Physician Job Search Tips: Negotiations Go Best with an Offer in Hand

Prior to launching HospitalRecruiting.com, I spent 7 years working for one of the larger physician recruiting firms.  During that time, I witnessed many physicians attempting to negotiate contract terms before receiving an offer and a few times before even interviewing for a given job.  You need to do these things in the right order, and negotiating before you have an offer for employment is usually a bad idea.  Here are some reasons why negotiations will go best with an offer letter, or contract in hand.

The physician hiring process normally goes something like this: initial contact, phone interview, maybe another phone interview, formal interview and site visit, contract offer, negotiations, and then signed contract.  Going through each of these steps in the order the employer prefers provides an opportunity for you to learn more about the job, the people you’ll be working with, and the community in which you’ll be working.  If early negotiations fail, then the door may close on potentially critical information, while going through these steps in the proper order will help you make your judgment on what to negotiate for from a more informed perspective.

Employers have a limit to how many times they’ll negotiate.  Eventually, if an employer begins to reach his or her limit, another negotiation attempt can lead to a rescinded contract and a label of “high maintenance” being applied to the physician candidate.  Each employer has a different level of tolerance for “high maintenance” candidates, but in general the higher the quality of the job and the more competition there is for the job, the less tolerance there will be for repeated negotiations.  Candidates who start negotiations early will almost certainly need further negotiations once an offer is in writing and put themselves in a position of peril if they find themselves needing multiple revisions of a written offer.

Negotiating pay, schedule, or other job perks at the onset of the hiring process creates negative implications in the minds of prospective employers.  Most employers of physicians would prefer to hire a candidate that is asking questions about the community, the quality of medicine in the group or hospital, or the backgrounds of the physicians they may be working with over a candidate who focuses on contract or compensation issues at the onset of the process.

Physician candidates who wait until the end of the hiring process before initiating negotiations give themselves several advantages.  The biggest advantage may be that by not focusing on contracts or pay benefits, they have created the impression that they are sincerely interested in the practice, community, and people they will be working with if they accept the job.  To many employers, this makes the candidate more desirable and often results in a better contract, pay rate, and benefits package.  When the candidate waits until he has an offer for employment in hand, he also gains a chance to learn more about the job, community, and people, and is in a better situation to negotiate.

We are not saying that negotiating early is always a mistake or never works, because sometimes it is smart, and sometimes it does work.  However, negotiating early can have a negative effect, while it almost never hurts to wait and learn. Therefore, on average, you’ll do better to wait on negotiations until you have an offer for employment.