Do you know how to negotiate a job offer like a seasoned professional? Do you have experience comparing physician offers? Unless you’ve matriculated through medical training with business or legal bona fides in tow, you’re probably a bit short. That doesn’t mean, however, you can’t nail the finer points of an offer or a physician employment agreement. In fact, with a few basics under your belt, you’ll be better able than ever to evaluate your opportunities, not to mention compare apples to apples.

Details matter when it comes to weighing the critical aspects of competing options. What should you know generally to launch yourself?

Step 1: Know yourself

For starters, you want to be comfortable in your own skin. That means approaching every interview and opportunity driven by your goals, confident in your leverage and eager to capitalize on what you know about yourself. What do you need in a position and workplace to satisfy your goals?

Ethan A. Nkana, JD, MBA, puts preferences ahead of provisions when it comes to working with his Rocky Mountain Physician Agency clients. That is, he’d rather concentrate on their priorities first versus what they understand—or don’t—in an agreement. That includes focusing on three key areas: work/life balance, practice support and professional development. 

As a candidate, you’ll likely benefit from the same introspection. If, for instance, work/life balance tops your must-have list, what does your workday need to look like to realize that coveted equilibrium?

Whatever your agenda, knowing yourself is key in charting your course. For instance, Eric Wargotz, MD, president of the Maryland State Medical Society (MedChi), recalls a well-worn phrase that rings true in medicine: “If you fail to plan, then you plan to fail.”

Indeed, the more clarity you have about your goals and the strategy to achieve them, the better your chances of success. Wargotz, who’s also senior staff pathologist at Luminis Health Doctors Community Medical Center, offers three “powerful sights” or perspectives for shaping your choices and advancing your career.

That is, over time, you’ll have the wisdom of hindsight, the vision of foresight and ultimately, the power of insight. 

For starters, the wisdom of hindsight refers to growing from your own experience. That is, what in your past has relevance now? Or what are you learning now that may have relevance in the future? 

The vision of foresight is about defining where you’re headed both professionally and personally. 

Finally, there’s the power of insight. As Wargotz notes: “The power of insight is putting it all together and seeing what’s in front of you today and understanding where you’ve been, where you want to go, and how to get there.”

Step 2: Get centered

Obviously, landing your first or subsequent position as a physician is an exciting, albeit stressful, journey. It’s helpful to focus on a few initial pointers that might help you expedite your efforts.

For starters, always compare and contrast. You may be excited about receiving a contract for your dream job, but it’s still a good idea to weigh multiple offers. 

Indeed, you have to judge the opportunity in terms of what will be expected of you. What are the roles and responsibilities? As Kurt Schussler, managing partner of Medical Advantage Recruiters, advises: “You have to take a look at the whole scope of practice. What’s involved and what’s not involved? The more interviews you go on, the more comparisons you’re able to make. That helps refine your interests a little bit more.”

No offer will work for you unless it answers your priorities and satisfies your professional and personal needs. Before you commit to a job, you want to make sure the contract reflects those items particularly important to you. But what are they? Is it the money? Is it the practice style? Is it the chance at an equity share or leadership role? The clear opportunity for a healthy work/life balance?

Step 3: Be a good inquisitor

An inquiring mind and the ability to ask good questions may be your best assets in arriving at a good deal. If something is important enough to include in your contract, it’s important enough to bring up and negotiate.

Indeed, you want to stand up for what you bring to the table. In fact, being comfortable in knowing your worth— and acting on it—is a critical asset. While you may feel good about the terms, you also want to confident enough to ask, “Is that really the best you can do?”

Unfortunately, says Gene Ransom, JD, health attorney and CEO of MedChi, that’s not always the reality. Many physicians don’t push back even for just a little bit more money, when a little bit more could significantly change their bottom line. “Once you’re working somewhere, that’s the base you’re working off of,” he says. “So, it’s really important to ask for what you want and what you need.”

Step 4: Keep on your toes

With a two or three-year employment agreement likely worth six or seven figures, you have a lot at stake. Don’t be like most physicians who, Ransom says, don’t spend enough time focused on every facet of the job or contents of the agreement prior to affixing their signature. He and his colleagues often hear from new attendings who, after signing, realize something they’ve agreed to in writing could be or already is an issue.

So how do you avert potential problems? For starters, anytime you’re communicating with the hiring team, be on your business toes, especially when it comes to what you hear and what you want to see in print.

You also should avoid focusing on what Matthew A. Varacallo, MD, Penn Highlands Orthopedics and Sports Medicine’s director of orthopedic robotic surgery, calls “flashing lights” or “shiny objects in the room.” That is, you don’t want to be distracted by the glow of a great salary, when you should know the ancillaries that come with it. What does the support team look like? Is there a path upward? “You could have a robust, even highly inflated salary,” he says, “but with no support system underneath or no opportunities for growth, it’s essentially meaningless.”

