How Physicians Can Negotiate Better Employment Terms

July 15, 2021 00:42:10
How Physicians Can Negotiate Better Employment Terms
Finance for Physicians
How Physicians Can Negotiate Better Employment Terms

Jul 15 2021 | 00:42:10

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Hosted By

Daniel B. Wrenne, CFP®

Show Notes

Knowing the right way to negotiate is important in many people’s lives. It’s helpful in employment arrangements/contracts and has many implications, especially financial ramifications. Negotiating is a skill that can make or break your job. Happy physicians deliver better care and better outcomes.

In this episode of the Finance for Physicians Podcast, Daniel Wrenne talks to Linda Street, a practicing physician and certified life coach who specializes in helping physicians negotiate better employment terms.

 Topics Discussed:

 Financial Ramifications: Learn how to negotiate well or deal with consequences

 Links:

 Simply Street MD

Simply Street MD Resources

Simply Street MD - Simply Worth It Podcast

Linda Street on Facebook

Linda Street on LinkedIn

Contact Finance for Physicians

Finance for Physicians

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Episode Transcript

Speaker 1 00:00:08 What's up, everyone. Welcome to the finance for physicians podcast. I'm your host, Daniel Raimi. Join me as we dig into what it looks like for physicians to begin using their finances as a tool to live better lives. You can learn more about our [email protected] let's. Jump into today's episode. Hey everyone. Today I'm talking to Linda street, she's a practicing physician and also a certified life coach that specializes in helping physicians to negotiate. I'm excited to dig into this because I know the skill of negotiating is such an important area in many people's Speaker 2 00:00:44 Lives. It has so many implications or crossovers. Uh, and in, in particular, it's helpful when it comes to your employment arrangements and contracts. Uh there's, there's also small things that come up along the way, even after you sign up or finalized an employment contract that are huge when you, you know, know how to negotiate and what the right way to do it is. And so getting that employment contract set up on the front end can really make or break a job has major financial implications. The little stuff along the way is extremely helpful too. So we're going to get into kind of what all that looks like as far as the right way to negotiate, uh, with Linda today. And I think it will be helpful for you, especially if you haven't spent much time understanding the mechanics of how to negotiate. So let's jump into today's episode, Linda, welcome to the podcast. Speaker 2 00:01:42 Thank you so much for having me. Yeah. I'm excited to talk more specifically about how physicians can negotiate better employment terms. That's just always seems to be a big topic and it can be like life-changing I know from our planning work we do with people, is it makes a big difference, uh, for people that have, you know, an, a good satisfying employment arrangement. And so I, I look forward to kind of getting into that with you, but I guess before we jump into that, can you share a little bit about your background background and kind of what you're up to? Yeah, yeah. Speaker 3 00:02:13 So I'm Linda street. I am a maternal fetal medicine sub-specialists by day, and I found very quickly in my career that there are ramifications if you don't negotiate well. So my first job out of fellowship was at a big academic center. Actually, I had trained there as a medical student and kind of circled back because my husband was from the area and I made several mistakes just really out of not knowing what I should be negotiating for. That ended up really contributing to burnout in an environment that didn't work for me. And so after doing that, I started to realize that I was not alone. There were plenty of others kind of in the same boat. So I tried to improve my situation at that job and spent a lot of time researching negotiation techniques, and really the thing that finally made it doable for me was working on my mindset. Speaker 3 00:03:04 So I had this very clean cut it's me versus them. This is a tug of war for me to get more. I have to pull harder type of mindset going in, which was really uncomfortable because these were people I worked with. I did focus on the patient care aspect and didn't want to seem greedy, um, which is a fear that comes up a lot for a lot of my clients as well. And so really attacking that mindset piece was key in my being able to get a $65,000 raise. So did that found out that it was not the money that was making the job not work. And I ended up leaving that job and during my noncompete year, really developing this business where these common themes that I saw women physicians primarily going through were very easy to overcome with a little bit of guidance. And so I do that now. I'm still practicing clinically full-time and it's a lot of fun Speaker 2 00:04:00 And that's simply street indie, right? Yes. Simply street md.com. Yes, sir. Yeah. On your website. I was, I was checking that out. Um, one of the things you had, I think it's maybe on the front page, but, uh, it says everyone knows a doctor with a doable contract. So I guess I was curious immediately when I saw that it's a good statement because it kind of strikes you for you. What does that look like? What does the enviable employment arrangement look like? Right. Speaker 3 00:04:27 And that's a loaded question. I think it varies from individual to individual. So the first step is really figuring out what do you want? Like things that I value in my list of what's most important to me, maybe very different than someone else's. So prior to the negotiation, some of your homework is figuring out what exactly do I want, because I think we've been somewhat socialized and kind of raised to have this expectation of this is how the job looks. This is how you take it. And we don't really think outside of those blinders