When Ramona Kwapiszewski, MD, left private practice to pursue a position at a community health center in Muskegon, Michigan, she realized job negotiations with a federally qualified health center like Muskegon Family Care would be limited. “I knew what to expect and there wasn’t much to negotiate other than personal preferences,” she says. “I felt comfortable with what I wanted; I clearly defined what I wanted”— and she got it.
Nephrologist Blake Shusterman, MD, in a private practice group in Greenville, South Carolina, has a different story to tell. Although he felt primed for negotiation from instruction he received during his fellowship program at the University of Virginia, he thinks talks fell flat. “I felt I was well prepared going in, but I really did not end up with a lot of negotiating power,” he says. “Maybe I just didn’t do a very good job.”
A number of factors that could have contributed to the different outcomes in Kwapiszewski’s and Shusterman’s experiences, but they both ended up taking the jobs in question—not for lack of options—and both are glad they egotiated. “It’s all business and shouldn’t be taken personally,” Kwapiszewski says. Shusterman agrees. “There really wasn’t much to be upset about in the end,” he says.
A little background goes a long way
So—before beginning the negotiation process, it’s important to do your homework and don’t be afraid to enlist help. “Find a mentor—a very good physician you’ve worked with, whom you’ve trusted, and have them go through what they think (the new doctor) would be best suited for,” Kwapisiszewski says.
Learn about the business and clinical reputation of the group that has offered you a job. Find out how much physicians in your specialty and in your area are earning. Figure out what you need from a job and what you want from a job. Although it may seem too early to bring on professionals, contract specialists agree hiring an attorney—preferably one with healthcare experience—as soon as a job is offered will help you navigate the process. Think of the attorney as an adviser; you may still do the negotiating, but you’ll have someone with whom to consult along the way.
According to Marci Jackson, the director of physician and provider recruitment at Southwest Medical Associates in Las Vegas, “Contracts are written to define who is going to do what. They’re not generally constructed to favor either employee or employer, but if the contract is going to favor one party over the other, it’s going to be the employer,” she says. “You need to see if the tradeoff is good enough for you and whether you’re getting enough to offset what you’re giving up.”
It is important, however, to understand that different types of employers may have varying ranges of bargaining capability. “The more complex the structure—the more bureaucracy you have—the less flexibility you’ll have in the contract stage,” says C. Joyce Hall, a healthcare attorney who is a partner at Watkins & Eager in Jackson, Mississippi. “If a doctor is being presented with a contract [from a group] that has clinics in 20 cities, he’s going to have a lot less bargaining power than with a small group in one city.”
That said, there are basic things to keep in mind when beginning the negotiation process. “The most important thing is that what you’re asking for is reasonable,” says Tommy Bohannon, the senior director of recruiting, development, and training at the Irving, Texas-based physician recruitment firm Merritt, Hawkins & Associates. “If you are asking for something that is out of the ordinary, you need supporting data to back that up. You have to validate your request.”
The second point to remember in negotiating, especially if your requests are out of the ordinary for the potential employer, is to let the employer know you’re ready to accept the job if the employer is willing to accept your requests. “You have to make sure there’s a commitment tied to the request,” Bohannon says. Otherwise, employers might not take you seriously.