Before the deal is officially sealed on an employment offer, clinicians must overcome the hurdle of the employment negotiations. Being prepared to ask the right questions can ensure a successful negotiation.

Compensation is always at the forefront of issues discussed during contract negotiations, according to Rachel H. Yaffe, an attorney at McDonald Hopkins, a Chicago law firm with health care clients. But restrictive covenant or non-competition agreements are also a hot topic.

Restrictive covenants, also referred to as non-compete agreements, can prevent a clinician from practicing the same specialty or even within the same field, within a certain distance of a former employer for a specified amount of time after leaving an employer’s business.

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Besides discussing compensation and other apparent issues, clinicians should review how the employment agreement offered is structured and whether it is malleable enough to allow for changes in relevant state or federal laws. “New state and federal laws can change how the healthcare community operates in the blink of an eye. Employment agreements need to be drafted with some flexibility to allow for the impact of changing laws,” Yaffe said.

She recommended that clinicians educate themselves about the job market and take into account whether demand for their particular specialty is high or low, and then tailor the tone of their negotiations based on the bargaining leverage they hold.  Bargaining power resides with the employer when demand is low or supply is high, Yaffe explained.

 Ultimately contract negotiations are a “balancing act” between the provider and employer.  “If you negotiate too heavily, you could lose the job opportunity,” she said. “However, if you don’t negotiate enough, you could end up with a contract with less than attractive terms and conditions.”

Clinicians must always realize that the person they are negotiating with is also seeking a favourable ending. “There will always be a push-pull dynamic existing between a clinician and a practice in contract negotiations. The biggest challenge is marrying the goals and objectives at both sides of the table,” Yaffe said.

Jennifer Leeper is a freelance medical writer living in Kansas City, Mo.