By FlexMedStaff

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“The More You know” was a popular television campaign created by NBC Universal in 1989 to provide Public Service Announcements (PSAs). The campaign slogan and catchy jingle were hugely successful for nearly 30 years. Since NBC no longer produces these commercials, we are forced to watch reruns on the internet or see parodies of them on Saturday Night Live (SNL). One of the strongholds of the campaign was to highlight the importance of education. This article aims to educate practitioners on the topic of negotiations.  

This article provides an overview of things to consider when negotiating a deal to contract directly for locums-type work. When it comes to being a great negotiator, the slogan, “the more you know,” could not be more applicable.  This article discusses the four elements you need to know to negotiate successfully. This includes having the right mindset, being educated about the topic, knowing the tactics of a good negotiator, and preparing a game plan to negotiate effectively. The more you know about each element, the more likely you will be effective at contracting directly for locums-type work.  

Having the Right Mindset.

It is not always easy for practitioners to negotiate with a facility to contract directly. It starts by having the right mindset. When negotiating with a facility, think of it as a “conversation” rather than a negotiation. If you have the mindset that you are negotiating, you are more likely to put more pressure on yourself to argue and fight for your points. Instead, a conversation is meant to be a back and forth of ideas between two parties. The more the conversation flows, the more likely you will successfully get across your points of importance. The more it flows, the more each party listens to the other leading to a convergence of ideas.

Nothing is worse than going into a negotiation with a “fixed mindset.” Rather than having a fixed mindset, have an “open mindset.” A fixed mindset can affect your attitude and response to the other party’s demands and offers. Instead, prepare yourself mentally to be flexible as you work thru the negotiations. Like a good boxer, you may need to “bob and weave” throughout the negotiations to find common ground.

For example, you may be disappointed with the facility’s initial compensation offer. Instead of overreacting and shutting down, continue the conversation with an open mind. Keep negotiating! Bob and weave your way back to a reasonable compensation rate that works for both parties.  

Stay Educated about Relevant Topics to Contracting Directly.

#1: 1099 vs. W2. Each practitioner looking to contract directly must understand the implications of contracting as a 1099 independent contractor and W2 employee. Knowing if the facility plans to contract with you as a 1099 or W2 will affect how you negotiate for pay, malpractice insurance, benefits, and travel reimbursement.

#2: Compensation Rates. “Know your worth” is a common phrase used by many, but in actuality, all practitioner should know their “Fair Market Value.” Knowing how to determine fair market value will enhance your chances of getting paid fairly.

#3: Malpractice insurance. Practitioners attempting to contract directly must be aware of their options for obtaining malpractice insurance and how to pay for it.

#4: Contractual Terms. Each practitioner will be asked to sign a Professional Services Agreement when contracting directly. Knowing the typical clauses and provisions in these Agreements will prepare you for items to negotiate before viewing the Agreement and after.

Tactics of a Good Negotiator.

  1. Be Friendly. A facility is likelier to work with someone nice with a positive attitude. There is no reason to be argumentative or feel insulted by the facility’s demands or offers. Take it all in stride. Even if the facility does not contract with you immediately, they may come back months or years later if you were pleasant to work with. They also may forward your information to another facility.
  2. Speak with Confidence. Sound intelligent about the topic of contracting directly. The more educated you sound about the topic, the more likely the facility is to work with you.
  3. Listen. Listen to the facility’s needs and preferences for setting up a deal to contract directly. Take what you learn from the facility and find a way to arrange a setup to satisfy both parties.
  4. Always be Selling Yourself. Always be thinking about how you can bring value to an institution. Are you valuable to a facility because you have unique skills or fill a staffing shortage? Try to demonstrate your worth with a sound rationale and always be willing to provide references from other facilities you have worked at.
  5. Provide full disclosure. Be upfront with the facility. Don’t mislead them. You don’t need to tell them everything, but it’s worth informing the facility of what arrangements you have made in the past and what you are now looking for. It would help if you prepared to offer your expected compensation rates with a solid rationale to support it.
  6. Concessions. Be prepared to bob and weave. When negotiating, it needs to be a Win-Win for both parties. The facility may not succumb to all your demands, so be prepared to concede in some areas. In some cases, prepare to offer alternative ways to reach an agreement. Do not concede to any item that you might consider a “deal breaker.”  
  7. Sometimes Less is More. Keep it simple! The more complexity you add to the negotiations, the less likely the facility may be to agree to your terms. Remember, sometimes the first offer is the best one. Make sure you don’t negotiate yourself out of a good deal.
  8. Remove your emotions. We are all passionate when we want something. Don’t allow your emotions to interfere with the negotiations. You may experience setbacks or what you feel are insulting offers, but keep calm and keep negotiating.

Determine a Game Plan.

A good game plan will allow your conversations to contract directly to flow. Please recognize that the discussions may not always go in the order you would like, so be flexible with how you negotiate these items.

  1. Working Arrangement. Work with the facility to determine the coverage they need and what you can offer. If you feel that you could create a good working arrangement, it is worth moving on to the other items.
  2. 1099 vs. W2. Knowing the facility’s openness to contract with you as a 1099 independent contractor or W2 is essential as it will alter how you negotiate for other items compensation, malpractice insurance, benefits, and travel expenses. The facility may offer W2 and 1099 packages. 
  3. Compensation rates. Compensation rates depend on whether you are contracted as a W2 or 1099. It may take time for both parties to settle on a compensation rate that is fair and aligns with Fair Market Value. If the facility fails to pay what you believe is fair, then offer to hire a Fair Market Value expert.
  4. Malpractice Insurance. If you contract as a W2, the facility should include you on their group policy. If you contract as a 1099, consider different options for getting malpractice insurance and how you will pay for it.
  5. Travel Expenses. If W2, the facility should pay for travel expenses. If you are 1099, you will need to negotiate for reimbursement, stipend, or other options. 


In review, a lot goes into negotiating an opportunity to contract directly with a facility for locums-type work. The better you understand how contracting directly works, the more successful you will be. The more experience you have negotiating for yourself, the more confident you will become.

The more you know, the better your negotiations will turn out!

Imagine you are watching NBC, the screen goes black, and the music jingle starts playing. A shooting star appears, and the words “The More You Know” run across the top of the screen.  

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