In this episode of Prosperous Doc, Ethan talks with host Shane Tenny about everything you need to know regarding contract negotiations, whether you’re a graduating resident or an experienced physician.
In a 2014 survey, the medical network Doximity found that over 72% of residents had negative feelings about negotiating their compensation, including feeling stressed, concerned, anxious, or lost.
31% of physicians felt prepared to network, while only 9% felt ready to negotiate. It wasn’t just first-time attending doctors who felt that way — doctors seeking raises were also affected.
It’s no wonder so many doctors feel anxious when few receive any training in contract negotiations.
But physicians shouldn't settle for less, says Ethan A. Nkana, Principle at the Rocky Mountain Physician Agency (RMPA), which advocates for doctors seeking fair contracts and compensation.
“I do think it's important for doctors to understand that when you go into those conversations, everything is negotiable. Yes, there may be certain things that with an employer you cannot move. But that does not mean that it's a nonnegotiable item,” he says.
Having an advocate like Ethan helps in certain high-level situations, but you don’t necessarily have to hire an advocate to get what you want.
Name: Ethan A. Nkana, J.D., MBA
What he does: Ethan began his hospital administration journey as a Human Resources intern, later expanding his skill set to hospital finance, physician contracting and compensation, hospital operations, and healthcare strategy. While working in physician contracting, Ethan observed that physicians frequently leave money and value on the table during their contract and salary negotiations.
Company: Rocky Mountain Physician Agency
Words of wisdom: “If I could give one piece of advice to first-time attendings that would really help give them the best chance for success: get more than one offer.”
Top takeaways from this episode
[02:21] Doctors need an advocate: Most people tend to think of doctors as high earners, but in reality, not all of them are. Today’s guest, Ethan Nkana of the Rocky Mountain Physician Agency, explains why doctors need an advocate when it comes to salary negotiation.
[04:14] Get more than one offer: Ethan offers an important piece of advice for first-time attending physicians: getting more than one offer improves your negotiating position by giving you more control.
[09:55] Everything is negotiable: Health insurance packages might not be negotiable, but most other things are. He discusses the three negotiable parts of compensation.
[13:39] Student loan forgiveness: Student loan debt is a top concern for new physicians, some of whom have six figures worth of debt. Ethan explains how he helps physicians get those numbers down by having the doctors themselves pay as little as possible.
[17:34] Get the numbers: It’s important for doctors to understand how salary ranges differ according to region and care setting. Some websites you can find this data are Medscape, Doximity, Physicians Thrive, and Merritt Hawkins. Data can also be purchased through Sullivan Cotter and MGMA.
[20:57] Negotiating for long-term physicians: Ethan shares a story about how he was able to score a seven-figure salary increase for a group of doctors whose employer initially refused to pay them more.
[27:14] Stark Law isn’t an excuse: Employers may use the Stark Law as an excuse to not increase a doctor’s salary. Ethan explains why this is “a bluff.”
[29:11] Significant disparities: A majority of clients that Ethan works with at RMPA are women due to the “almost criminal” pay disparities they experience in the workplace. He discusses the importance of closing the gap.
[33:21] Coast-to-coast negotiation: RMPA works with doctors nationwide. They also work with educational institutions and attorneys when legal referrals are needed.
[35:42] A painless process: Hiring an advocate as a new physician with mountains of student debt can be daunting, but RMPA only gets paid based on performance. Ethan explains why they use that model and how it works.
[39:28] Shoutouts: Ethan gives a shoutout to his mom and to Dr. Mark McKenzie, a doctor who helped develop the COVID-19 vaccine, but who also advised Ethan when he started the business.
Understanding where your cash flow is going every month is essential to creating an actionable plan for your financial goals. Use our monthly cash flow worksheet to give you clarity about where your money is going and help you create a budget.
Disclaimer: Prosperous Doc podcast by Spaugh Dameron Tenny highlights real-life stories from doctors, dentists, and those whose work can help them to encourage and inspire listeners through discussions of professional successes and failures in addition to personal stories and financial wellness advice. Spaugh Dameron Tenny is a comprehensive financial planning firm serving doctors and dentists throughout the U.S. To find out more about Spaugh Dameron Tenny, visit our website at http://www.sdtplanning.com . You can also connect with our host, Shane Tenny, CFP®, at shane@prosperousdoc.com.
Compliance code: CRN202603-3989571
Top quotes from the episode:
[3:43] “There are very vast disparities between doctors' pay not just [among] specialties, but within a certain specialty … [which] even amplifies the reasons why it's so important for doctors to advocate for their value. You and I don't want to make 30% less than the person next to us for doing the same work. And doctors don't want to do that either.”
[9:00] “It's so important for doctors: you must get more than one offer. And once you do that, now you're in control. Now you can say what you like and what you don't like.”
[27:54] “An attorney is very, very competent in negotiating a physician's contract. And typically, what they're going to do is say, [it] doesn't violate Stark Law to pay these doctors a reasonable amount based on these established thresholds. What RMPA does that nobody else in the industry is doing, is when your employer says, nope, we can't do it, that's when we say, all right, we'll see about that.”