Before you 'shake on it': What newer docs need to know about negotiating that job offer

Negotiating a work contract can be an intense, anxiety-inducing experience, whether you’re a novice or an experienced professional.For early-career physicians, successful negotiation of a job offer can set the path for the years to come. Doctors presenting at a Canadian Physicians Financial Wellness Conference, held virtually at the end of 2023, shared their experiences working through job contracts and offered residents advice on stepping up to the negotiating table.Before you "shake on it," read on.You’re negotiating, not fightingDr. Adam Shehata, a lawyer and family medicine resident at Queen’s University, said it’s important to approach negotiations as a collaborative process where both parties are working towards a common goal. Taking this approach—which works best when both parties share information—can open the door to brainstorming towards the most workable solution. Dr. Shehata described a scenario where a doctor negotiating a family medicine contract brings up their interest in also providing addictions medicine services.“There was no mention of addictions medicine (in the job offer) but you want to see if there is any room for you to practise it and you include this in your negotiations,” he explained. “All of a sudden, because you shared this information, the community might try to find funding for an (addictions medicine) clinic. So you’ve brought new value to the table—the community is certainly better served and you get to practise in an area that you’re passionate about. And the community looks like a hero.”Know your reservation valueIt’s important to know your needs and interests before starting negotiations, said Dr. Shehata. He recommended writing these down and, where possible, identifying which interests might be shared by both parties.“It’s not that you’re going to bring this as a list and read them out in negotiation, it’s just that you need that as a starting point,” he said.Another must-know before you start negotiating? Your “reservation value”—a fancy term, said Dr. Shehata, for the minimum offer you’re willing to accept. If the party across the table goes below that, you walk away.In addition to defining the boundaries of what’s acceptable to you, knowing your reservation value will allow you to hurry up and discuss potential alternative solutions. For example, if the proposed monetary compensation is moving quickly towards your reservation value during negotiations, you might want to see if there’s flexibility in clinical shifts, said Dr. Shehata.Read: Solve my problem: What are some tips for paying off debt and starting my practice on a good financial footing?‘Standard contract?’ Find the wiggle roomPhysicians just coming out of residency sometimes assume the work contract they’re being asked to sign is a “standard” agreement with fixed terms that apply to everyone in the same role. That’s a wrong assumption in many cases, said Dr. Katie Lin, an emergency, stroke and flight physician in Calgary.“The truth is, there often is wiggle room even within standard contracts,” she said. “The challenge with these standard contracts is there's an extra step where you actually have to open it up for adjustment and find where those areas of flexibility are, but it can help us to really probe around where within the contract can we actually see that flexibility.”One good way to find areas of flexibility is by talking to more experienced colleagues, preferably those practising in similar fields. Dr. Lin said it’s also a good idea to think about unique skills you’re bringing to the proposed role.“This is identifying my leverage so that I have some room to start probing for that flexibility in the contract,” she said, “In my case, because of my background in stroke medicine I knew that the (hiring) group wanted to bring that into their practice. I also knew there was a knowledge gap within the department for a lot of neurology topics . . . and I knew I could supply some of those things.”Ideally, the work of finding wiggle room in a contract should start before you come to the negotiating table, said Dr. Lin. She recommended “soft probing” or informal conversations with people in the hiring group.“So in my case, for example, I actually started to prepare for this many, many months before the actual hiring—meeting at the end of my graduation, reaching out to some of the leadership teams,” said Dr, Lin. “I also reached out to the department head just to see if he'd be willing to meet with me in advance to ask a couple of questions and to get a better understanding of how I might contribute to the department with some of my extra skill sets and share some of the ideas that I had.”Consider the best—and worst—alternative to walking awayAnother critical aspect of successful negotiations is knowing in best alternative to a negotiated agreement—or BATNA, for short—in advance. In other words, said Dr. Shehata, what other good things can you do if you walked away from the proposed contract? Could you accept a better contract in another community? Could you take a year off to travel?“What we want to do is have a particular best alternative to a negotiated agreement, but the flip side that we often don’t talk about is, what is the worst alternative?” said Dr. Shehata. “If you don't get a deal here, or things go exceptionally bad and you didn't secure a job in the next few months and you couldn't stay in the country . . . that’s a worst alternative, right?”Knowing your worst alternative, along with the best alternative, to a signed contract provides a good reality check that could keep you from making demands that may not be feasible, he added.Read: Solve my problem: What are some tips for paying off debt and starting my practice on a good financial footing?Stand your ground—and use leverage if you have itAfter she agreed to practise in her hometown of Kincardine, Ont., Dr. Janine Van Veghel was alerted by her lawyer to a clause in her return-of-service agreement that would allow the municipality to put a mortgage on the home she had planned to purchase using a downpayment from an interest-free loan included in the contract.“My lawyer recommended we try to remove that as part of the contract, but it wasn't a reason not to sign it if they refused to change it, which they initially did,” recalled Dr. Van Veghel. “When we started looking for housing mortgages, we soon realized that although you can have two mortgages on a property, it's very hard to do. Banks do not want to provide mortgages for a property with multiple charges and it requires extra approvals from the bank.When negotiations with municipal staff went nowhere, Dr. Van Veghel tried to get help from local councillors. Around this time, she had also found out a neighbouring municipality was offering new doctors contracts similar to what her hometown was offering but without the second-mortgage stipulation.“I used that to negotiate,” said Dr. Van Veghel. “After councillors became involved and understood that we were willing to leave the community, the clause was waived quickly and we proceeded with our house purchase.”Not sure if you should bother? Think beyond yourselfSometimes hashing out the terms of a contract feels like more trouble than it’s worth. Or maybe you’re just not comfortable with all the back-and-forth, which can feel adversarial at times. Dr. Shehata said it can be helpful to view these situations through a broader lens that extends beyond yourself.“Physicians can get very self conscious when they need to negotiate on their own behalf. Like, is it really needed? Do I really need to do this or am I being a stick in the mud?” he said. “But maybe you can look at it from the point of view of it could also make things better for other people, so your negotiation isn’t just necessarily on your behalf.”That was indeed the case with Dr. Van Veghel, whose steadfast insistence on removing the mortgage clause in her return-of-service contract led to that stipulation being taken out of that community’s contracts for all new doctors.“One of the things that makes (Dr. Van Veghel’s) story really, really nice is that she was able to use her negotiation to then advocate to make things better for those who have come after her,” said Dr. Shehata.Read: Done with residency? Financial tips for the road ahead

Before you 'shake on it': What newer docs need to know about negotiating that job offer

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