What I learned from negotiating my first physician contract

For almost ten years now, family physicians have been the most recruited specialty in the medical profession, and that is not likely to change anytime soon. We face a huge shortage of primary care physicians that is only going to get worse because we aren’t training family doctors as fast as they are retiring.

Business training isn’t in the curriculum

What this means for me and my fellow family medicine residents is we’ll likely have our pick of several jobs when it’s time to start looking. I recently signed a contract at the halfway point of residency. It was a long process and I didn’t feel like I was adequately prepared to handle the negotiations.

One of the failings of medical education and residency education is the lack of good business training. I have been in school and training my entire life, so this was the first time I had to negotiate important things like salary, benefits, or paid time off. Another thing I didn’t realize at the time was that I had the upper hand because I am the needed commodity.

I had no fewer than five places recruiting me to join their practice, and I continue to get emails and phone calls from recruiters and hospitals looking to hire family doctors. Needless to say, I had to teach myself along the way, and I hope I can educate other residents based on the mistakes that I made.

What I learned from negotiating my first contract

One thing to keep in mind when negotiating with potential employers is that pretty much everything in a contract is negotiable. Many recruiters and employers will start by making you think that there is very little room to negotiate by saying, “We have to follow Stark laws and pay you only fair market value,” or, “This offer is only good for 2 weeks.” They are trying to use this to get you to think that if you don’t accept now then the offer will get worse, but in my experience that’s not often the case.

In the end, they are running a business, and they want to get you for as cheap a price as they can. One thing that you must decide before beginning to negotiate is which parts of the contract you want to change. Most often these things are going to be salary, bonus, paid time off, and signing bonuses or stipends.

After identifying the parts you want to change, you then need to come up with your responses and take them up all at once. You need to put everything on the table up front. Another tip is to be patient because negotiations can drag on; be prepared for the long haul. Don’t give in on something that’s important to you just because it’s taking a long time to get them to meet you where you want to be.

Negotiations can take weeks or months due to constant back and forth. If you are feeling pressured, then it is fine to step back and reassess the situation. After all, this is a big decision that should not be taken lightly.

Finally, you must have a lawyer — preferably one that is a health care attorney — review your contract. It won’t be cheap on the front end, but it will save you lots of money in the long run if they catch something awry, and trust me, they do! It sounds like a lot of money when you are a resident to pay an attorney a few thousand dollars, but fixing a small mistake will be worth it for a contract worth $500,000 or more.

All in all, it can be a rewarding experience when you finally sign on the dotted line for your first big job out of residency. But, always keep in mind that you hold the power because you are a precious commodity.

Tate Hinkle is a family medicine resident. This article originally appeared in the American Resident Project.