Contracts, and
Negotiations
Daniel Goodrich, MPAS, PA-C
Assistant Medical Director
Lutheran Hospital Emergency Department
Cleveland, Ohio
Team Health
Negotiating
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Research shows that most people
are not very good negotiators for a
variety of reasons
 Lack
of time
 Dislike of the negotiation process
 Lack of skill
 Lack of preparation
Preparation
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Any meaningful preparation that you
perform prior to negotiation will afford
you with a tremendous advantage
It will boost your confidence to negotiate
successfully
Preparation is the key to interview
success
Preparation
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Research the Practice
Know the job description
Look The Part

How you look during the interview
depends on more than what you’re
wearing
 How
you smell
 Confidence
 Enthusiasm
 First three minutes are crucial
Lights, Camera, Action
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Your tone of voice, body language and
poise all play a role
When greeting the interviewer , think of
him/her as a friend , not an antagonist
Even if you are nervous don’t call
attention to it by apologizing
Concentrate on your message not your
own anxieties
Be Cool
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You want to come off as calm, cool and
collected
Fine line between confidence and arrogance
Stay with basics
 Don’t exaggerate
 Be honest
 No name dropping
 Careful not to talk too much about you
yourself
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Negotiation Techniques
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1. Analyze the other party
2. Establish your objectives
3. Plan your negotiating strategy
4. Negotiate, evaluate and close
5. Put yourself in their shoes
Know Your Bottom Line
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Salary
Type of work
Hours
Lifestyle
Know The Facts
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Determine who has the authority to
make decisions
Don’t waste your time with the
middle man
Start high - always make a counter
offer
Use Effective
Techniques
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Never take the negotiation
personally, negotiate with skill and
not anger or frustration
Listen during negotiations and never
interrupt
Remain silent if that is the best
response
Silence Is Golden
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In negotiation, it often quite literally
pays to be silent. Silence is a very
effective tactic for obtaining
concessions from the other side
Usually, the first person to speak after
an extended period of silence is the
one who makes the next concession
Techniques
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Confirm negotiated points in writing
Ask questions
Refer often to the need to work out
the best arrangement for “both
parties”
Know what you are willing to give
and what you gain from a
compromise
Techniques
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Feel free to describe the
unreasonableness of your
opponents position
Keep track of number, nature and
extent of your concessions and that
of your opponent
Your Objectives
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Identify your goals
Understand the market
Know your self worth
Make yourself marketable
To negotiate a contract competently
 Salary
 Benefits
 Type
of work
 Hours
Productivity and Cost
Effectiveness

Long been described and measured
 Time
per visit
 Office visits and procedures
 Charges generated
 Overhead reduction
Quality of Care
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Indicators of quality of care have been
measured by comparing processes and
outcomes between physicians and pa’s with
regard to functions performed by both
Pa’s have been shown to provide care
indistinguishable in quality from care
provided by physicians
Indirect indicators have shown favorable
physician and patient satisfaction
Market

No better time than now
 Managed
care
 Resident hours
 St.
Vincent’s hospital of N.Y
 Broad
base of specialties
 Here to stay
Hospital Budget Review
“We’ve made all the cuts we can spare. Now, if each of
our doctors can average one patient every three minutes,
well break even.”
Goals
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More training/better job
Specialty
Feed the kids
Humanity
Get married
Money
Ultimate Goals
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Teaching
Autonomy
Head of department
Administration
Marriage
Retire
Remember
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You are A professional
Respect yourself and your profession
Have conviction and show confidence
Know your capabilities and what you
bring to the practice
Know Your Profession
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Reimbursement
Salaries
Laws
Responsibilities
Your Liability
Demographics
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Primary Care
ED
Surgery
Specialties
36%
10%
16%
38%
Salary Expectations
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How low will you go
Benefits
Start low - medium - high
Know the market
Know the specialty
Salary
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Average for a minimum of 32 hours
Mean $93,486 – 104,000
Mean For New Graduates
$82,232 Survey 2010
High $92,500 Low $62,500
 80% PA’S on salary
 20% hourly
Salary
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Primary Care
$85,461
ED
$102,018
General Surgery
$92,429
Surgery Specialties $99,968
Pediatrics
$87,674
The Market
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Doctors salary
Nurses salary
Economy of the area
Housing
Your lifestyle
Benefits
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Vacation: 3-4 weeks
Health care
Life insurance
Disability
Retirement: 10-15% of salary
Bonuses: 2-10% of salary
Malpractice
CME: $500.00 to $2,500.00 and beyond
Benefits
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Car phone
Car
Beeper
National and local dues
Education
Remember benefits are not
taxed
Salary
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Remember to compare hours and
call time with pay
Remember
60 hours a week is 10 hours a day 6
days/week
 12 hours a day 5days/week

Salary
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New grad - how do I get my foot in
the door?
Start low
Rapid increase
Make a contract
Prove yourself
Resume
Summary
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Pa’s have been around for over three
decades
We have a proven track record
Remember who you are
Know the market place and hopefully the
hospital or physician(s) you work for will be as
informed and will reward you not only in
revenue but in professional satisfaction