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Negotiate Like THE Boss

Dr. Christina Arnold joins us on the blog today to discuss physician negotiation. This can be a very difficult skill, making conversations surrounding it difficult to navigate. Today, in this article, Dr. Arnold shares tips on how to "think like the boss" and negotiate for your worth.

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Negotiations are not just for the job interview and annual review. We negotiate every day. Negotiating in place can be a powerful mechanism to make your current job a better fit. The key to effective negotiations is to think like the boss. What are her concerns, goals, and interests? How can you align your goals with those of the boss and institution so that everyone wins?

At every point where you are asked to take on additional responsibilities or tasks, consider making an ask that will help you (and your institution) succeed. If your boss cannot adjust your salary, remember that salary is not the only adjustable factor. Negotiating for a title, off-service time, additional research funds, leadership position, or an accelerated promotion track could be at least as valuable as salary adjustments, for example. When millions of dollars and opportunities are on the table, leverage these top strategies to help design your ideal life through effective negotiations.

1. ALWAYS ask.

Of course, you will make some asks. The boss just might say “yes.” If you don’t ask, the answer is “no.” Some considerations may be non-negotiable, but you won’t know until you ask. So ask.

2. Direct your ask to the person who makes the decisions.

Many centers send the letter of offer from the secretary with a curt, " please sign and return.” This is a basic negotiating technique so that you feel uncomfortable making asks, but you are not a basic applicant. Determine who the person who makes the decisions is, and direct your asks to her. Ideally, direct your questions in a face-to-face format, such as video conferencing, so you can gauge the room and most effectively deliver your ask.

3. Know your value.

You have decades of life experience. You are a decorated, highly-trained physician in a pandemic. Write a list of all of your amazing accomplishments to remind yourself of your value. Know what sets you apart from other candidates.

4. Ask until you hear a ‘no.’

5. When you hear the ‘no’, don’t make it mean anything bad.

Your job is to advocate for yourself. No one else will do this essential job as well as you. If I don’t hear a “no” during a negotiation, I didn’t advocate hard enough for myself. When I hear the “no,” I feel great because I pushed until I found a boundary. I got every dollar on the table. I sometimes make an impossible ask just so I can get that “no” and help pressure the boss to say “yes” to an even more valuable negotiating item.

6. Make it easy for them to say “yes.”

Instead of asking, “can you raise the salary?” couch the ask with a reminder of why they want you: “based on my 10-year subspecialty experience, I would like to discuss a salary that reflects my additional skills, network, and training.”

7. Ask and then bite your tongue.

A common negotiating mistake is for an applicant to make an ask and then look away, withdraw the ask, or not give the other party time to respond. It is too easy to say “no” to an applicant who doesn’t appear to think she deserves the ask. The silence is uncomfortable only if you make the silence mean something uncomfortable. Ask with confidence, strong eye contact, and then create space, so the boss has time to respond. If you need to distract your brain, count in your head, remind yourself that you are worth it, and think of all the opportunities ahead if you can be strong in this brief negotiation session.

8. If you can, let them pick the first salary number.

Their number might be higher than your ideal number, so you want them to provide the first number. In general, the person who offers the first number has a weaker negotiating position. If you have to share your number first, pick a higher number than your ideal number so that you have built-in space to negotiate down and still land at or above your ideal number.

9. Don’t get distracted by shiny objects.

Some centers offer a one-time signing bonus to incentivize you to accept a lower base salary. Since future raises often tie back to the base salary, pushing for the highest base salary (and not becoming distracted by a shiny signing bonus) may make the most financial benefit over the long-term.

10. Some centers have fixed salaries.

If your future boss cannot negotiate on the salary, don’t forget that there are loads of additional negotiating items to consider still: book fund, research funds, administrative support, office space, annual bonus, signing bonus, academic time, upgraded equipment, clinical load requirements, moving expenses, leadership titles, accelerated promotion tracks, and additional training, among others.

11. Of all the potential negotiating items, prioritize your top three.

Negotiations are a delicate balance between advocating for yourself while maintaining a positive relationship with your future boss.

12. If you have trouble advocating for yourself, pretend you are negotiating on behalf of your daughter.

You sort of are negotiating for her because if you set yourself up for success, your family will undoubtedly benefit.

13. When you feel unsure of yourself, have an out of body experience.

Pretend you are the future version of yourself who is 15 years older, full professor, and full of confidence and wisdom. Invite her to run the negotiations. Pretend to be her. Get out of your head and focus on what you need to succeed. If your goals are aligned with your institutions, it is in everyone’s interest for you to succeed.

14. Yes, it is uncomfortable.

And you can do hard things. This 90 seconds will be worth millions of dollars over your career. You can feel uncomfortable for 90 seconds for millions of dollars.

15. Plan a gap

Once you start a new job, you often have to wait a few months before you can take time off. Secure time to mentally and physically transition by pushing out your start date to allow for a gap. Make sure to carefully look at your finances and insurance to determine how much of a gap you can afford.

Dr. Christina A. Arnold is a pathologist and professional coach. She can be reached at and

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