to question, maybe the job could fit me better if X, Y, Z. And so before you can advocate for yourself effectively, you have to know what you're advocating for. And so really looking at what it is you value is going to help you have a contract that other people are like, wow, she looks really happy in her job. Speaker 3 00:05:14 That looks pretty amazing for me. Flexibility and autonomy are actually way more important than salary. Salary is important. Don't get me wrong. I'm a pretty well-paid sub-specialists. So that's not a small part of what my compensation negotiations involved, but at the end of the day, it doesn't matter what you pay me. If you are micromanaging me and telling me what to do and giving me very little flexibility, I really don't care. I'm going to be miserable in that job. You can pay me $2 million a year and it's not going to be a job that I stay in very long. And so I think really looking at what it is that's valuable to you is the first step to creating that contract. You wish you had. Speaker 2 00:05:54 Yeah. And I think, uh, some people are clear on that. That's an excellent starting point. I think a lot of people are clear on that, especially, it seems like, you know, when you've had a little life experience and what's good and what's not, but, um, let's say you are, you know, looking for flexibility, you know, you're in an incredibly inflexible job, is it like I, and we have seen a lot of clients struggle with this. It's like, it is what it is is I see this mentality sometimes it's just like, it is what it is. But, um, is there hope for that kind of thing when it's like a complete conflict of what your ideal inviable contract looks like and your current job, if there's complete conflict, like it's like a complete 180 then, is it just like no hope or can you kind of make salvage what you have or when do you pull the plug on it? Great. So I think Speaker 3 00:06:41 You have choices there. One option is let's see how I can improve the current job. Anything that's been negotiated, ones can be renegotiated. So it never hurts to ask for what you want out of your current position. If nothing else, it's a great dry run for seeking a new opportunity, right? Because you're already there, you have the opportunity to potentially make it so that you don't have to leave, right? Because leaving is kind of a last-ditch thing. And you also, if you do end up leaving anyway, have that kind of knowledge of, you know, I tried to make it improve. They weren't willing to work with me. I need to look for something else that does work for me. But if nothing else you're practicing with techniques and things, and really just the comfort level with advocating for yourself, because just the mindset piece of negotiation, I was break it up into three different parts. Speaker 3 00:07:34 So there's the mindset piece, which is getting yourself to the table and navigating the conversation itself. And then there's the market piece, which is knowing what you should be being paid. So having some idea of what other people who are in a similar market are getting paid is helpful because if you don't know that you're being underpaid, then it's hard to advocate for yourself for a higher pay. Or if you realize, Hey, what I'm getting paid is the 80th percentile. You may be like, okay, maybe salary is not what I want to target. Let's target these other things. So having that market knowledge is important. And then the third part is really just taking the steps to make it happen. And you can use a lot of different strategies to accomplish that depending on your exact desires and goals. I try to keep it really, really simple because most of my clients, aren't trying to get a PhD in negotiation. They're trying to get a contract that serves them. And the skill set is something that we just don't really learn in medical education, but the people we're negotiating with have often been trained how to negotiate with physicians, how to make sure that the company's bottom line is protected, Speaker 2 00:08:36 Which is not a fair negotiation, I guess, uh, when you're going up against somebody that's like been trained already in it. And what's interesting when you get into that sort of conversation, a lot of times it makes you feel like you should have never brought it up in the first place, if it's an unsuccessful conversation and that that's not, you know, obviously a good outcome, but you can, there's a wrong and right way to do it. I think that's a lot of what you're talking about. So the mindset thing you talked about, and I think that I would agree, it's like, and I kind of wrap like confidence and with that, having your head, right. What does that look like? Great. Speaker 3 00:09:08 So I think some of it is the mindset regarding what you bring to the table. So I'll have a lot of people say, well, I'm just an average physician who am I to negotiate for X, Y, Z. And it just blows my mind because some of these people are people who've done phenomenal things. And so really taking the time to really do an inventory of what do you bring to the table. And it's not just your clinical skillset, so you have your clinical skillset and that's the primary thing that you're exchanging for money or for whatever the contract is. Right? But there's also a list of other things that you're bringing. Are you someone who works well with teams? Are you someone who builds quality metrics? Are you someone who speaks another language, whatever, do you have leadership opportunities? There are so many different pieces that we can bring to the table that can be leveraged to really make sure you get a better deal. Speaker 3 00:09:52 And then the other part of the mindset beyond that is looking at the negotiation is something you can do. And so there's so much of this. Like I can't negotiate. I don't know how to do this. They're just gonna not move on this anyway. Like they're not going to budge. This is set in stone. When I hear often is I'm an academics. They don't pay you that well. Right? And there all these