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Negotiate Your Contract: The Ins and Outs for Residents

By Dr. Frank Lee, MD, TeamHealth residency education outreach consultant, and former regional medical director

Tips for Residents on How to Negotiate Contracts

The topic of contract negotiations is something residents most often ask me about. I believe this is because most residents don’t want to feel like they have left anything on the table and they want to maximize their position. Through my experience as a regional medical director and chairman of my emergency department at TeamHealth, I have come to realize a few key points when negotiating contracts.

The Keys to Contract Negotiation

The first thing to understand is that you can have almost anything you want; you just can’t have everything you want. This is key when negotiating. You need to prioritize what is truly important and what things you can live without. For example, having tail coverage when it comes to malpractice insurance should be a top priority if it is not automatically provided (assuming it is not an occurrence-based policy), but asking for a 25% increase in CME allowance should not carry the same weight. The problem I see, however, is that many times a new candidate will negotiate EVERY issue as if it is a make or breakpoint. This frustrates all parties and can cause negotiations to hit an impasse very early on. You need to decide before going into negotiations what is truly important and what things are great to have but not absolutely necessary.

The second thing to remember is that the goal of negotiations is to come to a mutually satisfactory decision, one that both parties are happy with. This is important as these are the people you will be working with for the foreseeable future. You should not approach contract negotiations as a series of confrontations. If you negotiate with this confrontational mindset, it will certainly shorten your honeymoon period and create the impression that you are only there for the money.

With that in mind, understand that for any concessions you get, there should be some sacrifice on your part as well. I once had a new physician ask for a two to three-week vacation every month. This was a big ask but it was very important for this physician. Understanding that it was a big ask, this physician was willing to concede something back and agreed to be our Nocturnist. It turned out to be a win-win solution for both parties. He filled a desperately needed spot and everyone in the group was willing to be flexible to accommodate the vacation needs.

This leads me to my last point, and that is no matter what anyone tells you, almost anything is negotiable. You just have to have a good reason, and no malicious intent, behind the request and you have to be nice when you are requesting it. If you come into negotiate your contract with a demanding mood and abrasive attitude, you will be politely turned away from the job. However, if you explain your situation and are polite about it, sometimes exceptions can be made. I have made changes to “standard boiler-point language” many times when there was a good reason AND the person was genuinely a nice person.  Negotiations are about building a relationship

In summary:

  1. Prioritize what is truly important to you and your family and don’t make everything a must-have item
  2. The goal of negotiations is to walk away with both parties happy with the deal
  3. Negotiations are about building a relationship and if you understand this, almost anything can be negotiated

Want more resources to help you tackle your job search? For more information on TeamHealth residency outreach, please visit our new residency website or email us at

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