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Two Important Aspects of Negotiations for Physicians


Asking questions - especially the hard ones - benefits you as a physician and can do the same in negotiations.

We have aided clients as they negotiate agreements many times and have noticed two big errors everyone - including physicians - make in negotiations. No matter what brings you to the negotiation table, whether it is an employment agreement, the purchase of a practice, a provider agreement, or insurer contract, physicians can benefit by avoiding two common mistakes – showing neediness and making assumptions. Either one can sour any negotiation. They are deadly enemies that work to keep you from getting what you want. They work behind the scenes and act covertly against your desired outcomes. Fortunately, you can control both of these behaviors and guide your negotiations to success.

Neediness is a behavior we display when we are fearful. Needy behaviors send signals to the other side that we are afraid of something. We may or may not realize where the fear comes from, but the manner in which we speak, act, and think can provide the adversary with valuable information about us.

Neediness could be defined as the physical manifestation of fear. Talking too much and sharing important information are examples of needy behavior. Sometimes, neediness originates from a desire to be liked and accepted. Many people will agree to items that will hurt their team in an effort to be liked and viewed as "team players" by the other side. They accept less than perfect terms because they want to focus on the relationship and be liked. Little do they know those concessions will eventually hurt not only them, but the adversary as well.

One of the most important pieces of advice we would offer is to not let fear ruin your negotiation. Fear is a powerful emotion. It will hijack the entire decision-making process and cause you to give too much away. It is challenging to think clearly if you are afraid. Emotions will take control of your thought processes and yield unfavorable results. It is absolutely imperative that you know and understand your fears.

One of the most effective methods for controlling your emotions and fears is to use a solid system in negotiations. Always have a plan before you enter into any discussion, no matter how small or insignificant you might think it to be. By using a system, you are able to stay on task and remain focused on your objectives. Write everything down, and keep a log of your encounters. It will provide useful information and insight as you review your notes to prepare for the next engagement.

Another big mistake we see people make at the negotiation table is to make assumptions about what the other side wants, what the other side needs, and what they will agree to. It is impossible to know everything about everyone, what they are thinking, and how they will behave. To overcome this, we must not make assumptions during the negotiation. Assumptions can lead us down a dangerous path and toward less-than-optimal results from the negotiation process.

One of the reasons people make assumptions is that they believe themselves to be especially knowledgeable; that if they know a lot in one area, that knowledge somehow automatically transfers over to other areas in their lives. It's not their fault; it's the way our psyches are wired. But that natural wiring actually works to impair your negotiations. How many times have you made assumptions about a patient or staff member? What happened? You might walk into a room with a preconceived notion of what is going on and leave with a totally different diagnosis. That same thing can happen with negotiations.

How did we find the right diagnosis? We asked questions. We accepted the hypothesis that we may have incomplete knowledge and sought to fill in the gaps. The same thing happens at the negotiation table. How many times have you been surprised during a negotiation? You didn't expect the other side to make that offer or accept your proposal - i.e. you were caught off guard. Why? Because you tried to predict the future behavior and thoughts of another human being. If weathermen cannot get the weather right all the time with their mathematical models, how can we possibly think we can predict human behavior with greater accuracy? So, make it easy on yourself and refrain from guessing.

What's the best way to find out what the other party is thinking or what they want? Simple: Ask them questions. As physicians, we are taught to ask our patients hard questions. We usually have no issue asking about tough personal issues. We claim it's in their best interests. The same principle applies to negotiations. We should ask the hard questions. Set the tone for the hard questions by seeking permission to bring up the topic. Explain it is in the other side's best interest to ask this hard question so that we fully understand their point of view. You would be surprised how much information you can gather by asking the hard questions.

David J. Norris, MD, MBA, CPE is an anesthesiologist at Wichita Anesthesiology Chartered in Wichita, Kan.; the owner of the Center for Professional Business Development, which aids and educates physicians and other small business owners; and a member of the Physicians Practice Physician Advisory Board. E-mail him here.

Jim Camp is an expert negation coach and the author of the best selling book "Start With No". He is also the founder of the Camp Negotiation Institute and the creator of the software platform, Negotiator-Pro. During the last 27 years, Jim has coached CEOs of multi-national corporations on every continent.

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