My topic is how to negotiate a contract and this is more now focused on your own development, on your own skills or own needs and what I wanted to do in the next 50 minutes is give a quick comment on some legal issues, talk about what I think is most important about this topic which is knowing what you really want and finally some tips on negotiating. In terms of the legal issues, my advice is very simple, get a lawyer. I think that I'm not a lawyer so I'm not going to give you any legal advice but I do believe that this is important for a couple of reasons. First is that unless you are independently wealthy, your job is your biggest asset and to make sure that somebody is reading the language of your contract, that you don't fall into any surprises and that you protect that asset is very important. Believe me, whether you're on your first job or negotiating for a super high-end job, having somebody, another set of eyes look at the legal language and having somebody who you can ask questions to and who can sometimes even help you negotiate is worth the investment for sure. In addition, I think that sometimes people forget that contracts really establish a couple of things. When everything is going well and you have a great manager or a great chief, the contract might be not that relevant but when things don't go well, the contract becomes critical. The contract establishes your scope of your work and your authority, your compensation of course, your benefits, path to advancement, even if you're in a private group, how do you advance, how do you become partner but most important, what I think a lot of clinicians fail to understand are termination clauses, right? What do you mean I can't work in the hospital in front of here? What do you mean I can't stay here? Things like that are really problematic so have a lawyer look at it and give you some advice. That's my legal piece. The most important thing though I think is for you to know yourself and this is Richard Feynman had a great principle which is the first principle is that you must not fool yourself and you are the easiest person to fool. People go into new jobs without being sure what they want and if you don't do some soul searching and some really honest conversations with yourself, you're going to believe what everybody says around you and that is a problem. You have to set your priorities straight. We talked about this earlier. If you don't set your priorities, somebody will set them for you and you don't want that to happen when you're negotiating a contract so I think it's important for you to understand what's most important for you, what's not negotiable, what are the things you value, what are things that you want to ask for, what are things that are important for you in terms of location, advancement and really before you even look at a contract, take time to explore what you really want, what is important for you. I think that every time I talk about contracts with people and I talk with a lot of people about potential jobs, it seems that the only thing they care about is compensation. Now I don't believe that is true. I believe that they haven't really reflected on what they're looking for in a job and that's the only thing that they hear elsewhere and it's something that's a number that's easy to compare so too much people focus on that. Now I'm not saying that you work for free but negotiation is a lot more than negotiating a salary and that's what I think people don't understand about jobs and you can negotiate like a pro and still lose if the negotiation you're doing is in the wrong place. So getting the right job is much more important than negotiating very well and that is something that sometimes people don't take the time to really think about. When you talk about knowing yourself, I also want to just bring to your attention some of the cognitive biases that we all have that sometimes play into negotiations. There's a famous anchoring bias, right? So if somebody throws a number, you immediately will anchor around that number. So learn to recognize that, learn to re-anchor yourself, don't fall trap of the first information you hear. There's also the confirmation bias which is we tend to see things that confirm what we already believe. So that can be positive or it can be negative and you want to be much more objective and you want to broaden the view of things as you get information. The sunk cost fallacy is if you've been in a place for a long time or you've been negotiating for a long time, all that effort, you can't give up. So if it's not the right place, it doesn't matter how long or how much cost you have there, walk away. And finally, I think this is important and I share it, not necessarily whether it was negative for me, but the halo effect. My first job with my mentors, I didn't do any negotiating, I just signed what they told me to sign and I moved along, right? And that's not what you should be doing. If there's things that are important for you, you should be negotiating for those things, no matter what that's. So the halo effect is when maybe what you think of somebody impacts other aspects of what they do. And for a lot of people who train at a certain place and then stay at that same institution, that can be very common, right? You always have the right to ask questions. If you do it the right way, you always have the right to negotiate. So finally, let's talk about some practical tips. So first and foremost, do your homework. Adapt to the job market, right? Understand what's going on. There are some job markets that are desperate for people. You might have more leverage. There are some job markets where there's five people in line behind of you. You might have less leverage. Understand also who you're negotiating with in terms of what's the organization, the practice, the company, what do they value? Do those values align with what you want to do? What's the type of work that you're going to do? Is that aligned with what you're looking for? You might be talking with a recruiter or you might be talking with the head of a division, but also understand who are you finally negotiating with? Who makes the decisions? You need to understand that, right? Because there might be things that you might ask for that the person who's negotiating with you doesn't have the capacity, but you need to know who really makes those decisions. And then finally, understand the whole offer. The offer is a lot more than just a salary. Understand all the terms. Sometimes having a lawyer to read the contract with you can be very useful, but also understand what else the job entails in terms of opportunities. Talk with people at the organization. Talk with people who are doing your job and really try to understand as much as you can. In terms of leverage, people feel that a lot of times they don't have leverage because they just finished training maybe or they're young, but the reality is that in any negotiation, the person who can walk away from the negotiation is the one who has the leverage. So if you're negotiating to buy a car, right, if you walk away and they don't call you back, it means that that was really the last price they could give you. But more often than not, the salesperson will call you back the next day and tell you that the manager just figured out that maybe there's something we could