7 Physician Rules for Negotiating a Job Offer

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Physicians may consider themselves an expert when it comes to curing diseases and alleviating symptoms but when it comes to sitting down at the negotiation table, most will admit that they don’t feel as confident as they should.

There are a few rules that physicians can follow to ensure they get the best employment contract they deserve. As intimidating as negotiating a job offer might seem, if you can get through medical school, you can do this.

1. Don’t Sign the LOI (Letter of Intent)

When you apply for a position at a hospital or clinic, you will receive a letter of intent first thing. This letter will layout a sketch of what the employment contract will entail.

This letter might outline some of the compensation, bonuses, vacation, duties, and partnership opportunities that come with the position you are seeking.

Even though the LOI usually isn’t legally binding, if you sign this letter you are basically agreeing with all of the information written within it. This can make your negotiation tipped in the employer’s favor.

Instead, use this letter as a starting point to know what your employer’s lowest offer will be. Then ask for more.

2. Know Your Worth

There are many factors that will affect a physician’s fair market value.

This includes but is not limited to the location of the healthcare system, the amount of experience you have, and the type of practice for which you are applying.

If you don’t know how much a physician in your specialty is earning in a position similar to the one you are seeking, you may end up agreeing to compensation below the national average.

For a quick overview of the latest compensation trends, make sure you check out all of the compensation reports from the main research companies like Medscape and Merritt Hawkins.

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3. Never Accept the First Offer

The potential employer will always offer their lowest offer first. They expect you to counteroffer with some changes or requests that weren’t included with the first offer.

While there may be parts of the contract that are policy and non-negotiable, much of what they offer can have some wiggle room.

Make sure you look over the offer thoroughly to completely understand what is being offered, and more importantly, what isn’t.

 It would be in your best interest to hire an attorney to review your contract before agreeing to anything to protect you from unclear or misleading language.

4. Always Ask for More than What You Want

Just as your potential employer would offer less than they are willing to give, you should ask for more than you want.

The strategy is that if you lower your expectations from the beginning, you won’t be able to have any leverage to negotiate what you really want.

If you ask for more than you need, you can give something up to solidify the agreement for what you deem the most important part of the contract in your favor.

For example, you may request a $20,000 signing bonus but they want to reduce that number. You can agree to half if they give you an extra two weeks of vacation, which is what you really wanted anyway.

Since they see it as savings on their part, and you would have settled for less signing bonus to begin with but really want some time with your family, it’s a win-win situation.

5. Always Do Your Researc

Before accepting any contract, you should understand the ins and outs of the facility that you will be working with. Ask plenty of questions but don’t walk into a negotiation clueless.

You should have an idea of what kind of payor mix the clinic uses. Are they mainly PPO or Medicare? How much of the practice is HMO based?

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What are the turnover rates of physicians in the clinic? If it’s high, that’s a red flag. Why are physicians deciding to leave?

Another reason to do your research on the facility is to prove that you care more about just your own position, but for the benefit of the company as a whole.

6. Explain the Reason Behind Your Requests

When presenting a request in your counteroffer, pair that request with a reason for the request. This will increase the odds of the employer granting the request if they better understand why you want it.

This will not only make you look professional but also reasonable. When a physician is reasonable in a negotiation, an employer is generally more willing to work with them.

Whey you aren’t flexible, they won’t be either. The goal is to come to a mutually agreeable compromise.

7. Never Lie or Exaggerate

It may be tempting to exaggerate an offer that you received from a competitor to apply pressure to the employer you are currently negotiating with to offer more.

This can backfire and should never be a tactic in employment negotiation tactics. All it takes is a little digging for them to find out the truth. If they catch you in a lie, they may not want to work with you at all.


Physicians can successfully enter into a contract negotiation with the correct attitude and knowledge to give them the ability to find a position that offers them a solid contract.

Even though most physicians use a professional team of advisors to review their contract, it helps to know the basics of the process so they aren’t walking into something they don’t understand.

These seven rules can help physicians navigate the process looking professional and taken seriously.


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