1. Contracts, and Negotiations Daniel Goodrich, MPAS, PA-C Assistant Medical Director Lutheran Hospital Emergency Department Cleveland, Ohio Team Health

2. Negotiating n Research shows that most people are not very good negotiators for a variety of reasons u Lack of time u Dislike of the negotiation process u Lack of skill u Lack of preparation

3. Preparation n Any meaningful preparation that you perform prior to negotiation will afford you with a tremendous advantage n It will boost your confidence to negotiate successfully n Preparation is the key to interview success

4. Preparation n Research the Practice n Know the job description

5. Look The Part n How you look during the interview depends on more than what you’re wearing u How you smell u Confidence u Enthusiasm u First three minutes are crucial

6. Lights, Camera, Action n Your tone of voice, body language and poise all play a role n When greeting the interviewer, think of him/her as a friend, not an antagonist n Even if you are nervous don’t call attention to it by apologizing n Concentrate on your message not your own anxieties

7. Be Cool n You want to come off as calm, cool and collected n Fine line between confidence and arrogance u Stay with basics u Don’t exaggerate u Be honest u No name dropping u Careful not to talk too much about you yourself

8. Negotiation Techniques n 1. Analyze the other party n 2. Establish your objectives n 3. Plan your negotiating strategy n 4. Negotiate, evaluate and close n 5. Put yourself in their shoes

9. Know Your Bottom Line n Salary n Type of work n Hours n Lifestyle

10. Know The Facts n Determine who has the authority to make decisions n Don’t waste your time with the middle man n Start high - always make a counter offer

11. Use Effective Techniques n Never take the negotiation personally, negotiate with skill and not anger or frustration n Listen during negotiations and never interrupt n Remain silent if that is the best response

12. Silence Is Golden n In negotiation, it often quite literally pays to be silent. Silence is a very effective tactic for obtaining concessions from the other side n Usually, the first person to speak after an extended period of silence is the one who makes the next concession

14. Techniques n Confirm negotiated points in writing n Ask questions n Refer often to the need to work out the best arrangement for “both parties” n Know what you are willing to give and what you gain from a compromise

15. Techniques n Feel free to describe the unreasonableness of your opponents position n Keep track of number, nature and extent of your concessions and that of your opponent

16. Your Objectives n Identify your goals n Understand the market n Know your self worth n Make yourself marketable n To negotiate a contract competently u Salary u Benefits u Type of work u Hours

17. Productivity and Cost Effectiveness n Long been described and measured u Time per visit u Office visits and procedures u Charges generated u Overhead reduction

18. Quality of Care n 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 n Pa’s have been shown to provide care indistinguishable in quality from care provided by physicians n Indirect indicators have shown favorable physician and patient satisfaction

19. Market n No better time than now u Managed care u Resident hours F St. Vincent’s hospital of N.Y u Broad base of specialties u Here to stay

20. 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.”

21. Goals n More training/better job n Specialty n Feed the kids n Humanity n Get married n Money

22. Ultimate Goals n Teaching n Autonomy n Head of department n Administration n Marriage n Retire

24. Remember n You are A professional n Respect yourself and your profession n Have conviction and show confidence n Know your capabilities and what you bring to the practice

25. Know Your Profession n Reimbursement n Salaries n Laws n Responsibilities n Your Liability

26. Demographics n Primary Care 36% n ED 10% n Surgery 16% n Specialties 38%

27. Salary Expectations n How low will you go n Benefits n Start low - medium - high n Know the market n Know the specialty

28. Salary n Average for a minimum of 32 hours n Mean $93,486 – 104,000 n Mean For New Graduates $82,232 Survey 2010 High $92,500 Low $62,500 u 80% PA’S on salary u 20% hourly

29. Salary n Primary Care $85,461 n ED $102,018 n General Surgery $92,429 n Surgery Specialties $99,968 n Pediatrics $87,674

30. The Market n Doctors salary n Nurses salary n Economy of the area n Housing n Your lifestyle

31. Benefits n Vacation: 3-4 weeks n Health care n Life insurance n Disability n Retirement: 10-15% of salary n Bonuses: 2-10% of salary n Malpractice n CME: $500.00 to $2,500.00 and beyond

32. Benefits n Car phone n Car n Beeper n National and local dues n Education n Remember benefits are not taxed

33. Salary n Remember to compare hours and call time with pay n Remember u 60 hours a week is 10 hours a day 6 days/week u 12 hours a day 5days/week

34. Salary n New grad - how do I get my foot in the door? n Start low n Rapid increase n Make a contract n Prove yourself

35. Resume

36. Summary n Pa’s have been around for over three decades n We have a proven track record n Remember who you are n 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