do, right? So you still have that leverage to keep pushing down the price. And the same thing if you're talking about a negotiation. And I think that there's a lot of people who talk about this in terms of who can walk away from a negotiation usually has the leverage, but ultimately I think it goes to what Todd was mentioning earlier with conflict. What you're trying to do is not to create a win-lose situation. You're trying to create a win-win. If you're joining a practice, if you're joining an organization, you're not doing it for the next six months hopefully. You're trying to build, I mean, kind of a relationship. So you want to figure out things that are win-wins for both sides. And along those lines, remember that companies don't negotiate. Hospitals don't negotiate. People do. So you need to understand people dynamics in this negotiation. Number one is don't underestimate likability. There's no reason why you should be unkind with anybody doing a negotiation for a job, going from the people who receive you at the desk to the people who are supposed to give you that negotiation. I see this over and over again when physicians, and I deal more with APPs than physicians, are likable, our recruiters, right, and the people who are interacting with them are pushing for them to get more stuff. When they're not likable, nobody pushes for you. It becomes a lot harder. So be aware of how you're coming across to other people and try to be likable and kind. Help them understand why you're asking what you're asking. If you can always give a reason, right, an argumentation, I think it goes back to what Derek said about the whole idea of having an executive summary. Tell the story of why this is important for you and why you think you're worth it, right? Make it clear that they can get you. So if you're really interested in a job, make sure that they understand that. You really want to work there and that they can get you and that you're interested and you're not just testing the waters. A lot of times people just do basically salary checks, right, to see if they can get more money from where they are. But if you're really interested in that job, make sure that they understand that. Understand the people across the table. What are their limitations? What are their constraints? Negotiating with hospitals, Derek showed, I mean, what's going on in the hospital world. It's a tough world out there for them. Understand what the reality is and understand their constraints. And ultimately, I think, goes back to your homework, be prepared for tough questions, right? If your CV has some gaps or some things that are not clear, be prepared to answer those things. But when somebody asks you something, never take it personal, but try to see what is their intent. What are they trying to get at, right? And just be prepared for these things because I think ultimately that puts you in a much better position to obtain what you want. And in terms of the negotiation itself, like I said, a job is a lot more than just a number. Consider the whole deal. When are you going to be eligible for raises if you didn't get what you want? What are your paths for advancement? What other benefits do you have? What autonomy do you have? And when you're negotiating a contract, don't ask for one thing, they get back to you and not ask for another thing. So look at what's most important for you and say, look, these are the three or five things that I really think are important for me. Can we talk about these? So usually negotiate multiple issues simultaneously, not serially, because I think that a lot of times just puts people in a bad predisposition. Regarding ultimatums, avoid them. If you don't give me this, I'll walk away. Just say this is really important for me. If this doesn't happen, it might be difficult for me to whatever, but don't give me ultimatums. And if somebody gives you an ultimatum, I usually ignore it, because either they mean it and that's not the right place for you, or they don't mean it, in which case you just have to forget about it and keep engaging with the discussion. Don't negotiate just to negotiate. I mean, I have people that just love to negotiate and negotiate and negotiate like it's a sport. Do it for things that are important for you. There's a certain amount of capital that you have through a career. If you're always asking for more money, eventually people just get tired of you. If you negotiate at the right times because it's important, you're much more likely to get what you're looking for. And the last thing I'll say is, stay at the table always. What does that mean? The fact that you signed the contract doesn't mean you stop negotiating, right? If there's something that they said no, you can ask them, well, how could this become a yes, or could we bring it up again next year? And you can always be pushing and negotiating for things that are important for you. And I think that is very important because people think that it's a one and done, and then basically you have to wait for something to happen. You can always negotiate for things that are important for you. And that might be flexibility, autonomy, paying for leadership development, salary, time off. A lot of things come into what a contract really, really entails. So we talked about the legal issues, which I think are important for us to recognize, this is our biggest asset, get a lawyer, it's worth it, right? Build a relationship with a lawyer, and a lawyer can help you understand things. And don't assume that everything they send you is going to be right. There might be issues that you can definitely push back. It's important, I think it's worth it. Number two, know what you really want. Take the time to reflect before you go into a job search or before you're looking for another job. And understand what are your values, what are the things that you enjoy doing, and how does that fit into a job? And that, I think, is something that we don't do as often, and I think it's very important. And finally, when you're negotiating, start by understanding what the job is, what the market says, do your homework, talk with people. Unfortunately, in healthcare, there's still a transparency issue, so it's hard sometimes for people to figure out what other people are making, right? But believe it or not, a lot of people in surveys have showed that if somebody who's really negotiating a contract asked them about income and how much they're paid, they're much more willing to share because it's information that might be useful for them. There's also other ways you can figure this out. But also understand, what are the terms of termination? What's the norm, promotion? What does it mean if you're applying for an academic job in terms of protected time for research, if any? How do you build that in? So make sure that you understand what the job offer really is. And then as you negotiate, keep in mind those tips from being likable, from asking for things as groups, right? From being engaging, from justifying why this is important for you, but why you also think that you are worth it. And I think that ultimately, what you're trying to do is create a situation where both sides win and creates a relationship that can keep growing. So I'll stop there, and thanks very much for your attention. Thank you.

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