The New Gastroenterologist

Negotiating physician employment agreements


You have finally completed your residency or fellowship, and now you have a job offer. With some trepidation, you decide to read the employment agreement that has been emailed to you. You quickly realize that you do not understand much of it. All those legal terms! You lament the fact that medical school never taught you about the business of medicine. What are you going to do? The choices are actually quite simple: You can take the time to educate yourself or you can hire an expert. This article will review some of the basic principles of negotiating as well as some of the critical issues found in physician employment agreements today.

Whether you represent yourself or hire someone to do it for you, it is important to understand some of the basic principles of negotiating. These principles generally are applicable whether you are buying a house or negotiating your employment agreement.


Scott Roman is an attorney in private practice.

Scott Roman

The most important principle is preparation. For example, many physicians negotiate their salaries during the interview process. Consequently, it is imperative that, before you negotiate your compensation, you know the range of salaries in your area for your specialty. It is also important to know whether salaries are usually guaranteed in your market, or whether production-based salaries (which are based on the amount of your billings) are the norm. Never go into an interview unprepared!

Always try to gain leverage in your negotiations. The easiest way to accomplish this is by having multiple offers, and subtly letting your suitors know this. Allow adequate time to negotiate; the more time you have, the easier it is to negotiate. Establish your objectives and try to anticipate the objectives of the other party. Determine your best-case and worse-case scenarios, as well as the most likely outcome. Do not negotiate against yourself and try to get something every time you give something. Define the nonnegotiable issues, and do not waste time on them. Keep cool and be flexible.

The first question you must answer when you receive an employment agreement is who is going to negotiate it. Many new physicians hire attorneys to help them with their employment agreements and employers expect as much. It is best to engage an attorney before you begin your job search so you can get a better understanding of how the attorney can help you. Most attorneys do not charge a prospective client for such information. However, many physicians wait until they actually receive an offer before contacting an attorney. It is not uncommon for physicians to negotiate their salaries during job interviews even if they eventually hire an attorney to help them. This is usually attributable to a lack of negotiating experience and an eagerness to determine whether a job offer is viable. Keep in mind that an attorney often can negotiate a better starting salary than you, so try to resist the temptation to negotiate your salary during the interview process.


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