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Those of you who are either poker players or have watched those that play will understand the importance of having a poker face in some circumstances. Although poker typically results in a zero-sum game, the strategy and tactics in achieving an optimal outcome are quite similar to contract negotiations. Coming into the “game” prepared with a strategic approach and the ability to be observant, and having the aptitude to maintain a high level of emotional intelligence are fundamental to success. This is the third and final article on this special series titled “The Art of Negotiation.” In the first article, we looked at big picture concepts related to the negotiation of contracts in medicine (ACS Surgery News, October 2015, p. 13), and subsequently we delved the task of gathering information (November 2015, p. 9). We will end this series by looking at how we can put everything together in order to best position ourselves in reaching a win-win solution.
Understanding your emotional approach
One of the first things discussed early on within this series of articles is the fact that contract negotiations in medicine are far from a simple transactional deal. The relationship building in the negotiation context extends far beyond this one deal. For those new to the job market, the right job can be the culmination of dreams and ambitions years in the making. Job negotiations should not be taken lightly nor sabotaged by out-of-control emotions. You may experience a variety of emotions during a negotiation such as anxiety, anger, sadness, and excitement.
These feelings can directly affect the process, and therefore understanding how to internally deal with them can make for a smoother and potentially more beneficial end result.
Anxiety management
Anxiety is a feeling often experienced during the early stages of the negotiation process. One response to anxiety is avoidance – cut negotiations short and make a quick agreement. But avoidance can undermine some of the basic tenants of negotiation where the ability to be patient and persevere is critical. Anxious negotiators can end up making weaker offers, spending less time negotiating, and getting a less-than-optimal agreement. The ability to minimize feelings of anxiety is related to preparation and practice.
Have you ever walked into an exam feeling unprepared and wishing you had studied more or done a few more review questions? There is a clear difference in how you approach an exam you are unprepared for versus one for which you have mastered the material.
Do your homework and your anxiety will be less.
Imagine the following scenario. A colleague of mine was back for a second interview at a medical center that overall had what she was looking for, and therefore she had begun the negotiation process with the committee including the chief of the service. They began by telling her how wonderful their offer was, and even mentioned that a few other candidates were interested in taking this position if she hesitated. This technique to exert pressure on candidates is not uncommon, yet it made her anxious. As the conversation went on, her anxiety continue to build.
She was able to excuse herself for a moment and she texted me from her sanctuary, which at that time happened to be a restroom stall. “Joe, what if I don’t agree to the terms? Am I going to lose this potentially great opportunity? I should just sign the contract?” she said. I was able to remind her of a few things. First, I told her, you are at the table for a reason, which primarily has to do with the fact that you may provide value to the organization. Second, I asked her if she knew what were they looking for. It is critical to understand what the institution considers important since it will allow you to leverage your skill set. If the answer is not clear, then ask questions to help illustrate what they value to help advance their objectives.
Once you have determined what they value most, you can negotiate with greater confidence.
Finally, you should never sign a contract without taking time to really review it. If a potential employer is not willing to give you that time then it should be a red flag that something is not right!
Anger management
Anger is another emotion that, unlike anxiety, can result in an increase in intensity of the negotiation. While certain aspects of this might seem appealing and even at times beneficial, in general, anger impairs the overall process, results in a higher likelihood of an impasse, and potentially damages the long-term relationship. In fact, even if a deal is ultimately agreed upon, trust among the parties is reduced, making for a potentially difficult working relationship in the future. It is wise to make every effort to minimize aggression during the discussion and ensure the other team understands your goal of reaching a win-win solution. Remember that even in the best circumstances, these complex negotiations usually result in a combination of elements gained and lost. The most skilled negotiators will leave the table confident that they achieved a great deal, while making sure that the other party also feels good about the agreement.
The value of MESOs
The term Multiple Equivalent Simultaneous Offers (MESO) negotiation is a strategy that is used when multiple interests are involved. MESO fits perfectly with the type of compensation packages physicians aiming to negotiate where base salary is not the only aspect under discussion. The idea is to make multiple offers that, in your mind, are essentially equivalent.
The three steps required are as follows:
1. Identify and prioritize important issues, and assign them a relative weight
2. Identify different likely outcomes for each issue
3. Develop three or more equivalent offers
This strategy gives you the opportunity to gather information about the other side in order to better understand where their priorities lie, and provides you the opportunity to be assertive at the negotiating table but also flexible and cooperative. MESO does require an investment of time in putting together these plans, and will ultimately require you to reveal some of your own interests. At the end of the day, people feel good about being given multiple choices rather than a single option. This typically results in greater value, and will often enhance the probability of reaching an agreement.