beliefs that we hold to be trues, and they're really just thoughts. They're really beliefs that we have that have been repeated over and over. And so we've accepted them. And certainly it doesn't benefit the business that is hiring us to pay us more because then that affects their margins. And so they have no reason to challenge those beliefs. So until we challenge those things that we consider truths to be just thoughts and optional, I think you have a harder time even showing up to the table. Speaker 3 00:10:42 And then the next piece is just looking at the negotiation itself. It is simply a conversation with the goal of making an agreement. Physicians are actually really well suited for this because we do this with our patients every day, every day, we have conversations to try to come up with an agreement, to get people, to be compliant with treatment plans every day, we're having conversations about difficult topics with people that have major impact from the decisions made in those conversations. So we're not foreign to conversations that have difficult context. And a negotiation is certainly probably lighter than the majority of what those conversations with patients are. So it's actually easier than some of the things that you're already really skilled in. So taking away some of the magic of it's a negotiation, oh my God, I can't do this. And really looking at it as it's just a discussion with the goal of making an agreement, right? Speaker 3 00:11:31 And the person you're talking to, the other party, whoever you're negotiating with, they are not an adversary. They benefit as well by you having your skillset there at their institution. They benefit as well for this agreement to go through. Otherwise they wouldn't be entertaining the conversation with you. So looking at it as like, I need this job, they don't have to give it to me. There are other physicians, is it going to get you very far? You're just going to accept what they hand you, which is never their best hand. Versus if you go into it saying, no, I bring a lot to the table. These are the ways that I'm great for what you want for this position. Let's talk about how we make this work for both of us and really looking at them as a partner in the conversation instead of as, as an adversary. Hm. Speaker 2 00:12:15 Yeah. It's a mutually beneficial discussion and you're trying to make it win-win for both parties. It's not you versus me. I think a big part of what you're saying. Uh, what about people that, I mean, I've heard that a lot. You said it about academic and I think you can kind of fill in the blank on that. It's like this, and that's a pretty good one because it's like the academic institution has the reputation of being like very staunch in their policies and, you know, bureaucracy, and it's hard to get they're, non-negotiable, I've heard it a million times and, but I've heard other people say kind of different flavors of that is like, um, you know, there's no no point in negotiating because you know, so-and-so negotiated it and they didn't get anywhere with it. Or, you know, they've already conveyed that. It's non-negotiable but like, how do you get over that hump when it's just like, there's no point in even bothering, I know so-and-so is not going to talk to me about it. And is that, and is that your own, self-talk more just like procrastinating subconsciously or is it really like, I mean, that's, that's a big part of it too, I think. Yeah, Speaker 3 00:13:13 No, I think it's completely, you hit it on the head. It's this belief that it's not worth it anyway, because I mean, I got a $65,000 raise in academics in one year as a junior faculty, I was assistant professor. So I was not like tenured or anything, magic and fancy. And I was able to get a raise because what I provided for them was worth that. And so they, they valued it enough that me not leaving was worth putting forth that money. The other thing is, is even if you do have a culture where all the pay is very transparent and everyone at a certain level is making the same salary, what else would make your job more valuable to you? So money is not the only form of exchange. Certainly it's one of them, but with some flexibility in your time, be useful, would telecommuting one day be you school would having a little more time for your educational pursuits or research time or administrative time or whatever would something that's not pure dollars out of their pockets and into yours also be advantageous and really looking at different ways. You can be creative to make your job more valuable to you, even if it's not just simply a cash exchange is I think always worth at a minimum, at least that is worthwhile because there are a lot of things that are maybe low effort for them, but high value to you that you may be able to negotiate and it can make a big difference in your experience of going to your job every day. Speaker 2 00:14:38 Yeah. I think I've seen people struggle in medicine with the, our workload, maybe our combination of hours, plus the stress within the hour. A lot of people I think, feel stuck in they, and maybe this is true, especially in like subspecialties or, or rural areas where they're just kind of like, uh, especially, it seems like loyal people struggle with this even more, which is kind of interesting, but they're like, um, they need me, like, I'm, I'm the only one. Like I gotta, I gotta do it like who else is gonna do it? And, uh, but they I've heard him a lot of times, you know, express that they it's a very important for them to have more balance, but yet they're just in this crunch. And I think that just totally, uh, amps up all the burnout issues. Um, but what do you do in your, when you're in that sort of crunch feeling where it's like, like Speaker 3 00:15:26 Kind of balancing between your patient obligations and wanting to get the job to be more flexible for you? Speaker 2 00:15:34 Yeah. And especially when they have expressed that you're the only one or the key person and nobody else can do what you can do. Yeah. I