“Let us never negotiate out of fear but let us never fear to negotiate”

President J F Kennedy 1961

ASSERTIVE READERS may wonder why this chapter is in this book. If you’ve never had a problem negotiating a fee with a practice, skip the rest of this one! The majority of locums will at times have to negotiate with practices, often with the practice manager and sometimes with another doctor. Few of us enjoy confrontation and many readily admit they are not assertive enough. That is why this chapter has been included - knowing a little about negotiating skills may improve your confidence and assertiveness without obvious confrontation. Remember your livelihood depends on it and those who you are negotiating with have a tendency to ‘forget’ that. Because non-principals are often in short supply successful negotiation is a good way to remind them - it’s amazing how often it works!

Negotiation is about achieving an aim, about giving something in exchange for receiving something. This can be referred to as the ‘give-and-get’ principle. It’s a communication skill that improves with practice. The actual negotiation non-principals have with practices is often very quick, and perhaps because of this, many feel unable to get more control, or a better outcome. Here the process is broken down into its constituent parts.

Negotiators for large organisations often fear failure will cause a loss of face, that they will face threats and sanctions if they do not achieve their aim and that during negotiations they will face unfair tactics from the other side. Even as a sole negotiator with a practice, you may feel similarly as the consequences for you can be as critical as they are for experienced negotiators in industrial disputes. The way to reduce such fears is to prepare adequately. Know where the power lies. How desperate are you for work? How short is the current supply of locums? Can this practice get by without a locum - or are they at breaking point? How much notice are they giving you? What else could you be doing?

Whilst developing your negotiating skills, it is important to be yourself. Consider the common non-principal issues - eg numbers of patients per hour, signing repeat prescriptions, checking the mail, doing visits, mileage payments, cancellation agreement, payment for additional time etc.

Common mistakes are:

• to prepare inadequately;
• to forget the ‘give-and-get’ principle;
• to use intimidation (intimidators tend to lose);
• to get impatient - don’t force a result;
• loss of temper - this unwittingly shows your cards;
• talking too much, listening too little;
• ignoring conflict - eventually will lead to deadlock/breakdown;
• arguing but not influencing - will lead to deadlock/breakdown.

Objectives
Before starting set objectives. These fall into three categories.

• Musts - a list of things that you cannot or will not do without. Think laterally to ensure you include everything that may come up. This represents your bottom line.
• Intends - these are the important things that you intend to achieve out of the negotiation.
• Likes - your desires. Ensure they are realistic, achievable and genuine. They can represent your ideal. It may be worth making your opening position higher so that you fall back to your desires but consider whether this is realistic and genuine. If not it will be seen through in which case you should make your likes your opening position. You might get it!

The Pattern of Negotiation

Preparation
Preparation is essential. The degree of success is directly related to the quality of the preparation.

Preparation

Listen

Clarification

Listen

Exchange Views and Use Persuasion

Listen

Movement

Listen

A Deal

Clarification
The first position the sides take will have a major influence on the final outcome. If you are unsure what they are saying, clarify it and ensure your starting position is clear.

Exchanging Views and Persuasion
This is the critical time when your skills come into their own. Consider the other party’s motives for all positions. Ensure only good logic is used in arguments. Challenge anything you are uncertain about - especially inconsistencies, omissions, assumptions and credibility of statements. Consider taking the moral high ground to achieve your position. Use the potential effect of proposals on third parties when appropriate. (something like “it’s not worth paying the child minder for such a short session”). Be wary of mixed messages and clichés like “I’m going to be perfectly honest with you”. Think about what they are saying - are they really being honest and why? Do you believe what they say? Consider dividing the opposition if you can see a way to do so. This is hard in non-principal negotiations, but you may persuade one partner if not the practice manager. If you are not gaining ground, then threaten but be prepared to carry out your threats - or at least make it look as though you will!

All the time remember the mnemonic LISTEN

Getting Movement
The process of converting a willingness to an agreement is negotiation. It requires the use of communication skills and sometimes specific tactics such as

• tiring the other side out
• adjourning - know when to do this, use it for re-conferring if a new proposal is made, if there is disagreement on your side or if you are fatigued
• breakdown in negotiations - a last resort - you’ll probably lose.

To clinch the deal bide your time, keep gently pushing for more, asking if they can do better, and turning round their ‘final’ offer to another query on the fine detail. This way you should get something acceptable to you.

If you feel you want to learn more about negotiation skills visit your local bookshop’s business section, and consider spending time at a non-principal group meeting on the subject.

Examples of Negotiating Situations
Below are some examples of negotiating situations. Decide which course of action you would take and then see which the trained negotiator would take.

Examples

1. You are in negotiation with someone you have never dealt with before. He suggests a compromise - “I’ll meet you half way”. If you accept this proposal you will have achieved more than you had hoped for before you started the negotiation. Do you:
   
   a) accept;
   b) decline;
   c) tell him that his offer is insulting;
   d) make a counter offer;
   e) stay silent;
   f) explain that you are looking for more; offer him something he wants if he reconsiders his position?
   
   
2. You are buying a car for cash. You ask what the discount for cash is at this garage. The salesman asks “What do you have in mind?” Do you:
   
   a) suggest 5%;
   b) suggest 10%;
   c) suggest 20%;
   d) repeat your question to the salesman; ask for additional items to be included in the deal at no extra cost?
   
   
3. You have been in negotiation for a long time and you are approaching a position on which you are prepared to settle. The other party is called out of the room to answer a telephone call. When he returns he announces that he must terminate the negotiation immediately. He offers you a deal if you will accept the position already reached - take it or leave it. How would you react:
   
   a) ask for a five minute recess with your people;
   b) accept the offer;
   c) pretend that you didn’t understand what he has said and carry on with the negotiation;
   d) try to make him feel unreasonable; decline the deal?
   
   
4. You wish to sell your boat which cost £48,000 two years ago. Based on professional advice you would be delighted to get £39,000 although you have a fall-back minimum of £37,500. Before you get around to putting it on the market an acquaintance offers you £40,000. In response do you:
   
   a) accept with alacrity;
   b) accept; c) ask for £42,000;
   d) say you only wanted £39,500;
   e) ask what he will pay for the extras;
   f) stay silent; say you’ve been taken aback by his offer?
   
   
5. You are in negotiation in which you and the other party are unable to reach an agreement. Both sides believe firmly in their respective positions, and in many hours each has made only token movement. What would be your first preference of the following courses of action:
   
   a) change negotiators;
   b) offer a large concession;
   c) offer a further small concession;
   d) change the package and scope of the negotiation;
   e) let it go to deadlock; be open about your feelings at the lack of movement?

In each of the examples the ‘best’ responses are those that maximise your negotiating position. The recommended responses are:

1. d), f) or e)
2. d)
3. d)
4. f), e) or c)
5. f)