Parting thoughts
The process of negotiating a contract can be unsettling. This series has aimed to provide you with some of the basic principles that might help facilitate these discussions that at some point in time you will inevitably be required to have.
The following are 10 summary points that you might find helpful:
1. Preparation is the key. (Do your research, talk to people.)
2. Maintain a high level of emotional intelligence.
3. Listen and be observant during discussions.
4. Be creative in your approach. (Remember, its not all about the base salary!)
5. Maintain discipline when responding to questions (especially when unsure).
6. The only way to guarantee an agreement is to get it in writing.
7. The goal is to reach a win-win solution.
8. Maintain honesty and integrity throughout the process.
9. Understand that you are building long-term relationships.
10. Gut instinct is not a strategy.
Napoleon Hill said, “The starting point of all achievement is desire.” Whatever that desire may be, remember to think of all the variables critical to turning that desire into achievement. My hope is that some of the techniques I have described will be useful as you prepare to take that next step into the surgical workforce.
Feel free to tweet me for questions, comments, or ideas @Josephsakran.
Dr. Sakran is an ACS Fellow, and assistant professor of surgery and Director of Global Health & Disaster Preparedness for the department of surgery at the Medical University of South Carolina. He is the immediate past chair of the ACS Resident and Associate Society and recently finished a year at the Harvard Kennedy School of Government studying public policy, economics, and leadership development. He has no relevant disclosures.
Those of you who are either poker players or have watched those that play will understand the importance of having a poker face in some circumstances. Although poker typically results in a zero-sum game, the strategy and tactics in achieving an optimal outcome are quite similar to contract negotiations. Coming into the “game” prepared with a strategic approach and the ability to be observant, and having the aptitude to maintain a high level of emotional intelligence are fundamental to success. This is the third and final article on this special series titled “The Art of Negotiation.” In the first article, we looked at big picture concepts related to the negotiation of contracts in medicine (ACS Surgery News, October 2015, p. 13), and subsequently we delved the task of gathering information (November 2015, p. 9). We will end this series by looking at how we can put everything together in order to best position ourselves in reaching a win-win solution.
Understanding your emotional approach
One of the first things discussed early on within this series of articles is the fact that contract negotiations in medicine are far from a simple transactional deal. The relationship building in the negotiation context extends far beyond this one deal. For those new to the job market, the right job can be the culmination of dreams and ambitions years in the making. Job negotiations should not be taken lightly nor sabotaged by out-of-control emotions. You may experience a variety of emotions during a negotiation such as anxiety, anger, sadness, and excitement.
These feelings can directly affect the process, and therefore understanding how to internally deal with them can make for a smoother and potentially more beneficial end result.
Anxiety management
Anxiety is a feeling often experienced during the early stages of the negotiation process. One response to anxiety is avoidance – cut negotiations short and make a quick agreement. But avoidance can undermine some of the basic tenants of negotiation where the ability to be patient and persevere is critical. Anxious negotiators can end up making weaker offers, spending less time negotiating, and getting a less-than-optimal agreement. The ability to minimize feelings of anxiety is related to preparation and practice.
Have you ever walked into an exam feeling unprepared and wishing you had studied more or done a few more review questions? There is a clear difference in how you approach an exam you are unprepared for versus one for which you have mastered the material.
Do your homework and your anxiety will be less.
Imagine the following scenario. A colleague of mine was back for a second interview at a medical center that overall had what she was looking for, and therefore she had begun the negotiation process with the committee including the chief of the service. They began by telling her how wonderful their offer was, and even mentioned that a few other candidates were interested in taking this position if she hesitated. This technique to exert pressure on candidates is not uncommon, yet it made her anxious. As the conversation went on, her anxiety continue to build.
She was able to excuse herself for a moment and she texted me from her sanctuary, which at that time happened to be a restroom stall. “Joe, what if I don’t agree to the terms? Am I going to lose this potentially great opportunity? I should just sign the contract?” she said. I was able to remind her of a few things. First, I told her, you are at the table for a reason, which primarily has to do with the fact that you may provide value to the organization. Second, I asked her if she knew what were they looking for. It is critical to understand what the institution considers important since it will allow you to leverage your skill set. If the answer is not clear, then ask questions to help illustrate what they value to help advance their objectives.
Once you have determined what they value most, you can negotiate with greater confidence.
Finally, you should never sign a contract without taking time to really review it. If a potential employer is not willing to give you that time then it should be a red flag that something is not right!