could feel that. I mean, I'm sure that that's a pressure situation where you could potentially just go with it. And it seems like a lot of people just do that. They're like, well, I either leave the job or I, or I just deal with right. Speaker 3 00:15:56 And I think in that setting, I mean, I am the only one who does what I do, where I work. And, um, even in my prior job, I was one of two. So it was a fairly small division. I think some of it's just that mindset. Like if I don't do this, what will happen the year I was burning, my non-compete the community did not shut down. People still got care and have to travel a little more for it. They might have to wait a little longer for an appointment because there was one maternal fetal medicine doc down. But like it still happened. People still have babies. People still had high risk pregnancies, things still happened. And so I think that some of that is not necessarily true. Will they be able to get it in that exact way? Maybe not, but will they get care somewhere? Speaker 3 00:16:36 Probably. I mean, ultimately at some point, hopefully all of us are going to retire and there will be a hole and then somebody else will have to fill it or the fill the need will not be filled. And so I think some of that's not helpful thinking. The other piece of that from the flip side is you have a ton of leverage because leverage is really about how do you maximize their perception of loss if you're not there and how to, how do you minimize your losses and minimizing your losses is about having good alternatives, but maximizing their losses is really about showing them how, if you're not there, this is why it's going to be disadvantageous for their organization. And so if you're the only one doing things, and you're the only one providing that need, that's a huge amount of leverage to be able to get something that works better for you. Speaker 2 00:17:25 Yeah. It's such a good point. It's like, if you're that important for the specific institution or employer making, reminding them of that and that potentially that's even more negotiation leverage right there in itself. Right. Speaker 3 00:17:40 And sometimes you have to tell them what you're doing for them. So I think we go in because we're living and breathing it, we go in thinking, well, of course they know all the things I'm doing, but oftentimes negotiating with somebody who may not even be clinical and they have no idea what you're doing. So they have no idea what skillset you're providing. They have no idea how many patients that you are, the main safety net for. And so sometimes you just have to bring that up. Like you have to be willing to kind of break it down to the basics of I'm the only physician who is a safety net for this patient population. And this is why this is important. And it seems like covering the basics, but oftentimes the person you're negotiating with may not have the same grasp on that as you do. Speaker 2 00:18:18 Yeah. So for those who have not had that conversation, who is that person typically, uh, and what does that conversation, how does that conversation typically go in your experience in people you've worked with, Speaker 3 00:18:30 Right. So it varies a lot depending on the structure that you're employed under. So in academics it'll often go through like a department chair or somebody like that first who goes through some type of compensation committee or whatever at a more institutional level and more corporate jobs is oftentimes a non-clinical person. So, um, when I negotiated this position, I negotiated with the VP of something or another, there are so many of them I can't keep up, but, um, it's a non-clinical person whose job is to make budget decisions and try to make numbers make sense on a spreadsheet. And so it's someone who knows about the contracts and knows about the compensation and knows about negotiation, but may not be quite as intimately familiar with the ins and outs of what you provide as a service private practices. You're oftentimes discussing this with like a practice manager or with like a senior physician or a partner. Speaker 3 00:19:21 And so they may have a little bit better kind of on the ground idea of what's going on. And it just, depending on who you're talking to, it depends on how you approach it because the department chair is maybe going to be swayed by, Hey, this is a big need in our department. This is a big gap. We can really fill this need, get publications out, get prestige, things like that. Versus someone in a private practice is going to be like, well, that's nice that you got that prestige and published that, but like, we need to make sure the practice is solvent. We need to make sure that we're providing good patient care in a way that's also something financially feasible. And so the differences will depend on where you work. But I think that brings up the point of really doing your homework ahead of time. Speaker 3 00:20:06 Like you really shouldn't just show up to a negotiation and wing it. Why would you wing a decision that could make six figures worth of difference to your life without prep preparing you would never take your board exams, for example, without any preparation or maybe some would, but the majority of us spend months and months preparing and studying for a board exam. So why would you not with the contract that is going to determine what your life looks like day in and day out and how you get paid for it? Why would you not take some time to really prepare and know who you're talking to know what their priorities are? Because if you can appeal to them in a way that lines up with their goals and what they're trying to achieve, if you can present yourself as the solution to their problems, you're going to get a lot further in your negotiation than if you just show up and say, this is what I need, and this is why I should have it. Speaker 2 00:20:54 Yeah, no, that makes a lot of sense. Cause everybody at the end of the day is out for themselves. And so if you can leverage that, I think