You’ve already negotiated medical complexities and tough personalities throughout your residency. But the one negotiation that can set you up for your career is the contract for your first job.
By now, many of you may have already signed a contract and will begin working after many years of training. The tips in this article can help you make the most of your current contract. For those who haven’t signed the ideal contract yet, keep these following seven points in mind as you navigate through your negotiations.
This is, of course, the biggest point of negotiation when searching for your first job. If you haven’t finalized your contract yet, be sure to do your research to gain an understanding of the market value in your region for your services. Start with your peers because they may be more likely to share information about their salaries. Another helpful place to look is online, where there are numerous ophthalmology groups on social media where members openly share this information. The most accurate and complete information comes from physician compensation data firms like the Medical Group Management Association (MGMA) or American Medical Group Association (AMGA). You’ll have to pay for the most up-to-date data, but it will give you the most complete picture of physician compensation around the country.
The compensation you negotiate now serves as the salary base for the rest of your career, as well as the basis for future increases, so it’s important to be thoughtful in your negotiations, particularly if you are a woman. Countless studies have shown that women’s compensation often trails their male peers across nearly all specialties. There will be limitations on how much you can negotiate depending on the type of practice you join (i.e., academic vs. private), but there are often many other fringe benefits to include and utilize in your contract.
2. Health Insurance Coverage
This is an important and valuable benefit for you and your family. Health insurance coverage on the private market can be expensive, so be sure you get covered through your employer.
3. Professional Liability and Malpractice Insurance
This is crucial to your practice as an independent physician, as some estimates suggest that 95% of all ophthalmologists will be sued within a 35-year period. The Ophthalmic Mutual Insurance Co. (OMIC) is one that provides excellent coverage for ophthalmologists and has many resources for risk mitigation.
Unless there is true malpractice reform, lawsuits are simply the cost of doing business as a physician. Do not practice without malpractice insurance. Be sure to have this covered by your practice.
Furthermore, negotiate tail coverage into your contract, because most new physicians end up changing jobs. Tail malpractice insurance covers you for any claims for a certain period after you leave your job, and it can be expensive if you must pay for this yourself.
4. Retirement Plan and 401(k) Matching
If you’re lucky to join a practice that still has a pension plan, be sure to buy in as soon as possible. Most employers will offer a 401(k) — or the academic equivalent of a 403(b) — plan. Begin investing early and often as compounding interest can help your retirement savings grow quickly. If the practice or institution offers any match, definitely participate, as this is an effective boost to your income.
5. Expense Reimbursement/Professional Licensing Fees
Take advantage of reimbursements for qualified expenses and/or licensing fees. Licensing fees in particular can be very expensive and require annual or biannual renewals. In addition, utilize reimbursements for continuing medical education (CME), conferences, professional society memberships, travel expenses, moving expenses, student loans and any other cost that you might incur in your first couple years of practice.
6. Paid Leave
Although there may be limitations to how much you can negotiate your direct compensation, putting in the effort to maximize fringe benefits can impact your quality of life and serve as indirect compensation. Vacation time is one such critical fringe benefit. During your residency, you likely received a minimum of two to four weeks of vacation, so this should be the minimum you request at your first job. Take care of yourself and your family, and utilize your vacations!
As you negotiate paid leave, you will likely have a standard number of sick days included, but don’t forget to include paid maternity and paternity leave as well, especially if you cannot increase your direct compensation.
7. Partnership and Career Advancement
A transparent, well-written contract should also include expectations and clear guidelines for partnership or career advancement. You may not stay at your first job forever, but it’s a good idea to have the requirements and conditions for advancing at your practice. Have that discussion before signing anything. If you’ve already signed, approach your partners or supervisor and begin the dialogue.
Congratulations again on finally graduating after years of sacrifice. Your commitment to ophthalmology does not go unnoticed and is a tremendous benefit to patients and the entire profession. Contract negotiations are tough, so be sure to do your due diligence, speak with other recent graduates and your mentors, and consider professional help (www.mdnegotiation.com/ or https://physiciansthrive.com).
You deserve fair and equal compensation for your work and the career you have always envisioned.
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Viraj J. Mehta, MD, MBA,
is an oculoplastics surgeon at Washington Eye Physicians and Surgeons in Washington, D.C., and assistant professor at Georgetown University School of Medicine. He joined the YO Info
editorial board in 2020.