In a traditional job search, most people get excited when handed the employment offer and just sign it.  However, when considering accepting a job as a physician you may want to take a little longer with this process since you are making a decision that will impact not only yourself but your family and an entire community as well.   

Research

You are used to research.  Research the hospital or group that you are considering joining as if you were writing a publication or abstract.  How many physicians do they have and how long has each physician been there?  What is the turnover rate?  How large is the overall organization?  You may also ask to speak with the physicians that already work for the organization and see what their experience has been.   Answers to these questions will help you decide what questions to ask and how much negotiating room you have.  Read through your offer in a quiet place and then take some time to think about it before responding.  Come back to it a couple times and write down questions as you go.  Once you have gathered your thoughts, set up a time to discuss the offer with the hiring organization and politely ask your contact to explain each clause or provision that you do not understand.  You are dealing with a legal document and it is nothing but intelligent to ask questions.  

Legal Counsil

The organization should be very willing to accomodate you during this time so that you can make an educated decision without having to turn to legal counsil.  Legal counsil can be very costly and very time consuming when time is of the essense.  Contracts are not left on the table to marinate – the longer you wait, the better the chance that another physician will come along and take the position you want.   However, if you do not feel confident and very clear about the offer in hand after going through your questions with the hiring organization, you may have no choice but to turn to a lawyer for help.  Do not sign a contract that you do not understand.  Many physicians have found themselves trapped or in a compromising situation because they did not take the time to understand their contract before signing it.  

Size Matters when Negotiating

The larger the organization, the less flexibility they have to make contractual changes.  A small group or small community hospital typically has more flexibility so you must do your research, consider the size of the organization, and then decide how much time to spend disecting your contract versus how much time to spend on the negotiating points such as financials, vacation, CME credits, and benefits.  The larger the organization, the more you risk wasting time and money by hiring a lawyer because their contracts do not change.  They must remain fair and consistent among all physicians in all locations.      

Negotiate, Negotiate, Negotiate

When an organization posts the financials for a job, what they are willing to pay is typically from the bottom of the scale to the middle.  The top rung is reserved for professionals with stellar qualifications that blow away the requirements.  If you meet the requirements and a little more, you can negotiate yourself into the middle salary position.  You will probably also be able to get a little more vacation time and anything else that is negotiable in your contract.  Though many hiring organizations leave room for negotiation, it doesn’t hurt to ask when recieving your contract (before you have read it).  The successful job hunt is all about the relationship you create along the way and you do not want to insult anyone by assuming they are willing to negotiate when they have already given you the best offer possible.