that's, that's key. Some people are harder to read than others and any good tips for how to uncover that sort of information about someone. If you're not already familiar with what it is you to just straight up ask her. Yeah, yeah. Speaker 3 00:21:17 Both. So one of the good places to just start is look on the hospital website, what is their mission statement? What are they going for? Right? Because those are things that are publicly proclaiming are important to them. And so that's a good kind of like put your toe in the water. And then the next thing is, is at your interview ask, um, if you're interviewing for a new job, why is it because I think this is harder when you're interviewing for a new job that renegotiating, because when you're renegotiating, you're already fairly familiar with the environment you're within, but when you're interviewing for a new job, why is it that you're expanding to hire for this position? Why is it that someone left that you're hiring for this position? You know, find out a little bit about how they foresee that position fitting into the organization and why they're looking for someone to fill the need that you're being interviewed for. Speaker 3 00:22:02 I think also looking at what's your plan, what's your trajectory? What would be an ideal pathway? If everything went perfectly as to how you would see the organization progressing over the next few years, really asking them some questions about what they're hoping for, what they're looking for, what they are hiring you to do, instead of just looking at the clinical skill set that you're going to fit, because you're not just going to see those 20 clinics lots every day and then do a couple of surgeries or whatever. Like if their goal is say outreach and they want to make sure they're capturing the market share by XYZ, then you can focus on, okay, well, what skills do I bring that would make me really a good fit for this? Maybe they are looking into telemedicine as an expanding service line since that's kind of evolving and increasing as we've gone through the last 18 months or so. Well, if you have a lot of experience in delivering care over a telemedicine platform, or if you have experienced starting one up, maybe that's something that you can offer. That's more than your clinical skill set. And if you know that you can really present yourself that way, versus if they're not interested in that at all, telling them how wonderfully you set up this tele med service and a pickle and the pandemic is not going to mean much to them. Speaker 2 00:23:18 Yeah. They're out for what their particular goals are. And not necessarily what you're thinking about, any other areas of homework, uh, people can, can do like, um, um, I know, you know, understanding how you're compensated, right? Speaker 3 00:23:33 Great. Especially with production contracts, I feel like people's brains shut down when the contract is not just the base salary, what does the base salary most of us, you know, can figure out like, okay, I'm going to get paid this per year. Okay. Simple. When you start adding production. I think a lot of people really shy away from that because there's a little, it's almost like variable interest rates. Cause you're a finance guy. Like there's a little more risk to it, but it could be highly advantageous. I refinanced my student loans. I don't remember three years ago now. And I'm paying like half a percent, which is way better than the 6.8% they were at because I picked a variable interest rate and got lucky. Is there more risk maybe? But it was really something that worked out for me. Same thing with production contracts. Speaker 3 00:24:14 If you go into a clinic that is really, really busy, having a production contract can be really favorable to you. You may find that you're shooting way beyond what you thought you were going to earn very quickly versus if you go in and they're not marketing you in the clinic's not full and you're struggling to get people in to see and to take care of, well, then a production model is not really a good fit. And so I think kind of seeing it as not good or bad, but something that could vary is helpful and then really doing the math, like, okay, if I need, if this is how much I'm paid per RVU, which is a common production model and employed models, how many RVs would I need to equal my salary or to equal whatever salary I want. Okay. How many, how many does that make in a week? Speaker 3 00:25:00 If I take four weeks of vacation, how many is that a day? How many patients would, I need to see to make that happen? Is that feasible for me or holy cow, is that like 20 more patients than I need to be seeing in a day. So really taking some time to kind of break down the math into like, okay, it's 7,000 RVs a year. What, what does that mean for me every day, I think is a little bit more swallowable context. And also lets you know, is this feasible or do I need to ask like, are you going to support me with marketing or whatever? Or is it a chip shot? And like of course I can do that. That's no problem. Speaker 2 00:25:32 Yeah. Okay. So when is, when is too much homework? When do you get a lot of people suffer from the paralysis analysis, especially when you get into this kind of thing. Cause it's very, uh, it can be mentally challenging to go into a difficult conversation like this. And so I have been guilty of this. It's like I do my homework and it's almost my procrastination tactic and I do homework forever. So when is too much homework or how to, where do you draw the line? I mean, is there any, I know that's kind of a loaded question a little bit, but well, Speaker 3 00:26:02 And I'm the opposite kind of person. So that works well. I usually throw myself in, I'm like, okay, I got to do homework along the way. And I think some of that is figure out kind of what are their main goals? Why do they want to hire you? What do you want once you've done those three things, jump in and some of it's going to come up along the way. So you're going to find out more information