Anger management
Anger is another emotion that, unlike anxiety, can result in an increase in intensity of the negotiation. While certain aspects of this might seem appealing and even at times beneficial, in general, anger impairs the overall process, results in a higher likelihood of an impasse, and potentially damages the long-term relationship. In fact, even if a deal is ultimately agreed upon, trust among the parties is reduced, making for a potentially difficult working relationship in the future. It is wise to make every effort to minimize aggression during the discussion and ensure the other team understands your goal of reaching a win-win solution. Remember that even in the best circumstances, these complex negotiations usually result in a combination of elements gained and lost. The most skilled negotiators will leave the table confident that they achieved a great deal, while making sure that the other party also feels good about the agreement.
The value of MESOs
The term Multiple Equivalent Simultaneous Offers (MESO) negotiation is a strategy that is used when multiple interests are involved. MESO fits perfectly with the type of compensation packages physicians aiming to negotiate where base salary is not the only aspect under discussion. The idea is to make multiple offers that, in your mind, are essentially equivalent.
The three steps required are as follows:
1. Identify and prioritize important issues, and assign them a relative weight
2. Identify different likely outcomes for each issue
3. Develop three or more equivalent offers
This strategy gives you the opportunity to gather information about the other side in order to better understand where their priorities lie, and provides you the opportunity to be assertive at the negotiating table but also flexible and cooperative. MESO does require an investment of time in putting together these plans, and will ultimately require you to reveal some of your own interests. At the end of the day, people feel good about being given multiple choices rather than a single option. This typically results in greater value, and will often enhance the probability of reaching an agreement.
Parting thoughts
The process of negotiating a contract can be unsettling. This series has aimed to provide you with some of the basic principles that might help facilitate these discussions that at some point in time you will inevitably be required to have.
The following are 10 summary points that you might find helpful:
1. Preparation is the key. (Do your research, talk to people.)
2. Maintain a high level of emotional intelligence.
3. Listen and be observant during discussions.
4. Be creative in your approach. (Remember, its not all about the base salary!)
5. Maintain discipline when responding to questions (especially when unsure).
6. The only way to guarantee an agreement is to get it in writing.
7. The goal is to reach a win-win solution.
8. Maintain honesty and integrity throughout the process.
9. Understand that you are building long-term relationships.
10. Gut instinct is not a strategy.
Napoleon Hill said, “The starting point of all achievement is desire.” Whatever that desire may be, remember to think of all the variables critical to turning that desire into achievement. My hope is that some of the techniques I have described will be useful as you prepare to take that next step into the surgical workforce.
Feel free to tweet me for questions, comments, or ideas @Josephsakran.
Dr. Sakran is an ACS Fellow, and assistant professor of surgery and Director of Global Health & Disaster Preparedness for the department of surgery at the Medical University of South Carolina. He is the immediate past chair of the ACS Resident and Associate Society and recently finished a year at the Harvard Kennedy School of Government studying public policy, economics, and leadership development. He has no relevant disclosures.
Those of you who are either poker players or have watched those that play will understand the importance of having a poker face in some circumstances. Although poker typically results in a zero-sum game, the strategy and tactics in achieving an optimal outcome are quite similar to contract negotiations. Coming into the “game” prepared with a strategic approach and the ability to be observant, and having the aptitude to maintain a high level of emotional intelligence are fundamental to success. This is the third and final article on this special series titled “The Art of Negotiation.” In the first article, we looked at big picture concepts related to the negotiation of contracts in medicine (ACS Surgery News, October 2015, p. 13), and subsequently we delved the task of gathering information (November 2015, p. 9). We will end this series by looking at how we can put everything together in order to best position ourselves in reaching a win-win solution.
Understanding your emotional approach
One of the first things discussed early on within this series of articles is the fact that contract negotiations in medicine are far from a simple transactional deal. The relationship building in the negotiation context extends far beyond this one deal. For those new to the job market, the right job can be the culmination of dreams and ambitions years in the making. Job negotiations should not be taken lightly nor sabotaged by out-of-control emotions. You may experience a variety of emotions during a negotiation such as anxiety, anger, sadness, and excitement.
These feelings can directly affect the process, and therefore understanding how to internally deal with them can make for a smoother and potentially more beneficial end result.
Anxiety management
Anxiety is a feeling often experienced during the early stages of the negotiation process. One response to anxiety is avoidance – cut negotiations short and make a quick agreement. But avoidance can undermine some of the basic tenants of negotiation where the ability to be patient and persevere is critical. Anxious negotiators can end up making weaker offers, spending less time negotiating, and getting a less-than-optimal agreement. The ability to minimize feelings of anxiety is related to preparation and practice.
