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Negotiating Tips for Physicians: How to Get What You Want

By Vasilios J. Kalogredis, Esquire

Oftentimes, physicians will admit that they have difficulty in negotiating for themselves.  For that reason, some prefer to have another individual do their negotiating for them.

Nevertheless, it is important for physicians to have some background on negotiating skills since, in reality, we all negotiate every day (be it with one’s employees, insurance companies, patients, family members, etc.).  This article will set forth some tried and true practical tips.


It is important to gather as much information as one is able to before getting involved in negotiations.  Learn all you can about those with whom you are negotiating.  What is the history?  What is the other side looking for?  Why are they looking for it?  What is their reputation?  Why are you interested?  Why would you not be interested?  What are their constraints?  The more you know, the better off you will be.


Be prepared.

I am amazed how many people go into an important meeting in an unprepared fashion.  As a general rule, he who is best prepared wins.  You need to know what is important to you.  You also should attempt to determine what is important and why it is important to those with whom you are negotiating.  That may assist you in the negotiation process and may be used to your advantage.  Be sure that you set forth on paper what your important questions are and be sure to raise them.  Think critically about your best case scenario, what you must have (the bottom line), and what you are willing to concede/trade off for something else.


People like to hear good things about themselves.  Sincere compliments are fine.  If you do not ask, the answer is “NO!”  Be enthusiastic.  Create and emphasize the common ground.  Listen carefully.  Do not do all the talking.  Hear everything that is being said to you.  For example, someone may respond to a query “not yet.”  To some that is a “no.”  To others it may be heard as a “maybe yes, if and when.”  Pay close attention to the words being expressed, how they are said and the facial expressions and body language while they are said.  Be confident (not cocky) and visualize success.  Communicate clearly.  Remember that both sides benefit from a “win-win” result.  Aim high, without being ridiculous.  Leverage is an important thing.  Honestly evaluate who has the most to gain/lose in the matter being negotiated.  You might have more leverage and be in a better bargaining position than you think.

Never take things personally.  Remember, the other side is probably also aiming high.  That is part of the negotiation process.  Do not view the initial proposal as an “insult.”

By aiming high, you allow room for negotiation.  The more issues there are out there, the more there is to trade.  That is why it is important to throw everything out on the table and negotiate things on a “global basis.”  Do not negotiate on a piecemeal basis.

Be prompt and professional.  Do what you say you will do.  Look the other person in the eye.  As much as you can, “have fun.”

Use your planning to your advantage.  Keep short-term and long-term issues in perspective.  Never lose sight of what your most important “must have” points are and what it is you would be willing to “give up.”


At the end of a face-to-face meeting, be sure to summarize the areas of agreement and the “win-win” elements.

I always find it useful to capsulize things in writing, promptly.  That should clearly set forth the agreed to items as well as the open issues.  Hopefully, all parties’ recollection will be the same.  If it is not, it is best to find that out earlier rather than later.  It is not uncommon for the process to take more than one session.  Even when the deal appears to be lost, it may not be.  Nevertheless, at some point, one needs to “fish or cut bait.”  Just continuing to go around in circles does not make a lot of sense and ultimately will result in failure.


Ask for more.  There is nothing wrong with overstating one’s demands, so long as one is not ridiculous about it or insulting about it.  I often tell my clients that we are not really “demanding” things.  We are really merely asking for certain things.

Generally, it is best to respond to the “other side’s” proposal as opposed to being the first to lay one’s cards on the table.

As a general rule, never say yes to the first offer.

If you do, the other side may believe they have “done something wrong” and could have done better.

Some of the best negotiators I know are very good at “flinching.”  When people make a proposal, they are looking for your reaction.  Flinching may involve reacting with “surprise” or “shock.”  If you don’t flinch, the other side will begin to believe that their opening position is not that outrageous and may be acceptable.  An example of verbal flinching includes: “$300,000! I could not possibly afford to pay you that amount of salary.”  Another is “I have been offered more money by other practices.”  So often, what the other side sees visually may be more important than what is actually said.

Some of us have trouble curbing our emotions in showing openly how we feel.  Being a reluctant buyer or reluctant seller can go a long way towards helping you get a better deal.  The classic example is the individual who goes into a car dealership, sees a car that “he or she loves,” and cannot “keep a poker face” about it.  The salesperson knows right away that he has a real edge before any real negotiation begins.  An example of a reluctant seller is one who says “I really am not interested in selling this right now.”  If the buyer is really wanting this to happen, they realize they have to “step up.”  An example of a reluctant buyer is one who says, “I like what you are selling, but your price is too high.”

In some instances, at the end of the day, it really is best to have someone else do the negotiating for you.  Some doctors do not do well negotiating for themselves.  They fear “hurting the relationship” with the other side.  Therefore, they “give in” too easily or do not bring up all of the points.  That is not a condemnation.  But, it is a truism for many.

Some people are subject to “nibbling.”  One of the things that I do not like when I have gone through a negotiation is when the other side comes back after we believe that everything has been agreed to and seeks “a little more.”  Some people are most vulnerable when they think the negotiations are over.  The natural tendency after the initial agreement is to let down one’s guard and relax.  A good example is a car salesperson with a “by the way, there are additional charges for the extended service arrangement.

When all is done, congratulate the other side.  “Reluctantly” accept the last offer and make the other party feel satisfied.  Never gloat.  Let the other side believe that they have won the negotiations.

One of the most important and powerful tools in negotiating is the ability to “walk away.”  This can be a tough one.  If one becomes emotionally involved and “really has to have it,” it is tough for that not to come through.  It hurts you and you will usually end up with a deal that is not as good as it could have been.

Lastly, winning in negotiations does not entail “killing the other side.”  If it is not a “win-win,” at some point that fact will come back to bite you.

Vasilios J. Kalogredis, Esq. is President and founder of Kalogredis, Sansweet, Dearden and Burke, Ltd., a health care law firm, and Professional Practice Consulting Inc., a health care consulting firm in Wayne, Pa.  Among his areas of expertise are group practice arrangements, practice sales and mergers, doctor contract drafting and negotiation, tax and retirement planning for physicians, joint ventures, fraud and abuse matters, and evaluation of practice options for physicians.  He may be contacted at 610-687-8314 or by e-mail at BKalogredis@KSDBHealthlaw.com.

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