As I maneuvered through the winding cobblestone roads of the Old City in Jerusalem, the smell of fresh bread intertwined with spices filled the air. Sensory overload blended with the multicultural flavor of the Holy City is a scene difficult to paint with words. In the hustle and bustle of the market, I can still vividly see the image of a lady negotiating over a bag of zaatar (thyme). As her kids pulled on her garb trying to move their mom along, I watched as the buyer and seller went back and forth on the final price of the herbs. This was negotiation as an art form! With both parties satisfied with the deal and parting with a smile, it was clearly a win-win outcome. But bargaining in a fashion so common in the souk (open air market) is not the norm in the United States.
In my household, I was taught to never accept the first offer, and therefore, negotiating in second nature to me. As I neared the end of my fellowship and began my job search, I began to really enjoy the negotiation process with potential employers. I was surprised to learn, however, that not only was this not common practice among my colleagues, but also at times discouraged. I heard remarks like, “Don’t worry about your first contract, it doesn’t really matter,” and “These contracts are all pretty standard,” or “You better not ask for too much or they will find someone else,” or “Negotiating will upset them.” While I was baffled by this attitude, it dawned on me that, despite our trainees spending more than a decade in surgical training, many clinicians are currently entering surgical practice unprepared to negotiate the best contract to meet their needs. Let me be clear, I do not claim to be an expert in negotiations. However, I offer my experiences as a hope that it might provide some insight and guidance to those entering the medical workforce.
This introductory article is one of three meant to provide insight when it comes to basic negotiating principles for those doctors heading out into the work world. In no way is it meant to be a comprehensive guide, yet I hope that it offers an idea of what to look for and how best to approach these formal discussions.
Often individuals can find the negotiation process uncomfortable and stressful. However, the ability to negotiate well is something that can be learned, and is not predicated on some innate ability. The key to reaching optimal outcomes really comes down to two things: 1) walking into the negotiation prepared; and 2) maintaining a high level of emotional intelligence that allows you to be disciplined at the table. With the medical community being relatively small, the process should be geared toward building a relationship, in hopes of meeting the interests of all stakeholders. The resulting relationship, whether good or bad, will have future ramifications. This applies to both the employer and employee. Your goal is not to “one-up” the other party, but to ensure you walk away with a solution that meets your needs based on your interest.
Walking in prepared
One of the first steps in making sure you are well prepared is taking the time to determine what your interests are and how you would prioritize them. Do your homework! Often we get caught up in the salary number while losing sight of a wide range of potential benefits that might be discussed (for example, research support, time protection, employment for spouse, moving costs, signing bonus, mentorship, support for advanced degrees) and included in your overall compensation package.
The ability to be creative and move past focusing on one number will enhance your ability to attain better outcomes. That creativity requires that you take time to research the position, speak to colleagues and mentors, evaluate national salaries based on your specialty and expertise, and attempt to understand the other parties’ interest. This preparation will allow you to leverage the acquired knowledge in order to reach an outcome that would be considered a win-win. Part of your preparation also requires you to determine your best alternative to a negotiated agreement is (BATNA), a term coined in 1981 by Roger Fisher and William L. Ury in their book “Getting to Yes.” The BATNA essentially means if one does not accept the agreement, what is the best walk-away. Not only should you evaluate your own BATNA, but also that of the other parties.