as you're on your interview and you're asking like, why are you looking to hire? What are you planning on? Yada yada yada. And once you've started the interview, if you decide it's a good fit and you want to proceed, some of that's going to naturally start happening. They're not going to want to wait six years to talk about salary. Like some of it is going to start moving. Speaker 3 00:26:38 It often moves a lot slower than you would want it to. Sometimes it takes like six weeks between when you finish interviewing and you're like, yes, we'd like to have you and you actually get a contract in hand. I've seen it take months on occasion. Sometimes they have it right ready to go. And they're like, Hey, where do you sign here? And you want some more time. So I think knowing that you want to know basics of what you want and what they're looking for, but you don't need to know all the details and you don't even need to know all the details in the negotiation. I always tell my clients like have a get out of jail, free card, have something ready that if they shoot something at you that you're not prepared for, you can kind of circle back, like have a get out card. Speaker 3 00:27:17 It usually is something along the lines of, you know, that's a great point. I hadn't really considered that. I'd love to give that some thought, when can we circle back to rediscuss this? And it shows that you're paying attention, you're engaged. And it also very clearly says that you want to readdress it at a later time, which buys you some time to figure it out, to figure out like, is that something I want to take on? Is that something that's acceptable to me? Is that something I need more information for? But having like kind of something that when your brain goes into the, oh my goodness blank mode where you can't think of anything, you have something you can pull out to buy yourself some time I think is easy and really just pre anticipating when, once you're in the actual throws of the negotiation pre anticipating, what are all the ways they're going to tell me now? Speaker 3 00:28:02 Because when you're in the actual conversation, your brain goes into fight or flight mode and your ability to come up with creative solutions, completely tanks like you have, you're just like, uh, sitting there like you can't access words. And so having a list of like, what are all the ways they're going to say now? Are they going to say, well, we had budget cuts from COVID so we can't do this. Okay. Well what's my solution to that. And thinking about it ahead of time, are they going to say, we pair it, pay everybody the same so we can't pay you that. Okay. What's my solution ahead of time, because you're able to access a lot of really good reasons as to why that shouldn't be a barrier when you're not in front of them. And so taking the time to really look at like, what are all the reasons they're going to tell me now and have an answer for them and a response. And even if you don't hit every single question, because inevitably something they'll say that's basically a no is going to be something you didn't think of. Just having gone through the process, kind of tunes you up to think that way. And then it's easier to respond to whatever they do say. That's not like a hell yes. We'd love to pay you what you're asking. Speaker 2 00:29:07 Yeah. So in anticipating the objections is kind of like, you know, thinking about what the, how the conversation could go ahead of time, um, is always a good strategy. I think some people, uh, there's the other extreme there's, uh, an analysis paralysis types. And then the other extreme is just like the totally off the cuff. Like, Hey, I'm just going to go ask for a pay raise. Um, and some, what is interesting to me is, um, you know, I know people I'm not quite like that. Uh, I know people that are like that and I've been around some people that are like that. And a lot of times they still get it done or they get, get what they wanted and they have no background knowledge and not have D have not prepared for the conversation. They have the confidence and the mindset totally. Right. And they just jump in, but maybe that's not necessarily the best approach or is it right? Well, and Speaker 3 00:29:59 I think of the mindset, the market and the make it happen. You don't have to be perfect at all of them. You just have to be good at some of them or some good at all of them. And so if you have the mindset, nailed, people are going to believe you you're switching the leverage equation on their side, because they're saying, I don't want any doctor, who's say an obstetrician. I want this person. And the more they want this person, the more they're willing to pay for it. So if you have that confidence and charisma, people like that. And so they're going to be more willing to respond in a favorable way when you show up in a way that is very like confident in from, and this is why this needs to happen. And so you may buy yourself a little wiggle room on some of the preparation that you've overcome with confidence. Speaker 3 00:30:40 I more often see the opposite. So I more often see people who actually have a lot to offer and should be being paid more. And the conversation itself wouldn't be very difficult to sway, but they just can't get over that activation energy to show up for themselves and a good mind hack there is how would you show up for your patient or for your best friend or for your sister? Because a lot of us have a really hard time advocating for ourselves, especially in service industries. I think there's that help or mindset where you're like, well, I just really want to help the patients. And my argument to that is you can't help them when you're burned out crying on your couch. And so you need to advocate for something that works for you. So you can continue to help them like you having a good contract is actually exactly what you need to make sure that over the long-term you're able to help your patients fast, but to get kind of through that, I just want to help