How to negotiate well

How to negotiate well

It's often not what you say, but how you say it

December 2017

ASKING a potential employer for more money can be uncomfortable, especially for new physicians. But experienced doctors say that if done well, negotiating pay or other factors in a job offer makes perfect sense.

Here are some communication tips to help young doctors negotiate successfully during their job search without coming across as too aggressive.

“Interpersonal dance”
Mark Silberman, MD, chief of emergency medicine at Saint John’s Riverside Hospital in Yonkers, N.Y., describes negotiating as a delicate balancing act. “If it’s handled well,” Dr. Silberman notes, “it never hurts to ask and try to negotiate. When done politely and respectfully, it’s worthwhile having a frank, cordial discussion of how a group can make the offer more attractive to you. It’s like an interpersonal dance.”

“Some practices are starting to stick with a tighter salary figure or salary range.”

Sherriff~ Julie Sherriff
Sherriff & Associates Inc.

To get started, appraise the needs of the practice you’re interviewing with and see where you fit in. “Are there a lot of people applying for this position, or are you one of a few?” Dr. Silberman suggests asking. “It’s good to get an idea of the circumstances behind the hiring. If you want to negotiate, you should have a sense of where the offer might stand.”

If you decide to negotiate dollars and cents, take a gradual approach. “It doesn’t make a good impression for the first question in an interview to be about how much you’re going to be paid,” Dr. Silberman says. “It’s OK to ask early on about the structure of the team, how everyone works together and what kind of coverage the group has, but I would recommend that candidates not focus on salary and benefits on the front end. It’s better to get a sense of whether a job is a good fit first and then move on to those questions.”

Jumping right into a conversation about money can leave a bad taste. “It makes the best impression if you focus on the type of patient population and collaboration with your colleagues to really give the impression that you’re an outstanding professional first,” Dr. Silberman says. “Once you have those questions answered and you feel like a job is a good fit and you’ve presented yourself as a professional, you can begin to talk about the other details.”

The right—and wrong—approach
If you decide to talk about money, there are ways to avoid rubbing people the wrong way. “Even if it’s your dream job,” Dr. Silberman says, “it doesn’t hurt to try to negotiate. Say something like you’re very interested and you really like the organization, but you were hoping to make X dollars, and then ask if there is any flexibility. It all depends on how you ask, but I think there’s very little downside to at least politely exploring the possibility.”

Chris Elsayad, MD, an attending in the department of medicine and co-clerkship director for medical students at Nassau University Medical Center in East Meadow, N.Y., likewise suggests that physicians take a low-key approach to negotiating pay. “Ask if there is any movement in this number,” Dr. Elsayad explains. “Some groups will say, ‘We’ll see what we can do.’ It depends on how much they like you and how much they need a physician.”

Not everyone, however, takes that approach. “I’ve had physicians come in who from the start are trying to find out how they can make the most money possible,” says Dr. Silberman. “If you’re a physician, you need to show that you’re focused on what you’re doing for your patients and your colleagues. If you’re concerned about only money, you sound like a hired gun, a mercenary who is not very professional. I have had physicians come in like that, and it was a very big turnoff.”

Veteran health care recruiter Julie Sherriff, president of Sherriff & Associates Inc., says that over the last couple of years, she’s started seeing pushback from employers and recruiters who are unhappy with what they see as unrealistic expectations from physicians. “Some practices are starting to say that the fair thing to do is stick with a tighter salary figure or salary range,” she explains. “They are no longer going to bend over backwards to attract physicians by paying them more than is typical in their market.”

Ms. Sherriff also says that some employers are hearing what they consider to be unreasonable demands about call. “Some young physicians say, ‘I’ve got kids and I can take call only every fourth weekend or every two months.’ ”

Faced with such situations, some practices are saying enough is enough. “Their position is, ‘We’ve got to move on because we will never be able to meet their demands and they’ll never be happy here,’ ” Ms. Sherriff says. “We’ve learned that by trying over and over again to provide a more personalized program, the real losers are the patients.”

Industry veterans suggest that physicians take a middle approach. Even given the huge physician shortage, find a middle ground where you stick up for what you want, but without antagonizing the organization on the receiving end of those requests.

Who did well in kindergarten?
Being consistent can go a long way toward keeping negotiations calm, according to Annie Fowler, vice president of physician services for Sound Physicians, a performance management organization specializing in critical care and emergency and hospital medicine. “As long as candidates are not aggressive in how they communicate and are respectfully posing questions, it is in their best interest to be very clear about what they consider to be a deal-breaker.”

Dr. Silberman puts it even more simply: “I like to say that we hire people who did well in kindergarten playing together in the sandbox,” he says. “We look for mutual respect, a willingness to help out and interpersonal communication skills. Those are some of the most critical skills for a physician to be successful.”

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