Have you ever walked into an exam feeling unprepared and wishing you had studied more or done a few more review questions? There is a clear difference in how you approach an exam you are unprepared for versus one for which you have mastered the material.
Do your homework and your anxiety will be less.
Imagine the following scenario. A colleague of mine was back for a second interview at a medical center that overall had what she was looking for, and therefore she had begun the negotiation process with the committee including the chief of the service. They began by telling her how wonderful their offer was, and even mentioned that a few other candidates were interested in taking this position if she hesitated. This technique to exert pressure on candidates is not uncommon, yet it made her anxious. As the conversation went on, her anxiety continue to build.
She was able to excuse herself for a moment and she texted me from her sanctuary, which at that time happened to be a restroom stall. “Joe, what if I don’t agree to the terms? Am I going to lose this potentially great opportunity? I should just sign the contract?” she said. I was able to remind her of a few things. First, I told her, you are at the table for a reason, which primarily has to do with the fact that you may provide value to the organization. Second, I asked her if she knew what were they looking for. It is critical to understand what the institution considers important since it will allow you to leverage your skill set. If the answer is not clear, then ask questions to help illustrate what they value to help advance their objectives.
Once you have determined what they value most, you can negotiate with greater confidence.
Finally, you should never sign a contract without taking time to really review it. If a potential employer is not willing to give you that time then it should be a red flag that something is not right!
Anger management
Anger is another emotion that, unlike anxiety, can result in an increase in intensity of the negotiation. While certain aspects of this might seem appealing and even at times beneficial, in general, anger impairs the overall process, results in a higher likelihood of an impasse, and potentially damages the long-term relationship. In fact, even if a deal is ultimately agreed upon, trust among the parties is reduced, making for a potentially difficult working relationship in the future. It is wise to make every effort to minimize aggression during the discussion and ensure the other team understands your goal of reaching a win-win solution. Remember that even in the best circumstances, these complex negotiations usually result in a combination of elements gained and lost. The most skilled negotiators will leave the table confident that they achieved a great deal, while making sure that the other party also feels good about the agreement.
The value of MESOs
The term Multiple Equivalent Simultaneous Offers (MESO) negotiation is a strategy that is used when multiple interests are involved. MESO fits perfectly with the type of compensation packages physicians aiming to negotiate where base salary is not the only aspect under discussion. The idea is to make multiple offers that, in your mind, are essentially equivalent.
The three steps required are as follows:
1. Identify and prioritize important issues, and assign them a relative weight
2. Identify different likely outcomes for each issue
3. Develop three or more equivalent offers
This strategy gives you the opportunity to gather information about the other side in order to better understand where their priorities lie, and provides you the opportunity to be assertive at the negotiating table but also flexible and cooperative. MESO does require an investment of time in putting together these plans, and will ultimately require you to reveal some of your own interests. At the end of the day, people feel good about being given multiple choices rather than a single option. This typically results in greater value, and will often enhance the probability of reaching an agreement.
Parting thoughts
The process of negotiating a contract can be unsettling. This series has aimed to provide you with some of the basic principles that might help facilitate these discussions that at some point in time you will inevitably be required to have.
The following are 10 summary points that you might find helpful:
1. Preparation is the key. (Do your research, talk to people.)
2. Maintain a high level of emotional intelligence.
3. Listen and be observant during discussions.
4. Be creative in your approach. (Remember, its not all about the base salary!)
5. Maintain discipline when responding to questions (especially when unsure).
6. The only way to guarantee an agreement is to get it in writing.
7. The goal is to reach a win-win solution.
8. Maintain honesty and integrity throughout the process.
9. Understand that you are building long-term relationships.
10. Gut instinct is not a strategy.
Napoleon Hill said, “The starting point of all achievement is desire.” Whatever that desire may be, remember to think of all the variables critical to turning that desire into achievement. My hope is that some of the techniques I have described will be useful as you prepare to take that next step into the surgical workforce.
Feel free to tweet me for questions, comments, or ideas @Josephsakran.
Dr. Sakran is an ACS Fellow, and assistant professor of surgery and Director of Global Health & Disaster Preparedness for the department of surgery at the Medical University of South Carolina. He is the immediate past chair of the ACS Resident and Associate Society and recently finished a year at the Harvard Kennedy School of Government studying public policy, economics, and leadership development. He has no relevant disclosures.
