1. Review your contract and identify the most important items to negotiate
2. Understand what you should ask for in physician contract negotiations
Preparation is the best strategy for successful physician contract negotiating. Review your contract carefully, which you can do with the help of this member-exclusive simple checklist that will help you identify possible concerns.
Make a summary of items most important to you, and order them by priority. Identify the major goals you’re seeking in an employment opportunity and any concerns. Understanding your goals and what is important to you can help refine your review. For example, if burnout is a concern, consider prioritizing scheduling issues or avoiding burdensome administrative or call requirements.
Although some people like to have “throw away” items to use in negotiations, this can sometimes backfire if the employer is presented with a laundry list of issues, some of which may be of questionable value or consequence.
Talking with other physicians in the organization about how they have been treated can help you learn more about what you can negotiate for in a contract. Ask for the same or different items or treatment based on the information collected.
The willingness of any employer to modify an employment agreement depends primarily on the employer itself. Is it a large organization with standardized contracts they can’t or won’t change substantively? Do you have extra negotiating power because the employer badly needs a physician? Has the employer agreed to changes in the past but later regretted that decision? Every party to a contract negotiation comes with its own set of experiences and goals, and it helps to understand what they may be.
Payment of your AAFP Membership
08
Clearer for-cause termination provisions
07
Limiting enforcement of non-compete agreements to only certain reasons for termination, excluding reasons outside of your control, like force majeure
06
Increased time off
05
Work location and schedule clarification or changes
04
CME funding
03
Time outside of patient care hours to complete administrative tasks
02
Increased salary
01
Some of the top items to consider negotation for roles in any setting include:
Choosing and hiring a lawyer and working with a financial advisor are the best ways to equip yourself for success.
A financial advisor can help you understand the tax implications of your salary offer and can research compensation averages in your area to help you negotiate salary.
An attorney can discuss the contract language with you, including focusing your attention on issues you may not have noticed or understood.
3. Hire the right advisers to coach you
READ MORE
Know what questions to ask an attorney before you hire one to review your contract.
How to Choose a Lawyer
A negotiation is the beginning of your relationship with the employer and sets the stage for what working together will be like. You’ll gain insights about your future employer through direct interaction and can better convey your needs and concerns than a legal representative could. Plus, many of the items you’ll likely identify for negotiation, such as salary and daily activities at the organization, don’t involve legal issues.
A self-led negotiation can demonstrate your thoughtfulness to the employer and give you insight into the employer-employee relationship you are considering entering into. For example, if the employer seems indifferent or dismissive of your concerns or responds in a condescending or rigid manner, that’s a potential red flag. On the other hand, you can find great reassurance in an employer’s responsiveness and detailed explanations on various issues. None of this can be fully captured by having legal counsel engage in the discussion on your behalf.
Additionally, you’re best positioned to directly address items you have questions about from your interview conversations and previous discussions.
Bringing legal counsel into the negotiation is best when there are legal issues that remain after you’ve worked through the initial items on your list with the employer. Narrowing down the items to be negotiated before counsel gets involved can also help reduce legal expenses.
4. Conduct negotiations yourself
Many times, physicians are forced to rely on verbal assurances and promises when they negotiate an employment agreement. Many employers, especially larger ones, simply will not make any changes in the written contract, meaning that you must trust that the employer is acting in good faith if you choose to sign an agreement with them.
As you assess elements of your contract you are not able to get changed in writing, you have to decide what you are willing to live with and if the issue is worth walking away from the job opportunity.
If you sign onto a contract that does not perfectly reflect the terms you had hoped for, it is especially important when this happens that you're aware of and satisfied with the contract exit strategy. Ask yourself: If I am not happy in my job, do I understand the termination provisions? Do I know how to get out of my contract and what the consequences will be?
5. Get every change in writing
Be aware of exactly how you can terminate the agreement and what that would look like before you sign. Termination can have numerous effects on items like insurance, bonuses, non-compete agreements, and loan forgiveness. A lawyer can help you develop a plan.
6. Know your exit strategy
"...though I negotiated to get what I thought I wanted, I didn’t clarify enough details. In the end, it was really the wrong fit."
Read Member Contracting Advice
A contract should present more pros than cons. Only in a situation where you have no other likely opportunities, for example, due to issues such as immigration or loan forgiveness requirements, should you sign a contract with more cons than pros.
Compromise too much, and you can find yourself in an unhappy employment situation. Although negotiating often means letting go of some items, stick to your original priorities (e.g., if providing obstetric care is important to you, make sure your contract includes that scope of care).
7. Abandon negotiations if your priority items can't be met
7 Contract Negotiation Tips and Tools
Use these seven tips to guide your physician contract negotiation strategy and reach a successful outcome:
~ MaryAnn Dakkak, MD, MSPH
Review your contract and identify the most important items to negotiate
1
Understand what you should ask for in physician contract negotiations
2
Hire the right advisers to coach you
3
Conduct negotiations yourself
4
Get every change in writing
5
Know your exit strategy
6
Abandon negotiations if your priority items can't be met
7
READ MORE
Work with AAFP partner Resolve to find data and professional negotiation support.
Exclusive AAFP member benefit with Resolve
A negotiation is the beginning of your relationship with the employer and sets the stage for what working together will be like. You’ll gain insights about your future employer through direct interaction and can better convey your needs and concerns than a legal representative could. Plus, many of the items you’ll likely identify for negotiation, such as salary and daily activities at the organization, don’t involve legal issues.
A self-led negotiation can demonstrate your thoughtfulness to the employer and give you insight into the employer-employee relationship you are considering entering into. For example, if the employer seems indifferent or dismissive of your concerns or responds in a condescending or rigid manner, that’s a potential red flag. On the other hand, you can find great reassurance in an employer’s responsiveness and detailed explanations on various issues. None of this can be fully captured by having legal counsel engage in the discussion on your behalf.
Additionally, you’re best positioned to directly address items you have questions about from your interview conversations and previous discussions.
Bringing legal counsel into the negotiation is best when there are legal issues that remain after you’ve worked through the initial items on your list with the employer. Narrowing down the items to be negotiated before counsel gets involved can also help reduce legal expenses.
Watch Videos
Improve your negotiation skills which can have a long-term positive effect on your career and personal life.
Members Only: Free Negotiation Video Series
Watch Videos
Improve your negotiation skills which can have a long-term positive effect on your career and personal life.
Members Only: Free Negotiation Video Series
Watch Videos
Improve your negotiation skills which can have a long-term positive effect on your career and personal life.
Members Only: Free Negotiation Video Series