Indeed, no matter what you earn, you’ll likely live comfortably. So, if it’s a choice between an extra $50,000 on an already healthy salary versus getting a few other contract assurances, it might be “exponentially better,” Varacallo says, “to leave that $50,0000 on the table.” For instance, guarantees that you’ll have X number of nurses in your office, or Y number of mid-level professionals in the operating room, “can actually be worth their weight in gold.”

Likewise, since a sign-in bonus or even loan repayment also can be “shiny objects,” make sure to read the fine print about clawbacks or service commitments attached to either. If you leave early, for instance, you could be on the hook for a major payback to your employer. Likewise, since bonuses also can be taxed heavily, it might be advantageous to negotiate other areas of your offer rather than giving even more to Uncle Sam. 

Thomas Lee, MD, cautions against focusing so intently on the clauses that you miss the bigger picture. As both a neurosurgeon and executive vice president of the Medical Society of the State of New York, he says: “When you dive too much into the legalese and the language of the contract, you lose sight of the job you’re taking,” he says. “So, I think it’s a two-edged sword.”

Varacallo agrees, warning against “hyper obsessing” about the contract to the point that you’re trying to make it perfect.

Step 5: Tap another pro

Hiring an attorney to review your contract should be high on your to-do list. A lawyer, like a financial advisor, can provide perspectives about an offer that you simply don’t have unless, of course, you’re schooled and experienced in both fields.

No matter how tight your budget, tapping an attorney, particularly one skilled in health law and physician employment agreements, can make all the difference.

“I definitely would advise getting an experienced attorney who covers health care contracts and health laws as a specialty,” Varacallo says. “That’s really a good investment.”

Lee, on the other hand, admits taking a more “cavalier approach” by not involving an attorney when negotiating his first job. He eventually found himself fighting a non-compete clause. In the end, he paid a $25,000 settlement plus resigned his privileges at hospitals within the contract’s 25-mile radius.

If Lee were to do it over again, he’d enlist an attorney who knows the laws of the state and can assess employment contracts in that market. “I think that would have been more constructive,” he says. The right attorney also can fill in the blanks with valuable feedback on every nuanced clause, from job requirements to extrication terms. “All those issues should be addressed and pointed out,” he says, “so that you know what you’re signing.”

Final thoughts

You may be a tenderfoot when it comes to negotiating the right offer and achieving the best deal. If so, you definitely have company.

The good news, however, is that you can build on what you do know, while supplementing what you don’t know, to achieve what you expect professionally. Since offers and contracts are all about details, you’ll have many factors to consider in comparing apples to apples with multiple offers.

By focusing first on those five big picture steps, you’ll be ready to nail the finer points of any contract. What’s more, you should be well-positioned to playfield like a seasoned professional. •

Do you know how to negotiate a job offer like a seasoned professional? Unless you’ve matriculated through medical training with business or legal bona fides in tow, you’re probably a bit short. That doesn’t mean, however, you can’t nail the finer points of an offer or a physician employment agreement. In fact, with a few basics under your belt, you’ll be better able than ever to evaluate your opportunities, not to mention compare apples to apples.

Details matter when it comes to weighing the critical aspects of competing options. What should you know generally to launch yourself?

Step 1: Know yourself

For starters, you want to be comfortable in your own skin. That means approaching every interview and opportunity driven by your goals, confident in your leverage and eager to capitalize on what you know about yourself. What do you need in a position and workplace to satisfy your goals?

Ethan A. Nkana, JD, MBA, puts preferences ahead of provisions when it comes to working with his Rocky Mountain Physician Agency clients. That is, he’d rather concentrate on their priorities first versus what they understand—or don’t—in an agreement. That includes focusing on three key areas: work/life balance, practice support and professional development. 

As a candidate, you’ll likely benefit from the same introspection. If, for instance, work/life balance tops your must-have list, what does your workday need to look like to realize that coveted equilibrium?

Whatever your agenda, knowing yourself is key in charting your course. For instance, Eric Wargotz, MD, president of the Maryland State Medical Society (MedChi), recalls a well-worn phrase that rings true in medicine: “If you fail to plan, then you plan to fail.”

Indeed, the more clarity you have about your goals and the strategy to achieve them, the better your chances of success. Wargotz, who’s also senior staff pathologist at Luminis Health Doctors Community Medical Center, offers three “powerful sights” or perspectives for shaping your choices and advancing your career.

That is, over time, you’ll have the wisdom of hindsight, the vision of foresight and ultimately, the power of insight. 

For starters, the wisdom of hindsight refers to growing from your own experience. That is, what in your past has relevance now? Or what are you learning now that may have relevance in the future? 

The vision of foresight is about defining where you’re headed both professionally and personally. 

Finally, there’s the power of insight. As Wargotz notes: “The power of insight is putting it all together and seeing what’s in front of you today and understanding where you’ve been, where you want to go, and how to get there.”

Step 2: Get centered

Obviously, landing your first or subsequent position as a physician is an exciting, albeit stressful, journey. It’s helpful to focus on a few initial pointers that might help you expedite your efforts.

For starters, always compare and contrast. You may be excited about receiving a contract for your dream job, but it’s still a good idea to weigh multiple offers. 

