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Getting what you want

Personal Best

Annoyance. Frustration. Self-doubt. Perhaps you felt all of those when you couldn't get your partners to revise their call schedule; you hit a stone wall in your negotiations with the managed care company; the Toyota salesman rejected your offer; or you and your spouse battled over how much to spend on your home remodeling.

Negotiating is part of daily life, whether you're dealing with patients, insurers, colleagues, or family members. But negotiation is a dance, and if you don't know the steps-or even know that there are steps-you'll trip over your own feet. When you're toe-to-toe with a mortgage broker, salesman, or employer, he or she has likely been through this process many times, and probably has had sales training. They know the dance and how to do it

But that doesn't mean you can't come to agreements that satisfy you. These skills and tactics can help you bargain more successfully:

So accept the fact that you may indeed feel awkward or distressed for the short period of time that you're negotiating. Remind yourself that the chance to get a superior outcome is well worth some brief anxiety. "Temporary inconvenience, permanent improvement" is a slogan worth remembering.

Figure out what you're prepared to give up and be ready to compromise. In order to get, you often have to give. But don't compromise so much that you're fuming inside. What you realistically want to shoot for is to get enough of what you want, not everything you want.

Before entering negotiations, figure out what would be your plan B-if you had to walk away from the deal. Roger Fisher, of the Harvard Negotiation Project, uses the acronym BATNA-your Best Alternative To a Negotiated Agreement. If you can't negotiate something better than your BATNA, walk away.

Be creative about solutions. Once you know what the person you're dealing with truly wants, be open and creative in what you might offer. For instance, if you see your family during Christmas, pick another holiday to get together with your spouse's side. Think of several different options that might solve the problem in different ways. If a prospective employer doesn't seem willing to budge on salary, perhaps you can bring something else to the table, such as your ability to be visible in the community and negotiate a bonus for the extra patients you bring in to the practice.

Speak up. State outright what you want; don't hint and don't expect the other person to divine your desires. Wishing, hoping, and praying won't convey the message as directly as saying, "I'd like you and the kids to help me clean the garage." Better to say what you mean than internally stewing, "Can't they see the garage needs cleaning?"

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Jay W. Lee, MD, MPH, FAAFP headshot | © American Association of Family Practitioners