From Residency to Reality
Your Future Practice:
Options & Opportunities
AAFP Practice Management
Teaching Tools, Series I
Session D-1
Practice Options
 How
to Negotiate an
Employment Contract
Tricks,
Traps,
& Techniques
Becoming an Effective Negotiator

Note: Negotiating 101 is not a required
course in most U.S. medical schools.
Before You Negotiate
 Who
are the
decision-makers?
 What
background
information have
they given you?
 What
are their
key interests in
negotiation?
Before You Negotiate

What additional
information
could you
legitimately
obtain from
outside sources?
Opening the Negotiations
 Defining
your interests
and their interests
 Finding areas of mutual interest
 Affirming key principles and values
to be honored in the negotiations
 Agreeing on the negotiating process
(who, what, when, where, and how)
The Middle Game: In
the Heat of Negotiations



Stick to your negotiating principles
Be collaborative, but watch out for your own
interests (they’ll watch out for their own).
If the variables are shifting, keep your
eye on the bottom line.
The Middle Game: In
the Heat of Negotiations
Key Concepts:
Principles
& Priorities
Anchors & Targets
Upper & Lower Limits
BATNA & “walk-away”
The Middle Game: In
the Heat of Negotiations
Don’t
Do




Select your opening bid
carefully (modestly high,
but not outrageous)
Bring written materials
to support your position
(MGMA income surveys)
Know your “walk-away”
(BATNA) position
Have alternative or
competing offers in mind





Don’t talk more than
you listen.
Don’t legitimize a bad offer
with a counter-offer.
Don’t give out your best and
final offer prematurely.
Don’t make an ultimatum.
Don’t burn any bridges -you may negotiate with
these folks again someday.
The Middle Game: In
the Heat of Negotiations
Monitor Your Emotions:
Angry
or Frustrated?
Too Eager?
Insecure?
The End Game:
Coming to Closure
 ABC
-- always be closing
 What
further information could I provide
to help you make your decision?
 When will the board ( search committee,
etc.) meet to make their final decision?
 When should I tell my spouse (partner,
friends, other potential employers) that
we will be able to come to a final decision?
The End Game:
Coming to Closure
NBD -- never be desperate.
 Make your initial commitment conditional.



(the contract looks okay to me, but I just need to run it
by my lawyer, accountant, spouse, mentor, etc.)
Keep your “walk-away” options open until
both parties have signed the contract.

Otherwise you’ve lost your bargaining power -- you
have no option but to accept any last-minute changes
they demand.
Negotiating Tricks & Traps

Ambiguous Authority

I’m sure my partners will
be happy to cover for you
when your baby’s born.
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Watch out for last-minute
deal changes

(one little thing -- we
had to go with the 5-mile
no-compete clause after all;
that’s not a real problem,
is it?)
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Dubious Intentions

After two years you can buy
into the practice -- I’ll be
retiring soon, and this will
all be yours!
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Phony Facts

Even without a guarantee
you’ll make $200,000 in
your first year -- EASY!
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Good Guy / Bad Guy

I’d offer you more, but my
partner is pretty
conservative; Let’s just get
you here and once he gets
comfortable with you we
can re-look at things.
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Less than full disclosure

Once this new kid gets here
we can offer evening and
Saturday hours and open
that satellite clinic we’ve
been thinking about.
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

Dubious Delays

Since you’re asking for
more than our standard
salary I’ll have to take it to
the PHO board -- they meet
again in June. When did
you say you want to start
work?
Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Negotiating Tricks & Traps

The Standard Contract
Everybody signs it!
 If we changed it for you,
we’d have to change it
for all the doctors.
 Gee, nobody ever questioned
it before.
 You don’t need a lawyer.
 Don’t you trust us?

Adapted from “Getting to Yes: Negotiating Agreement without Giving In”
(Authors, Roger Fisher and William Ury)
Final thoughts

Remember -- it’s
not just about money.



Did you get the job you
wanted?
Are these the colleagues
you want to work with?
Did you maintain your
personal values and
priorities?