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Negotiation. Society for Academic Emergency Medicine Definition of Negotiation u Compromise: concessions on the part of both parties u Confer and discuss.

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Presentation on theme: "Negotiation. Society for Academic Emergency Medicine Definition of Negotiation u Compromise: concessions on the part of both parties u Confer and discuss."— Presentation transcript:

1 Negotiation

2 Society for Academic Emergency Medicine Definition of Negotiation u Compromise: concessions on the part of both parties u Confer and discuss to reach an agreement

3 Society for Academic Emergency Medicine Why Physicians Dont Negotiate: Excuses u No time u Embarrassed u Not comfortable u Dont like conflict u Feel that asserting themselves during negotiations isnt professional u Physicians want to be liked

4 Society for Academic Emergency Medicine What type of things have you negotiated for in the past?

5 Society for Academic Emergency Medicine Typical Physician Negotiations during their Career u Salary u Home u Car u Legal/financial/accounting fees u Equipment Purchases u Consumer goods Purpose: Empower you to save 5-10% when negotiating

6 Society for Academic Emergency Medicine Negotiation Case u While on vacation you go into a jewelry store and see an attractive looking watch. You ask the stores owner how much it costs and he replies $ How much would you offer to pay for this watch?

7 Society for Academic Emergency Medicine Two Types of Negotiations u Cooperative: Long term relationship u Competitive Negotiation: One time deal

8 Society for Academic Emergency Medicine Cooperative Negotiation u Search for a Win-Win solution *Find best deal for both parties *Find ways to make a bigger pie to divide *Invent options for mutual gain u Sensitive to the others needs: listen u Build trust: integrity u Stress looking for a long term relationship

9 Society for Academic Emergency Medicine Competitive Negotiation u Opponent wishes to: WIN * Discloses little information as possible *Shows little concern for you *Manipulates you *Uses variety of negotiating tactics to win

10 Society for Academic Emergency Medicine Principles of Negotiation u You negotiate all of the time u Willing to practice u Negotiation skills dont change as the negotiation gets bigger & more important u Avoid thinking you have the weaker position u Options give you power: BATNA u Worst thing you can do: let the other side know how much you care u Point of time decision at time it exists

11 Society for Academic Emergency Medicine Principles of Negotiation u Two way affair u Understand cultural differences of negotiation u Concentrate on the issues u Remove the personal from the issue u Dont be confrontational u Avoid positional negotiation u Allow the other side to save face

12 Society for Academic Emergency Medicine Principles of Negotiation u People believe in what they see in writing more than what they hear u Specific numbers have credibility u Follow the law of probabilities u Find person who can make the decision

13 Society for Academic Emergency Medicine Principles of Negotiation u Body language: watch CHANGES in body language u Dumb is smart: *If too smart: want to compete against you *If dumb: people want to help and educate you u Never change your offer *Except in response to specific counter proposal *Preferable in writing u Dont close deal until all of the issues are settled u Contract rules: *Read ENTIRE contract every time it is returned *Write the contract

14 Society for Academic Emergency Medicine Personal Power: Dont let it intimidate you u Legitimate: power of the title, position in he marketplace u Reward: power to reward you u Coercive: power to punish you u Reverent: consistent set of values u Charismatic: power of the personality u Expertise power u Information power: side with the most information usually does better u Situational power: if you have to make the concession anyway, do it immediately & nicely; maintain goodwill

15 Society for Academic Emergency Medicine Informational Power: Active Listening u Active Listening *Ability to hear u What is said u What is omitted u Equivocal statements u Verbal leaks *Prevent misunderstandings

16 Society for Academic Emergency Medicine Informational Power: Want your Opponent to Like You u Needs: *What are they looking for *Need to be successful u Interests: Find compatible interests to build on *Values *Family (children, pets, spouse) *Professional achievements *Hobbies *Athletic achievements *Travel

17 Society for Academic Emergency Medicine Informational Power u Ask tough questions: they may answer them u People are reluctant to admit they dont know u Most people like to talk about themselves u Appear ignorant of certain matters: people love to teach u Chance to judge their reaction u Ask away from the workplace u Search for commonality: people share information across: *Peer groups *Professions u Dont be elitist: obtain information from clerks, secretaries, janitors, patients, peers, former workers

