The first question we usually ask physician negotiators might sound simple, but it isn't. When you're in a negotiation, whether with a payer, employer, or other entity, whose perspective are you using? Whose needs and problems are you considering throughout the negotiation? Whose viewpoint are you thinking about?
As physicians, this thinking is natural in the clinical environment. When speaking with a patient, whose perspective do you have in mind at that encounter? Whose needs are you focused on at that time? Naturally, we are focused on the patient's needs and work to find a solution to their problems.
You might not realize it, but you are already practicing two important aspects of negotiations: Keep the proper perspective and have a mission and purpose statement focused on the other individual. As we went through medical school and residency, we were trained to act with the other's best interest in mind as we make decisions in the clinical setting. These same skills can be very useful to us at the negotiation table.
Understanding of Patients and Negotiating Parties
If you had the other side's best interest at heart, how do you think you would approach their problems? What if you honestly desired to find a solution for their needs? What if you aimed to solve their problems?
It seems to us, whenever we begin to talk about negotiations, our human nature creeps in and takes hold. Our own self-interests begin to bubble to the surface. We become focused on ourselves — on our needs. Sometimes, we are so focused on our needs and problems, we fail to see how we can solve the other side's problems. We miss the point of being at the negotiation table.
Who we are focused on is vitally important to a successful negotiation. Many skilled negotiators work to manipulate and leverage our own self-interests for their benefit. They may dangle all sorts of carrots in front of you because they're focused on themselves and want to benefit themselves by manipulating you. You may use sticks instead of carrots. Neither side makes much progress. It can also be difficult for you not to do the same to them. How good do people feel after they perceive they've been manipulated? How successful will the performance of a contract be if either party feels manipulated or had leverage used against them?
So, what's the alternative? To be completely focused on their needs. We do this as physicians each and every day. The same sort of results can occur in any negotiation too.
A recent example of this comes mind. A practice was negotiating a service agreement with a moderate-sized hospital for a particular call service. The hospital desired to pay less for the call services than the practice was willing to offer. The practice felt the scope of the service proposed by the hospital was too large for the payment structure. Rather than focusing on their needs, the practice sought to better understand the needs of the hospital. They asked probing questions so they could understand the real needs of the hospital. They were not certain the hospital's administration truly understood their own needs. Rather than fighting with the hospital for a dollar amount the practice wanted for the proposed scope of call, they approached the situation from the hospital's viewpoint.
In doing so, they were able to uncover the real needs of the hospital. By asking good questions focused on the hospital's needs, the practice discovered that the decision makers in the hospital had two different ideas about the scope of call services needed. However, these decision makers had never discussed this amongst themselves. By focusing on the hospital's needs, the practice was able to help the hospital administrators see what they really needed in call services. If the practice had been focused on their needs only, they would have missed the needs of the hospital and probably fallen short in their service to the hospital. Ultimately, both sides would be unhappy with the agreement. However, in the end, the practice and the hospital agreed to a smaller scope of call services at a payment amount the practice wanted.