Indeed, you have to judge the opportunity in terms of what will be expected of you. What are the roles and responsibilities? As Kurt Schussler, managing partner of Medical Advantage Recruiters, advises: “You have to take a look at the whole scope of practice. What’s involved and what’s not involved? The more interviews you go on, the more comparisons you’re able to make. That helps refine your interests a little bit more.”

No offer will work for you unless it answers your priorities and satisfies your professional and personal needs. Before you commit to a job, you want to make sure the contract reflects those items particularly important to you. But what are they? Is it the money? Is it the practice style? Is it the chance at an equity share or leadership role? The clear opportunity for a healthy work/life balance?

Step 3: Be a good inquisitor

An inquiring mind and the ability to ask good questions may be your best assets in arriving at a good deal. If something is important enough to include in your contract, it’s important enough to bring up and negotiate.

Indeed, you want to stand up for what you bring to the table. In fact, being comfortable in knowing your worth— and acting on it—is a critical asset. While you may feel good about the terms, you also want to confident enough to ask, “Is that really the best you can do?”

Unfortunately, says Gene Ransom, JD, health attorney and CEO of MedChi, that’s not always the reality. Many physicians don’t push back even for just a little bit more money, when a little bit more could significantly change their bottom line. “Once you’re working somewhere, that’s the base you’re working off of,” he says. “So, it’s really important to ask for what you want and what you need.”

Step 4: Keep on your toes

With a two or three-year employment agreement likely worth six or seven figures, you have a lot at stake. Don’t be like most physicians who, Ransom says, don’t spend enough time focused on every facet of the job or contents of the agreement prior to affixing their signature. He and his colleagues often hear from new attendings who, after signing, realize something they’ve agreed to in writing could be or already is an issue.

So how do you avert potential problems? For starters, anytime you’re communicating with the hiring team, be on your business toes, especially when it comes to what you hear and what you want to see in print.

You also should avoid focusing on what Matthew A. Varacallo, MD, Penn Highlands Orthopedics and Sports Medicine’s director of orthopedic robotic surgery, calls “flashing lights” or “shiny objects in the room.” That is, you don’t want to be distracted by the glow of a great salary, when you should know the ancillaries that come with it. What does the support team look like? Is there a path upward? “You could have a robust, even highly inflated salary,” he says, “but with no support system underneath or no opportunities for growth, it’s essentially meaningless.”

Indeed, no matter what you earn, you’ll likely live comfortably. So, if it’s a choice between an extra $50,000 on an already healthy salary versus getting a few other contract assurances, it might be “exponentially better,” Varacallo says, “to leave that $50,0000 on the table.” For instance, guarantees that you’ll have X number of nurses in your office, or Y number of mid-level professionals in the operating room, “can actually be worth their weight in gold.”

Likewise, since a sign-in bonus or even loan repayment also can be “shiny objects,” make sure to read the fine print about clawbacks or service commitments attached to either. If you leave early, for instance, you could be on the hook for a major payback to your employer. Likewise, since bonuses also can be taxed heavily, it might be advantageous to negotiate other areas of your offer rather than giving even more to Uncle Sam. 

Thomas Lee, MD, cautions against focusing so intently on the clauses that you miss the bigger picture. As both a neurosurgeon and executive vice president of the Medical Society of the State of New York, he says: “When you dive too much into the legalese and the language of the contract, you lose sight of the job you’re taking,” he says. “So, I think it’s a two-edged sword.”

Varacallo agrees, warning against “hyper obsessing” about the contract to the point that you’re trying to make it perfect.

Step 5: Tap another pro

Hiring an attorney to review your contract should be high on your to-do list. A lawyer, like a financial advisor, can provide perspectives about an offer that you simply don’t have unless, of course, you’re schooled and experienced in both fields.

No matter how tight your budget, tapping an attorney, particularly one skilled in health law and physician employment agreements, can make all the difference.

“I definitely would advise getting an experienced attorney who covers health care contracts and health laws as a specialty,” Varacallo says. “That’s really a good investment.”

Lee, on the other hand, admits taking a more “cavalier approach” by not involving an attorney when negotiating his first job. He eventually found himself fighting a non-compete clause. In the end, he paid a $25,000 settlement plus resigned his privileges at hospitals within the contract’s 25-mile radius.

If Lee were to do it over again, he’d enlist an attorney who knows the laws of the state and can assess employment contracts in that market. “I think that would have been more constructive,” he says. The right attorney also can fill in the blanks with valuable feedback on every nuanced clause, from job requirements to extrication terms. “All those issues should be addressed and pointed out,” he says, “so that you know what you’re signing.”

Final thoughts

You may be a tenderfoot when it comes to negotiating the right offer and achieving the best deal. If so, you definitely have company.

The good news, however, is that you can build on what you do know, while supplementing what you don’t know, to achieve what you expect professionally. Since offers and contracts are all about details, you’ll have many factors to consider in comparing apples to apples with multiple offers.

By focusing first on those five big picture steps, you’ll be ready to nail the finer points of any contract. What’s more, you should be well-positioned to playfield like a seasoned professional. •