I appreciate the opportunity. My bio is I used to be an internist. I've been a lawyer for almost 30 years now. And you said, well, what's my tie to medicine or certainly to women in cardiology? Good question. My wife is a cardiologist. She's a head of cardiology at one of Penn State's hospitals. We have a daughter who's an intern. We have another daughter who's a medical student. So although I'm a man and about half of my clients in my legal practice are female physicians. Although I'm a man, I have a very big vested interest in the success of women in medicine and women in cardiology in particular. And I'd like to share some of my perspective on some of the things I think you could do better to put yourself in a better position when it comes time to talk about your contract. And because you're interventional cardiologist here, I'm gonna be direct about this, but I want it to also be constructive. I've got six points I wanna discuss. The first one is, if you're talking about renegotiating your contract, improving your position, if you're in a job and there's things about that job you'd like to improve, you must take the initiative. Women are particularly vulnerable here because I have found that women are more willing to quietly sacrifice in hopes that it will be eventually recognized and you will be rewarded for all of your sacrifice. I have found women are particularly vulnerable to that. Do not fall into that mindset. Because what happens is you sit and you give up your week of vacation because somebody had to have emergency surgery. You take extra call, you give up your research days, you pick up extra committees, you pick up some part of the fellowship education responsibilities, and you're quietly sacrificing, in hopes you'll eventually be showered with reward. That is theoretically possible, but I have never seen it happen. Then what happens is when you reach the end of it and you're ready to quit, because you can't do it anymore, then you call me and say, I need your help. I feel like I've been taken advantage of. So in some ways you have, but part of it is you need to take the initiative. If things are not going the direction you want, you need to step in and say something and do something. The other thing that's important here is when someone asks you to take on a little extra responsibility, they say, hey, we're a little short staff, can you take on a little bit of this? Okay, you can say yes, but you also need to say, yes, I can take that on. How long do you want me to do this? Is it a week, a month? Like how long is this gonna last? Because if you step in and just do it without any time limit, you're never gonna get yourself back out of that. And then you're just quietly sacrificing, hoping somebody recognizes, you must take the initiative too. When it's time to negotiate or renegotiate, you have to rank your priorities. You have to know exactly what you want. A common thing that happens is someone will call me, it's either a new contract or they wanna renegotiate their old contract. And I say, okay, what are you looking for here? And they'll give me eight or 10 things. Okay, you're not gonna get eight or 10 things. Whether it's, no matter how badly they want you, that's too many. You have to prioritize them. And it also helps you get the things that are most important to you. And it makes it easier for the other person. If you come to me and you need 10 things, I'm like, oh man, where do I start? But if you come to me and say, I'm really happy with most things here, I just got a couple of things I'd like to talk about. Much easier for me. You can only do that though, if you know what's most important to you. So the other things are, they should be on your list in the back of your mind, because you may not get the things you really want and you wanna come away with something, but always rank your priorities. Before you negotiate, discuss anything, know what you want and know exactly what you want. Let's suppose your goal is research time. You've had some success with research and publications, you got a little grant, you'd like more research time. And your goal, so okay, that's a good goal. And you wanna talk to the chairman about this. How much research time do you want? You say, well, I'd like two days of research. Okay, you're ready to talk to the chairman. You know what you want, you know what your priority is, and you know exactly what it is. Okay, seems easy. Common mistake people make is you get to the chairman, you have the meeting, you make your pitch, you're looking for more research time. The chairman says to you, okay, I hear what you're saying, how much research time you're looking for? Okay, what's the answer? Two days a week. If you give me two days a week, I'll be thrilled to death, I'll sign up for another couple of years. That's the correct answer. I find that people hesitate. Women are particularly vulnerable here because you don't wanna seem demanding or difficult. So what you say when the chairman says, how many days are you looking for? You know what a lot of us say when we say something like this, you'd say, I don't know, I was thinking maybe a day or two. Okay, what kind of answer is that? Okay, the answer is two days. What did you say? You started by saying, I don't know. Yes, you do know, okay, don't say that. I was thinking, yes, you were thinking and now you know the answer. So don't say the first two things. And then what did you say? Maybe a day or two. Okay, why did you say one day? You wanted two days, okay? You have to practice this. You have to practice it. You have to be ready. Because in the heat of battle, you're gonna dilute it out. People do it all the time. I think we wanna seem reasonable, flexible, nice, non-demanding. If you want two days, you have to say two days. Don't say maybe a day or two. I was thinking, what do you think? That you're selling yourself short. I see people do it all the time. If you want a $50,000 raise, practice in front of a mirror saying $50,000. When the time comes, you say $50,000. You could be nice about it, but don't water yourself down, dilute it and slur it. You wind up with nothing. The chairman says, yeah, we could probably give you a day. And then you come out of there saying, yeah, I don't know. I think it's because I'm a woman. They sold me short. No, you asked for a day or two. They gave you one day, okay? Don't say one if you want two. Very, very important. Three, negotiate from agreement and toward agreement. People make negotiation unnecessarily difficult because they just do a frontal assault on every issue. You know, if you want more money, let's suppose you want $50,000 more in your salary. The usual approach people take, whether it's by email or in person, is you say, hey, I was looking at my contract and can you raise my salary $50,000? You know, that's a hard way of doing it. Okay, first of all, I don't know where you're coming