energy to a it's important to ask for yada yada yada energy. Sometimes you can just say, what would I tell my friend? And you usually wouldn't tell your friend, well, you just want to help people. So maybe you shouldn't ask for that raise. I think you should just help people, but we tell it to ourselves all the Speaker 2 00:31:49 Time. Right? I think some people wish they could have somebody else go in, negotiate for them, Speaker 3 00:31:54 Right? Yes. All the time. No, I will teach you how Speaker 2 00:31:58 You're right. I think some people do that, but that's, I would say that's not quite as effective as if you are in their heart and soul, you know, cause obviously it's, you're the one directly involved, but Speaker 3 00:32:11 There's going to be more after the contract, right? Like we all live in the real world where we need things to do our jobs. Sometimes I'm a year into my job and I'm still negotiating for resources or for whatever. Right now I'm negotiating for space because we've outgrown our clinic space. And so there are going to be these micro negotiations that aren't maybe as big as your entire contract negotiation, but are going on along the way. And you can't, you can't phone a friend every single time versus if you learn to do it for yourself, you're like, oh, this is easy. If I could do this one, I can do this one too. Yeah. Plus you're seen as like their perception of you as someone who advocates for themselves effectively. So they're coming into the conversation, knowing that you are someone who's going to ask for their worth. And so they're going to be more likely to give it to you when they walk in the door versus, oh, that's somebody who paid that lawyer to negotiate for them. But like they can't really hold their own. Speaker 2 00:33:03 Yeah. It's funny how that works. People tend to kind of mirror a little bit about how you behave in these nos. You know, they will tend to follow that, that we've we find that with our, our clients in our financial planning business it's um, with our clients that are very, very on top of things and on the ball, it's much easier to be on top of things and on the ball ourselves when you're working with somebody that's that away partially just because they're setting that expectation. And so if you're somebody that will regularly bring up the difficult conversation about, you know, negotiating a tough situation, I think you start to develop a little bit of a reputation of someone that's willing to have the tough conversations. And I think that's the hardest part is crossing the threshold of it's an normal, comfortable conversation where you're just receiving the information to like where you take the control and shift it to where you ask. Speaker 2 00:34:00 Cause I think a lot of people get bulldozed, uh, in these kinds of conversations because there's just, um, part of it is not experience and maybe mindset is not there. But I think this comes back to mindset is you gotta work on that confidence, right? Like you gotta get your mind, right. To be ready to flip the coin on them and, and ask because that's what, in my experience, a lot of times it comes down to just maybe just having one question to kind of shift the conversation. Right. Right. And cause they, they, they typically have their agenda when you're in a meeting because that's typically where it comes up and or do people typically prearrange these negotiation conversations? Well, Speaker 3 00:34:35 Especially in the new job, there's often kind of this pre expectation that once we finished the job interview, we decide you're a good fit. I'm a good fit. The next step is negotiation. So I think there is more of an expectation that that's the next step with renegotiations. Oftentimes people will have these auto renewing contracts that just kind of go on and all perpetuity, if you don't do anything to them and people will kind of get complacent when that happens and just be like, well, I don't want to ruffle feathers or I don't know if this is a good time to ask for this or whatever excuses we make. And those are the ones we're really kind of seeking out an opportunity. And I usually tell people, just ask for it. And I also like to tell them what I'm asking for. So, Hey, I'd like to have a meeting to really discuss my contractor, to discuss my compensation or whatever it is so that you're not blindsiding them so that they can show up to the meeting prepared for the discussion that you intend to have, because if you blindside somebody, none of us like that. Speaker 3 00:35:31 And especially people who tend to be in powerful positions really don't tend to like that because oftentimes feel the people in powerful positions positions have this, um, aversion to being caught off guard. And so if you can kind of pre-warn them, this is what I'd like to talk about. You're, you're taking down that guard instead of pulling it up, which is going to be helpful for you, but just asking to have the conversation instead. Speaker 2 00:35:57 Yep. It also forces you to, I have kind of minhag myself into having tough conversations by just like telling the person I need to talk to them about this thing. And then I have to code to them about that because otherwise I was probably gonna you procrastinate or something, but you know, once you get it out there, it's like, okay, now, and then it's the conversation it's going to happen. And you kind of prep for that. But I think what, what is Quito in? What you do is w what's what I like so much is this is one of those classic examples of things. I think that it's difficult to like self diagnose. It's, uh, it's hard and it's complicated. It depends on every situation. And, um, we tend to like, psychologically, you talk about mindset. We tend to like really work our mind into probably not necessarily helping us in this regard and having like a third party. Speaker 2 00:36:52 Um, I think a lot of physicians I talked to, uh, don't even really think that's a thing that exists to have somebody like help you or teach you in this regard. And the