Tips for Effective Contract Negotiation for Physician Practices

A Physician’s job/service comprises various responsibilities in the stack. Among that, the most important and even imperative part is the Physician Contract. However, here’s where that many Physicians are least comfortable with. Many Physicians are tempted by the attractive offer to accept it and get to work. However, this could lead to loss of compensation, an undesired working environment and missing opportunities.   

In that case, positive negotiation and a careful review of the Physician Contract can make all this work differently! This article could change your career as a Physician, by acquiring all your needs during the Contract. Learn how to negotiate, what to look for in a Contract, and mistakes to avoid during negotiation.  

What Should Be Considered Before Negotiation? 

For satisfactory working conditions, you must consider many things before you ever sit at the table. Initially, you have to determine what’s most important to you, for instance, which is your priority, the right work-life balance, career advancements, and more one-on-one time with patients. Moreover, it’s advisable to include the other stakeholders and decision makers in your life as well.

Yes, you’re right! Not everything is negotiable. Of course, you’re not going to get everything that you want. In fact, you’re possibly going to need to make a list of priorities of what you actually need and what your deal makers and deal breakers are.  

Experts recommend that you define your BATNA (Best Alternative To a Negotiated Agreement). This defines the minimum you are willing to accept. If you can’t get your BATNA after negotiation, it means it’s time to consider other options.  

Ask the Right Questions 

You’ll be an effective negotiator if you’re well-informed before negotiation. So, take the time to learn as much as you can about the potential employer and the position, by asking a bunch of questions. Initially, you may have to get out of your comfort zone to do it.  

Here are Top Questions for You to Ask 

  • How is Compensation Structured? 
  • Is there a Base Salary Along with Incentives or Bonus? 
  • Is There a Non-Compete? 
  • If So, What are the Terms? 
  • What are the Schedule Expectations? 
  • Is Call Coverage Covered?
  • If So, How Many Hours are Included in the Base Salary?
  • What are all the Benefits offered? 

The Principal and Founder of Contract Diagnostics, Jon Appino, a Company that exclusively focuses on Reviewing Physician Contracts, stated that it’s important to have an honest conversation with the Employer. 

Determine If the Offer is Competitive 

It’s crucial to evaluate the Offer’s Level of Competition before deciding whether to accept it (or make a counter offer). Insights on the patterns they are noticing among the Doctors they are staffing in your specialty and region can be shared by Lawyers, Companies, and Staffing Agencies like CompHealth that evaluate a lot of Contracts. Some businesses could also provide information on Comparative Pay from sources like MGMA.  

According to Jon Appino, “We can discuss trends that we detect over time and mix it with localized data.” For instance, Boise is experiencing an outbreak of infectious disease as well as the formation of a new group. That’s not the same as if there was an infectious disease in Boise and three people had recently left their jobs or would be retiring in five years.  

What to Negotiate 

Depending on your personal priorities, you can decide what to negotiate. A Non-Compete may not matter to you if you only want to reside in the area for a short while. How a Signing Bonus is Refunded, how you can leave, and how malpractice is covered, might be of more relevance to you. The Non-compete provisions can be more significant to you as a Doctor who plans to settle down, create a home, and start a family.  

How to Negotiate 

Negotiating may introduce you to a new zone, basically out of your comfort zone but practically speaking, it’s well worth the effort. You may feel awkward asking for any money. Let’s see what experts say about their experiences during their negotiations. Dr. Thieszan opens up about his uncomfortable experience: “I felt awkward asking for any more money, but in the 30 seconds it took, the Healthcare agreed to $20,000 as a Sign-on Bonus. Still, that was the best 30 seconds of awkwardness I ever spent.”  

From the Physician’s perspective, it’s their responsibility to negotiate, but it’s also their responsibility to keep in mind that there are several Do’s and Don’ts to consider.  

Do: Make it Comfortable for the Employer 

The first and foremost thing is to make the Negotiation as Comfortable as possible for the Employer. Ensure to check the following things: Does the Employer prefer Phone Calls or Emails for correspondence? Does the Physician perceive the Employer as being quite forthright or does the Employer like to be a little less so during Negotiations? In any case, you should emulate that Employer’s Communication Approach. 

Do: Have All Your Questions Ready Up Front 

It’s advisable to come up to the table prepared with all of your Questions. Return to the Employer as little as possible, bringing a List of all the Modifications you want, any Questions you have, and anything else you wish to address. This would reduce the amount of back-and-forth time for Negotiation. 

Do: Have a Justification for What You’re Asking For 

You should have a Justification for any requests for additional compensation, benefits, or special treatment. “Always have an explanation for what the Doctor is requesting. “More than just “Well, since that’s what I want” will suffice, “, says Holloman. “The Physician must explain why the Employer should agree to their request for an additional $30,000 in remuneration, if one is made. The Doctor shouldn’t request that $30,000 if they are unable to respond to that query.

Do: Obviously, Go with Positive Attitude 

For a successful Negotiation, an Optimistic Outlook and willingness to make concessions are essential. “I win, you lose, or you win, I lose”, says Appino. It reads, “Let’s get there to aid patients. Let’s work together to make sure we understand each other.

Don’t: Sign a Letter of Intent Prior to Negotiation & Try to Renegotiate It 

Physicians frequently make the error of accepting an Initial Offer and then Signing a Letter of Intent (LOI) before trying to Negotiate the Compensation or other Terms of the Contract. Holloman advises against doing this. “An LOI is similar to a handshake, but is not legally binding. I often argue that you would be miffed if the Company issued a Contract with a Salary of $270,000 after you Signed a Letter Of Intent with a $300,000 Compensation. However, the inverse is also accurate. You cannot approach the Employer and request $330,000 after Signing an LOI for $300,000. Therefore, it is advisable to Avoid Signing a Contract, before the end of Negotiations, whether binding or not.

Don’t: Fail to Tell Your Attorney the Whole Story 

Ensure that your Attorney or Negotiator is aware of any previous discussions, if Negotiations take place before they are present. This will stop awkward and pointless conversations. If a Doctor has already begun the process, Holloman adds, “It makes it much more difficult for me to come to the Terms a Doctor desires.” It resembles the beginning of a cake-baking process. You prepare, bake, remove it from the oven, and then hand it to a Chef with the instructions, “Ok, repair it.” I can’t turn this into a fabulous dessert, if it has already taken the wrong turn. 

Don’t: Demand Changes to Things That are Determined by Policy 

Negotiations may fail if a Hospital is requested to alter Benefits or Conditions that are Governed by Policy. “For instance, if they give PTO and the Policy determines it, they cannot alter it”, claims Appino. They are not allowed to create an exception for a certain Doctor. Some Doctors believe that they should have more personal freedom, yet there are some aspects that a Hospital just can’t change. The earlier in the process you are aware of what is and isn’t Negotiable, the better. 

Reviewing the Contract 

After the Negotiations are over, spend the necessary time going over the specifics. Dr Ariana Peters, a Hospitalist, advises getting Legal Counsel. Since there is so much Legalese, she advises against Signing anything before having an Attorney Review it. “I Reviewed a Contract with a Lawyer, and the Lawyer saw things that I would have never seen in a million years.”, she says.

A Child and Adolescent Psychiatrist named Dr. Catherine Francis also seeks Legal Counsel: “At this point, I wouldn’t even consider Signing a Contract without a Contract Attorney who certainly knows how to keep my best interests as a Physician, in mind. I’ve heard far too many people remark, “I wish I had known”, therefore I want to be able to use the Contracts to my advantage.

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