Mastering the art of physician contract negotiations

Contract negotiations for physicians-whether a first job out of residency, a change in employer or even revisiting an existing agreement-can be an uncomfortable exercise.

From not knowing what they truly deserve to not knowing how to ask for it and even fear of looking greedy or selfish, Rhode Island-based internist Michele G. Cyr, MD, has a simple message for her peers.

“Get over it,” Cyr told a group of physicians at this year’s American College of Physicians 2016 Internal Medicine Meeting in Washington, D.C.

Cyr said contract negotiations for physicians come down to figuring out what doctors want, what the party they are negotiating with wants and figuring out how both groups can get what they truly want.

Cyr says physicians should negotiate for things like resources, compensation, a better schedule or hours, opportunities-everything that will be necessary for a physician’s success.

“If you think about it this way, you are not being greedy or selfish, but putting [yourself] in a position where you’ll be successful and bring success to whomever is employing you,” she said.

Next: Negotiating salary

Another tip for physicians when it comes to putting a price tag on their value is to ask for the pay you deserve, not what you need.  Cyr talked about how staff come to her asking for raises to pay for increased child care costs or other personal reasons.

. “[The needs] are relevant to you, but not relevant in the negotiation. Stick to your value, not what you need,” she advised.

When it comes to negotiating salary, benefits, and other tangibles, Cyr’s co-presenter, Florida-based attorney Christopher L. Nuland, JD,, offered a bit of contradictory advice to physicians in attendance.

“It’s not about the money … it’s about all the other things beneficial for you, for your patients and the quality of life you want to go for,” he first advised, before later coming clean. “OK, I lied. It is about compensation … to some degree.”

Nuland presented a series of negotiating tips for internists when negotiating their next contracts, including:

• Ensure that duties are not “assigned by board of directors,” but rather “within the specialty” of practice

• Do not submit to your employer’s policies and procedures without reading them first

• Make sure you have adequate support and back-up so you can practice medicine and someone else can take care of administrative duties

• Rather than agreeing to contract language that states “minimum of 40 patient contact hours per week,” negotiate a “goal of 35 patient contact hours per week” for a clearer expectation

• Negotiate for a minimum three weeks of vacation; five days and $2,500 for CME activities; and allocations for society memberships, expenses and malpractice insurance

While Nuland encouraged audience members to have an attorney review contracts to point out what is standard and what can and should be negotiated, he also warned that bringing a lawyer to the negotiating table was a bad idea. The other party will likely do the same and that’s where things get complicated.

“[Attorneys] screw things up,” he joked. “It’s what we do.”