18 Society for Academic Emergency Medicine Informational Power: Do your homework u Search the internet, public filings, company catalog, annual reports u Ask for informational packet from the other negotiation teams representative u Have facts, documents, figures available u Demonstrate that your proposal or terms are the industry standard or accepted practice u Power of precedents and policies

19 Society for Academic Emergency Medicine How to Deal with Difficult Questions u Defer u Defect u Delay u Decline u Rule the question out as improper u Ignore the question u Respond generally to a specific inquiry u Plead ignorance u Plead irrelevance u State the question is too personal u Answer with or answer a different question

20 Society for Academic Emergency Medicine Three Stages of Negotiation u Develop a relationship of trust * Dont offer anything you cannot follow through on *Let them air their options *Focus on mutual interests 1. What do they want? 2. Gather information 3. Win/Win negotiation

21 Society for Academic Emergency Medicine Beginning Moves u Never jump at the first offer u Ask for more than you expect to get u Flinch at the other sides proposal u Avoid confrontational negotiation

22 Society for Academic Emergency Medicine Beginning Move: Never Jump at the first offer u Want the other side to feel they won u Otherwise the other side wonders whats wrong u Dont form opinion how the other side will respond

23 Society for Academic Emergency Medicine Beginning Move: Ask for more than you expect : Bracket your objective u Probably will end up with less than you ask for u You may just get it u You dont know what the bottom line is u Raises perceived value of your service u Creates a climate where the other side can win u Prevents deadlocks when dealing with an egotistical person

24 Society for Academic Emergency Medicine Beginning Move: Asking more than you expect : Bracket your objective u How much more should be asked for than we expect to get? Assume that you will end up midway between your and their opening positions -Must get them to commit first to their very best position: bracket them so the midpoint is what you really want -If they get you to commit to your best position: they bracket you so the midpoint is what they want

25 Society for Academic Emergency Medicine Beginning Move: Flinch at their proposal u React visually = shock at their proposal u Often other side is watching for reaction u Visual reaction overrides auditory in most people Exercise: picture your medical school graduation

26 Society for Academic Emergency Medicine Beginning Move: Avoid Confrontational Negotiation u Arguing increases peoples wish to prove themselves right u Forcing them to defend their position u Use instead: feel/felt/found

27 Society for Academic Emergency Medicine Middle Negotiating Moves u Time Pressure u Remove their resort to higher authority u Decision at point of time u Patience is a virtue u Silence is golden u Information power

28 Society for Academic Emergency Medicine Middle Negotiating Moves u Never be pushed into making a decision *Vague higher authority u I have to check with the board or committee *I have to check to see if this creates conflicts of interest for me *I want to avoid even the appearance of impropriety *Offer to make decision but let them know it will be negative if you have to make it now

29 Society for Academic Emergency Medicine Middle Negotiating Moves u Remove their resort to higher authority *Appeal to their ego *Get their commitment that they will recommend it to a higher authority

30 Society for Academic Emergency Medicine Middle Negotiating Moves u Never offer to split the difference *Encourage other side to split difference u If you make a concession, get reciprocal concession immediately u Handling an impasse: set aside technique

31 Society for Academic Emergency Medicine Middle Negotiating Moves u Deadlock: neither side sees any point in talking to each other because its not going anywhere any more *To Resolve: Third party: must appear neutral u Arbitration: Winner, loser u Mediator: Facilitates solution: no power

32 Society for Academic Emergency Medicine Middle Negotiating Moves: Concessions u Everything you give up is a concession u Need to understand the value of any concession to your opponent u Try to get something of equal or better value in return for every concession you make u Try to get opponent to make first concession u Start with the largest concessions first and reduce the size u Story of concessions: make the opponent look like a hero to their organization

33 Society for Academic Emergency Medicine Middle Negotiating Moves u Trading Off: If we do this for you what can you do for us? *Reasons to do this: u May get something u Elevated the value of the concession u Stops grinding away process *