benefits of that are huge. And that's kind of what you've started to do is just, you've seen this area, that's a major hole and you kind of act as that third party to help kind of people get their mind right. And iron this out in their situation. So I guess before we, as we start to wrap up, I'm curious if you can tell us like a little more specifically about what that looks like, like, what are your resources? I know you have your podcast and, and can help physicians with this specific area, but what does that look like? Yeah. Speaker 3 00:37:31 So working directly with me, I do one of two ways. So I have what I call the emergency situations. I get these emails where it's like, oh shit, I have a meeting in 48 hours. Like, can you help me? I'm like, well, let's see what we can do. Um, and so there are a lot of those, and that tends to be just like a one-on-one strategy session. I actually have a process that I go through looking at like the mindset piece, like, okay, what are the big hangups that you personally have and how do we need to overcome those so that you can get through this negotiation in a way that serves you and then kind of looking at the data, looking at the numbers. So I use MGMA, but any of the data sets are equally as good as another. It's just a jumping off point to kind of have a base base idea of is what they're offering reasonable or is this absolutely crazy and insulting. Speaker 3 00:38:16 And it's very rarely too high, very rarely state offers that are initially just up in the clouds. And then if they are, you're always like, okay, what else is going on here? Cause this seems really, really strange as the first part of the story. Really? Yeah. You might need to start asking some questions. So kind of knowing ballparks is good. And then we just go through the techniques and I, to make things really simple because I'm not trying to get them a PhD in negotiation. I don't have one either. Like our goal is to have the conversation in a way that you can effectively get a contract that serves you. And so really looking at like, what are the things that they're coming forward with? What is their mindset? How do we move leverage in a simple way? What are those obstacles and strategies? Some of the things we've talked about and just really kind of walking them through it in an organized fashion. Speaker 3 00:39:02 And then a lot of the, especially when we get to the obstacles, like looking at like, how are they going to say no to me, I'll be like, okay, well, how would you respond to that? And people are like, whoa. And some of those after doing it day in and day out, I do this probably five times a week. You get a little bit better at like, okay, well what about this? Or what about, oh yeah, that would be a good answer to that. And I had a gal this week that one of the things that we had strategized for a know popped up and after she responded the way we'd pre-practice, they were like, that is a really good point. I'll get back to you on that. Versus had she just gone in and went like, okay, that's just a no, I mean, that was money left on the table. Speaker 3 00:39:39 And so it seems so simple, but it works because it uses kind of pre-planning and human behavior on your side instead of against yourself. And then, um, in addition to the emergency sessions, I have like a group program where the goal is really more to learn the skill set. So it comes with an emergency strategy session as well, so that they can prep for a certain negotiation, but it's a little more focused on really developing the skillset, really being able to go to each conversation, ready to target what you want. You get to benefit from watching other people going through their own negotiations so that you can kind of see like, oh, I'm not alone in this. Like other people have this problem. This is how they solved it. This is what happened for them, because I think there's some comfort in knowing, Hey, I'm not alone. And B these things do work for other people too. Like it's not that Dr. Street is a special snowflake. We just got one. Speaker 2 00:40:34 Yeah. So this is also the, the, the thing about negotiating is I think it applies to so many things. It's absolutely, it's a huge skill that you can use in everything. Like, for example, parenting, you know, I am constantly negotiating with my child. You know, sometimes they are very difficult to negotiate with and you're like, this is unreasonable, but you know, you still are trying to get an outcome that's, uh, you know, mutually beneficial. Um, and so the, the interesting thing about negotiating is it's one of those things you can kind of apply to different circumstances. It's very helpful in multiple areas. So it's, I love that you're doing this well, Linda, thanks for coming on. I've enjoyed our conversation. Um, you can, your website is simply street md.com. Speaker 1 00:41:21 You guys can find her there. And Linda, I hope Speaker 2 00:41:23 We can stay in touch and I enjoyed our conversation. Speaker 0 00:41:26 Yes, there may as well have a good one. Speaker 1 00:41:28 Thank you so much as always. Thank you so much for joining us today. If you found this valuable, please give us a review on iTunes and share with a friend. Also check out our website at finance, for physicians.co for all sorts of additional content. See you. Next time. Finance for physicians is not an investment tax legal or financial advisor. All content included in this podcast is for informational purposes only, and should not be considered financial tax or legal advice. Material presented. It is believed to be from reliable sources and no representations are made by finance for physicians as to another party's informational accuracy or completeness, all information or ideas provide, and it should be discussed in detail with an advisor accountant or legal counsel prior to the implementation. You don't have an advisor or like a second opinion. Feel free to check out our website for recommended advisors.

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