Contract Negotiation

[midazzoler]

Topic has come up recently. Haven’t seen this in a separate thread. Wondering what crazy ideas or demands or tricks have been used out there. Any contract; employee/partner or hospital.

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[IMGASMD]

Treat it like any other job, it’s no more special than someone who is getting a good paying job.

Always ask for what you think is fair. The worst they can say is no.
A lot of mom and pop shop will tell you that all the partners have the same contract, true or not, you be the judge.

I’d advocate always have a contract lawyer do a once over. Can be the best 1 grand you’ve ever spent. (According to one of my good friend who joined a GI private practice….). If you go through this route, you should have the lawyer see the “offer letter” too.

Know the local market, my lawyer gave me a copy of mgma, another added bonus.

I don’t think there are tricks, but sometimes when amc or an position is desperate (usually not a good thing) they will be more welling to negotiate…..

 

[ryanjmy]

Negotiation is about information and leverage. If you could see the other guys hand in poker but he can't see yours, you have an incredible advantage. Like if you knew the last guy was getting $300/hr vs not knowing. And the employer knowing you'd accept $250/hr vs not knowing. Whoever has more information has the advantage.

The other thing is leverage. Who needs to make the deal worse? You have 3 good options vs being location locked. The employer having a stack of CVs vs no leads and being short staffed.

 

[Mehd School]

Negotiation is about information and leverage. If you could see the other guys hand in poker but he can't see yours, you have an incredible advantage. Like if you knew the last guy was getting $300/hr vs not knowing. And the employer knowing you'd accept $250/hr vs not knowing. Whoever has more information has the advantage.

The other thing is leverage. Who needs to make the deal worse? You have 3 good options vs being location locked. The employer having a stack of CVs vs no leads and being short staffed.

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

 

[nimbus]

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

You’re paying $15k for each week of vacation if you go with the semi academic gig but they’re not paying you $15k/week to work.

 

[GassYous]

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

Is it "little duke"?

In this market the pay should be going up, not down.

If it just starts there and goes up then maybe. But the fact that you're a "junior attending" says it all. Our group treats everyone relatively fairly from day one. When you're the call guy you have total control over the schedule, you get out based on your call number, your vote as a new guy is worth the same as the guy who has been there for 30 years etc.

I'd estimate a week of vacation at about 10k a week. I take about 8 weeks and that feels good to me.

 

[Blockit]

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

“Negotiation” means always being willing to push back from the table.

 

[ryanjmy]

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

If you really want the academic job you don't have much leverage. If your happy with all three jobs I'd contact them and say you really want to work there but have other offers at $400k+ and don't think you can pass up the extra income. Ask are they sure they can't match it or at least do better.

It's entirely possible that they don't need much help right now. I can tell you from experience that if a practice is short handed an extra 10% in pay usually isn't an issue.

 

[coffeebythelake]

Plenty of academic places that are trying desperately to hire new anesthesiologists.

 

[deleted126335]

Tricks is too broad a question to answer. As far as contract language examples include: Language that caps compensation but not hours.
Language that allows them to terminate or change major things with little notice are obvious ones.
It is not uncommon to hire a doc at a fat salary and then work the snot out of them.

 

[kidthor]

Plenty of academic places that are trying desperately to hire new anesthesiologists.

Desperate sure - but do they have the ability/drive to sweeten the deal? I have several friends in academia at different places where they're chronically underpaid to the point of staff hemorrhage, yet the department/university still won't up salaries. So they're just operating very short rather than fixing the salary issues. They have ongoing hiring problems because their low salaries become even lower as other shops up wages bit by bit. Some Kaisers seem stuck in this stagnant salary pit too.

 

[Aheadbyacentury]

Well how about this. I'm interviewing with a small semi-academic group and I know that everyone there is making over $410k, yet they offered me $345k. I'm a CA3 so I know as a junior attending I'll be more work for the group, but theres one guy that got $385k three years ago and it was his first job out of residency. I told them I need $400 to consider the job. I have two private practice offers that are both at $405k but the academic spot has 4 additional weeks off per year. They don't seem to be budging much and said they could do $350 so I'm torn.

Have to play hardball if you want what you want.... Tell them its yourway or the highway.. Take the pvt practice offer.

 

[Aheadbyacentury]

Desperate sure - but do they have the ability/drive to sweeten the deal? I have several friends in academia at different places where they're chronically underpaid to the point of staff hemorrhage, yet the department/university still won't up salaries. So they're just operating very short rather than fixing the salary issues. They have ongoing hiring problems because their low salaries become even lower as other shops up wages bit by bit. Some Kaisers seem stuck in this stagnant salary pit too.

They wont budge until they feel the pain. Closing an OR costs about 50-60k per day.. If they are doing that, they may budge.

 

[GassYous]

Desperate sure - but do they have the ability/drive to sweeten the deal? I have several friends in academia at different places where they're chronically underpaid to the point of staff hemorrhage, yet the department/university still won't up salaries. So they're just operating very short rather than fixing the salary issues. They have ongoing hiring problems because their low salaries become even lower as other shops up wages bit by bit. Some Kaisers seem stuck in this stagnant salary pit too.

My residency program is like this. Courtesy of a crappy hiring structure borne of a super partner structure before the hospital just took over. Now they churn and burn through new people and can barely hold onto their own grads.