34 Society for Academic Emergency Medicine Ending Moves u Defense *Good guy/bad guy: u Try to equal size of negotiating team u Identify the tactic to the other side *Nibbling: make them feel cheap *Be prepared to walk away: Have options

35 Society for Academic Emergency Medicine How to Say NO Politely u I would love to but Im swamped u I am honored, but I am focusing on other areas u Sounds interesting, could you send me a written proposal u I am not an expert in this area, but I can refer you to Dr. X u Let me check my schedule & get back to you u Im sorry but I have a previous commitment

36 Society for Academic Emergency Medicine Negotiation Case u Divide into 2 groups u Take a yellow or blue sheet depending on your assigned role u Paper and pen required

37 Society for Academic Emergency Medicine Negotiating Case u Division Director *You are looking to hire a junior faculty member for a position in your Division. *You need to hire a physician to work as a clinician educator in your Division as your current faculty members feel clinically overworked. *You have plenty of senior faculty members in your Division that are in administrative and research positions. *Your facility is not located in an attractive area of the country but the area is family friendly and the cost of living is low. *You are competing for subspecialty physicians with two other institutions within a 50 mile radius. u Your institution has a better academic reputation than the other two institutions and there is low turnover of faculty as the institution is known to be physician friendly. u Your institution pays less than the other two institutions. * You are interviewing an excellent candidate who will complete fellowship training in 6 months. *The Chairman of your Department has permitted you to hire only one physician and you feel that your Division will still be understaffed. *The institution will not allow you to pay this new physician more than $150,000 per year. *All salaried physicians working for the institution receive 4 weeks of paid vacation time and are given $3,000 and one week off for CME per year.

38 Society for Academic Emergency Medicine Negotiation Case u Junior faculty candidate *You are completing your fellowship training in a few months and looking for a junior faculty position. *Your spouse plans on not working outside of the home to care for your infant son. *You have $150,000 in medical school debts. *You are an excellent candidate as you have published 2 clinical research articles and have an outstanding reputation as a clinician at your training institution. *You are interviewing at Institution X: u Your spouses entire family lives in the region and you have agreed to move there. u The institution has an excellent academic reputation and is known to be physician friendly. *There are two other hospitals in the region that are actively recruiting for physicians in your field. Both hospitals are non-academic institutions but pay a higher salary. One institution advertises a starting salary of $160,000 per year. The other two institutions are unable to provide you with any clinical research opportunities. *You would like a position that would give you 80% of protected research time as you enjoy research and wish to advance professionally in your field. *You cannot support your family or pay off your medical student debts if your salary is less than $130,000 per year.

39 Society for Academic Emergency Medicine Bibliography u The Successful Physician Negotiator: How to Get What You Deserve by Babitsky and Mangraviti, S.E.A.K, Inc. Legal and Medical Information System, Falmouth, MA, 2001 u ACPE: Negotiation Course by Roger Dawson

40 Society for Academic Emergency Medicine Author Credit – Negotiation: Maria Ramundo Questions

41 Society for Academic Emergency Medicine Postresidency Tools of the Trade CD 1) Career Planning – Garmel 2) Careers in Academic EM – Sokolove 3) Private Practice Career Options - Holliman 4) Fellowship/EM Organizations – Coates/Cheng 5) CV – Garmel 6) Interviewing – Garmel 7) Contracts for Emergency Physicians – Franks 8) Salary & Benefits – Hevia 9) Malpractice – Derse/Cheng 10) Clinical Teaching in the ED – Wald 11) Teaching Tips – Ankel 12) Mentoring - Ramundo 13) Negotiation – Ramundo 14) ABEM Certifications – Cheng 15) Patient Satisfaction – Cheng 16) Billing, Coding & Documenting – Cheng/Hall 17) Financial Planning – Hevia 18) Time Management – Promes 19) Balancing Work & Family – Promes & Datner 20) Physician Wellness & Burnout – Conrad /Wadman 21) Professionalism – Fredrick 22) Cases for professionalism & ethics – SAEM 23) Medical Directorship – Proctor 24) Academic Career Guide Chapter 1-8 – Nottingham 25) Academic career Guide Chapter 9-16 – Noeller


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