GPs are perceived as being empathetic, pragmatic and aiming for ethical correctness. It might appear that these qualities do not sit well with being a 'good negotiator'.
However, good negotiation doesn't have to involve 'hard talk' or manipulation to be successful. Ideally, negotiating an issue will lead to a 'win-win' situation.
GPs are required to be increasingly good at negotiation on broader and more responsible levels, locally, regionally and nationally. Therefore, it is useful to hone your negotiating skills during GP training.
Planning and research
GPs who negotiate with managers or other professions will notice the often differing backgrounds, attitudes, styles and even ethical values.
It is essential to know of and prepare for differing styles; otherwise it is easy to feel intimidated.
Often, GPs will negotiate with people and institutions (for example, the primary care or acute trust) with whom they must maintain a long-term working relationship. It is important, therefore, to consider your long-term goals.
Try to understand the position of the other side. Before entering into the negotiation, learn about their (perceived) assets, weaknesses and pressures (for example, maintaining a financial balance). Having this information will help you feel confident and in control before you even meet.
Be aware of simple situational issues that can influence the balance in the negotiation process.
For example, the location of the meeting, the number of people involved (ensure small but equal numbers if possible) and even where you are seated (together as a team or split up).
Outline your goals
Plan well beforehand. Outline your main objectives, your absolute minimum goals and then the results that would be reasonable and justifiable.
Create an optimistic wish list of desirable 'extras' of all variables that you might be able to achieve or improve if the discussion goes really well (money, time, conditions, services).
You may miss an opportunity to improve on any of these points if you fail to consider them beforehand.
On the other hand, define what concessions you are willing to make. Be willing to be reasonably generous but obviously ensure that you will not go beyond what you can sensibly give or promise.
Rehearse what you are expecting to happen during the negotiation. This will help you to get your point across fluently and to overcome some of your weaker areas. This will increase your confidence and flexibility.
Start the negotiation with a number of fairly small and easily agreeable items, which ease the path to some of the bigger topics.
Summarise regularly to reinforce positive achievements in the negotiations and to commit everybody toward the finalising phase.
Keep in mind that almost everything is negotiable. Beware of the trap of urgency or time pressure which could force you to concede or compromise before you had planned to. Remember that even deadlines are often negotiable, or that some things might be agreed even after a deadline has passed.
A fundamental negotiation rule is that you should never accept a first offer, however attractive it may seem. You are meeting to negotiate, so go through the process and perhaps improve this offer considerably.
Equally, never start with your best or final offer. You might give away more than necessary, or restrict your options if your offer is flatly declined early.
One simple but often effective way to force an immediate concession after the first offer on an important issue is your body language: flinch or even gasp in surprise. It may feel somewhat exaggerated, but, if used sparingly, it can work well.
Consider the reverse: if you do not do this, and you take a modest or even outrageous offer with too much calmness, then it may look like that you are willing to accept even a lot less than that.
Make use of the potential 'walk-away power'; do not get too attracted or attached to anything offered.
Suggest that the other side could improve their offer, but do not necessarily specify in what way they should improve it.
Add perceived value to what you have to offer. Emphasise how much extra effort/work/cost a concession is causing you, and how much of a benefit the other side is going to gain from it - for example when you take on practice-based commissioning services.
Ensure that when you make a concession you always only trade it for something immediately in return, otherwise you are likely to undersell yourself.
Practice negotiation actively whenever you can in your daily life. Being good at negotiating is a general life skill as well as a professional duty for a GP.
- Dr Jacobi is a salaried GP in York
- This topic falls under section 4.1 of the RCGP curriculum 'Management in Primary Care', www.healthcarerepublic.com/curriculum
1. Good negotiation doesn't have to involve 'hard talk' or manipulation to be successful.
2. Try to understand the position of the people you are negotiating with.
3. Before entering a negotiation, outline your main objectives, minimum goals and expected results.
4. Start the negotiation with easily agreeable items and summarise regularly.
5. Practice negotiation in daily life.
1. Forsyth P. The negotiator's pocket book, 2nd edition. Management Pocketbooks Ltd, 2003.
2. Donaldson M C. Negotiating for Dummies, 2nd edition. John Wiley & Sons, 2007.
3. Shell R G. Bargaining for advantage. Negotiating strategies for reasonable people. Penguin Books, 2006.