from. I don't know what that's gonna get me. If I give you $50,000, are you gonna be happy? Or are you gonna say, well, thanks, I got some other things here too, buddy. We need to talk. People tend to not wanna negotiate into a vacuum. They also don't wanna get hit out of the blue with a big issue. Make it easy for the other person. You wanna talk about salary, here's how you talk about it. Let's suppose it's a new contract for a new job. You would say something like, hey, I'm really interested. I want you to know I really like this job. I can see myself here and I'd like to build my career here. I was looking at the contract, I'm very satisfied with most of the terms. I do have a couple of questions about the salary. And if we can work them out, I'm ready to go. You see how much easier that is. I told you I like the job. I said, I wanna be here. I said, I'm really happy with almost everything. I just got a couple of questions about the compensation. For some reason, my battery's running low, excuse me. I just have a couple of questions about the compensation. And I have a couple of questions about the compensation and we're good to go. I've made it very easy for you. And now you're gonna say, well, what are your questions? And I just said, then I would say, well, the salary is a little low, can we raise the salary? Draw the other person towards you, compliment them. Say, I'm really happy. I've been very happy here the past couple of years, but I'd like some more research time. I'd really like to make a longer commitment, but I need some help with the call schedule. So make it easy for the other person. Let them know you're really close. There's just a couple of questions. Let's just iron this out. I find people make negotiating hard because they just wait for a quiet moment. And then they say, can you increase my salary $50,000? It's hard. Don't do it that way. It's hard for both people. And quite frankly, I think it's not very effective because you haven't given me any background on this. Let me know where you are, make it easy, and then tell me what you want. Don't worry about the gender pay disparity. It's defeating. It is self-defeating. I think it's real. And I think a lot of it is women negotiate differently. But even if it's based on misogynistic underlying principles, don't worry about it. Why? Because it defeats you. I have women call me, cardiologists been in their career 10 years, they wanna renegotiate their contract. These are successful women holding pretty prestigious positions. And I bet you 25% of them say to me something like, yeah, I'm hoping you can help me out because you know I'm at a disadvantage because I'm a woman and they're probably gonna not treat me. But I don't know, what do you think? I have a chance. What are you doing to yourself? Why are you showing up saying, yeah, I'm probably gonna lose, but I don't know, maybe you can help me. Where did that, you've never had that attitude your whole life. Did you, and when you applied to med school, did you say, yeah, I know I'm a woman, so they're probably not. Did you, no, you didn't. When you applied to interventional structural cardiology fellowship, did you say, yeah, I'm a woman, so no, you didn't say that. You wouldn't get where you are by saying that. Don't go in with that mindset because you're setting yourself up for defeat. Because as soon as you meet resistance, you're already primed thinking it's because I'm a woman. And then you go in knowing you're gonna lose. And as soon as you meet resistance, you're like, that's it, I lost because I'm a woman. Don't do that to yourself. I don't know if they're gonna pay you less because you're a woman or more because you're a woman or the same because you're a woman. It's irrelevant. Your goal is to make the most of it, to go in and prioritize what you want and make a good sales pitch and argue your case. And you might wind up with a lot, you might wind up with nothing, but don't go in with this defeatist attitude that you know you're gonna lose no matter what you do. You're setting yourself up for failure. Don't try, I find women are vulnerable to this. Don't try to figure out what they're thinking or what their motives are. Look, here's what I tell folks. I say, let's take what we have on paper. So they made us, we got something on paper. Let's see what it says. Let's work from that. I find women often want to know why they did this. Well, why do you think that? Why did they propose this? Why is this a salary? What do you think they're thinking? Most people out there these days are not thinking. Thinking is not as popular as it used to be. So a lot of these people aren't doing a lot of thinking. And in terms of what their motives are, I don't have any idea. I don't know if they're generous and just not very bright. I don't know if they're greedy. I don't know if they're trying to trick you or lie to you. What I encourage people to do is to take what you have on a piece of paper, what they have proposed, what your existing contract says, and let's talk about how to try to improve it to get another piece of paper that you can then sign. Don't spend too much time on the psychoanalysis because ultimately this is what we need is a piece of paper that you can sign. Now, I will say, if you find out that they're evil, dishonest, scheming manipulators, then you probably should have worked there. But beyond that, don't spend too much time trying to figure out why they did what they might've done. It just doesn't lead anywhere productive. You have priorities, you know what they are, you know exactly what you want, stay focused on that. Don't get distracted by this stuff because it doesn't improve your position. My last point is don't expect everything. I find many physicians are reluctant to accept partial victory. You went in, you wanted three things. You got one of them, you sort of got part of another one, and the third one, you got nothing. So you got like 1.5 out of three. That's an improvement from where you were. So it is a gain. But I find, and maybe it took you three months to get there, I find that physicians are often reluctant to accept that. It's like, well, I failed. No, it's a partial victory. Take your winnings off the table, sign a new contract or a new amendment, get the things, the 1.5 things you negotiated, get them, and then reload and try again in six months or a year or a year and a half with a new list of priorities. Don't expect everything. And please don't let partial victory be turned into total failure. Know when to take your winnings, get it in writing, and move on, renegotiate next time. Thanks for listening to me. Thank you, Dr. Victor, that was excellent. I think the take home points are we should take our initiative, avoid compromise, speak up, and prioritize. Very well done, thank you.

cardiology

contract negotiations

women in medicine

assertiveness

strategic negotiation