• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Avoid Negotiating Landmines


With years of study and endless hours of residency now behind him, it's time for our young physician to boldly face his next challenge, interviewing for his first position and negotiating his terms for compensation. Will he succeed?

After 10 grueling years of training to become a physician, you can finally see the light at the end of the tunnel. You may be receiving countless emails that advertise amazing starting salaries, sign on bonuses, and/or loan repayments that almost seem too good to be true. Dozens of calls are coming in on a weekly basis from recruiters who want to help you find your dream job and the prospect of quadrupling your income has certainly caught your attention.

Enjoy this time, you deserve it! But, it is equally important to proceed with caution. You do not want to get caught up in all the excitement with blinders on. Those blinders could have you wandering into a field filled with negotiation landmines as you attempt to secure your first opportunity out of residency.

You are well prepared for your medical career, but are you equally prepared for all that comes with negotiating your first contract? Do you know how to negotiate a contract? Have you considered the possibility that you could ruin your chances of landing that perfect job in the contract negotiations process? Many have learned that lesson the hard way, but you don’t have to!

View the video below to determine whether this physician will be able to successfully navigate his way through the negotiation minefields or if he will fall prey to illusions of grandeur and misinformation. What did he do right? Where did he go wrong?

Below is your complimentary copy of a tool that will equip you with techniques and strategies for negotiating a compensation package. Learn how to build and maintain a healthy relationship with your potential employer without leaving anything on the table.


Compensation is certainly one factor you must consider when determining which opportunity is best for you, but is not the only consideration, and for some this may not be the most important. Your colleague may accept an opportunity with a significantly higher starting salary, but you may determine that you would not thrive in the same type of community or practice. Ultimately, you must consider the factors that are most important to you, and make the best decision for you.

In my career, I’ve negotiated some $500 million dollars of physician compensation packages and I understand the importance physicians place on starting salaries. But you cannot overlook how you will maintain or increase your income once your guaranteed salary expires. Many physicians receive a two-year guaranteed salary and after those two years expire, their income is based on their productivity.

I’ve seen too many physicians purchase homes and cars; then create a lifestyle based on their initial guaranteed salary. Those who are unable to sustain that level of income can feel under-valued and may seek to find the next guaranteed salary. Some physicians work for six or seven different employers over 10 to 12 years. Suffice it to say, you do not want to find yourself in that situation.

To avoid this pattern, I recommend placing as much focus on the big picture in your negotiations as you do your initial salary. You have to consider what it will take to maintain or increase your income over time. Here are a few questions that will point you in the right direction:

• Can you walk me through the compensation structure?

• Is there a productivity formula? If so, how does it work?

• If I perform well, what is the income potential for Year 1? Year 2? Year 3?

• Do you anticipate acquiring any new systems that will impact and improve patient care?

• Describe the process and formula you use in transitioning from a guaranteed salary to productivity compensation.

• How have other physicians adapted to the change after two years?

• How many patients will I need to see to earn $XXX,XXX per:

• Year?

• Month?

• Week?

• Day?

• What is the current waiting period for a new patient to see a physician?

• How busy will I be from day one?

• Is the hospital going to help market my practice? If so, can you walk me through what the marketing plan looks like?

• What are my responsibilities to build a successful practice here and are there any bonuses if I exceed my milestones?

For more complimentary career and life planning resources, visit

About the Author

Todd Skertich is the founder of Adventures in Medicine (AIM), an innovative media company whose online platform is dedicated to delivering the highest quality career and life planning content and resources for residents and physicians.

Related Videos
Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice