also discuss the list you made in step 2 with the attorney and add relevant topics to put up for discussion.

STEP 4. Call your employer and tell him that there are some concerns regarding the contract that you would like him to address. His response to you will be “This is a standard contract for everybody.” But politely insist that you would like some changes in it and offer to email or fax him the list. The employer may want to discuss it right then and there, but if the list is too long, do let him know. It is a good idea to give them some time to think on it. The employer usually will also run it by his attorneys.

STEP 5. Type up the requested changes in bullet points on a word processor. Do make reference to page number, section, sub-section and line number. Also add an excerpt of the sentence you want changed and the language of the new sentence. Make separate bullet points for asking increase in salary, vacation days, sick leave etc. Send this list to the employer.

STEP 6. Most likely you will receive a call back from the employer, who by that time would agree to some of the changes and will decline the others. Now it is your turn to think whether the declined changes are significant enough for you to refuse the offer. Tell the employer to give you a day to think and then call him back later regarding your decision. Remember you will not get everything that you wanted. The principle of negotiation is to meet half way where both parties feel they won.

STEP 7. If you feel that there is something that definitely needs to be changed then inform the employer about the same. Be clear. Usually this is a gamble because if the employer really cannot give it up then most likely he will go for another candidate. But remember he has spent some amount of time and money trying to negotiate contract with you. So it is not easy for him to back off too. He will try to either convince you to give it up or may try to work out an alternate solution. If nothing works then he may either give in or let you go. You can execute this step very well if you have an alternate physician job or plan in hand. In that case power balance tilts in your favor. The upper hand in a negotiation is of a person with a plan B.

STEP 8. You will receive an amended physician contract from the employer. Again carefully review the contract and make sure the agreed upon points have been added or amended in the contract. Have the amended physician job contract reviewed by your attorney again.

Step 9. Be sure to understand "non-competition" clause. Almost in all physician contracts, there is a non-competition clause where you should pay a special attention. This will affect you and your future plan if you leave the practice (including academic institute) or terminate the contract. Non-competition clause basically tells that you cannot compete/practice the same nature of practice/specialty within certain radius and within certain years. This clause will exclude you practice within certain miles of radius of employer's location for certain years. So knowing ahead and planning ahead so that you will not be trapped in a very difficult situation.