Negotiate value and not money

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Hello everyone. Welcome to today's episode of the Clinician Researcher. So I think I'm calling today Negotiation Mondays. I'm calling today Negotiation Mondays. Today I'm talking about why you negotiate value and not money.

1:22 Alright let's talk about it. Why you negotiate value and not money. And I want to tell you that the stuff I'm going to tell you today is just the tip of the iceberg. There is so much to negotiating your academic career, and that is why we have a program called Academics Negotiate. And it is a 12-week boot camp to help you become a master negotiator in your academic career so that you can build the research program you want to build. And we talk not about just the big master negotiations like salary, which is very important. But I tell you that you will negotiate your salary just once. Or actually I don't recommend negotiating it once. I recommend negotiating it multiple times.

2:04 But you'll negotiate your salary, big things like your salary, much less than you negotiate the small things in your academic career. How do you manage your daily schedule? How do you contain your wild clinic? How do you process requests that seem at first glance to be prestigious but on closer look to be grunt work? And those are the kinds of things we talk about negotiating in Negotiation Academy. And so if you check out our podcast website, clinicianresearcherpodcast.com, you'll see information about the next Negotiation Academy enrollment and Academics Negotiate is for you if you're building your research career.

2:44 All right. I hope to see you there. All right. So when I first started my academic career, my first big negotiation was salary. It was one of my big negotiations. And to be honest, when you start to think about negotiations, you realize that all of your life is a negotiation. So you're always negotiating. But the point at which you come to a place where you're like, oh, this is a negotiation, you know, this just depends on your level of awareness. And the reality for academic clinicians, especially clinicians, is that you're always negotiating. And all the decisions you're making impact upon your ability to create value in your research.

3:26 I'm going to say that again. All the things that you're negotiating and you're not recognizing that you're negotiating impact your ability to create value through your research. For example, somebody sends you an email. Oh, we just need three faculty to show up for 10 minutes to talk to medical students at 3 p.m. Just 10 minutes. Sounds innocuous, except that, you know what, smack dab in the middle of your writing time, your best writing time. And it's just it's just 10 minutes. Right. That's what they tell you. And it's probably a senior person who's like, I just need you for 10 minutes.

4:07 But that 10 minutes will eliminate three hours of writing productivity. OK, that's a big negotiation. But you just missed it. You timed it at 10 minutes. And so I had been negotiating for a while. But the negotiation I finally recognized was the one where I was negotiating salaries. So that was my first big negotiation that I recognized. And in the negotiation, I was struggling over the dollar amounts. That's all I was negotiating. They would say, OK, this is the amount. I'm like, oh, this doesn't feel good to me. And then I would negotiate for a higher salary. And eventually I got to a salary that I guess was better than where I started.

4:51 Still wasn't satisfactory to me, but I couldn't even name why it wasn't satisfactory. There was just a sense that it was too low, but I had no idea why. And now in retrospect, I understand why I felt like it was low. And some people would say it was like, oh, you didn't know your worth. You know how I feel about that statement. It's like, it's not about your worth. It's about what value can you create. It's because I recognized somewhere deep inside it was unspoken that I could create a lot more value than the dollar sign that I had just received next to my appointment. So now that I recognize better about how to negotiate and why negotiation is so important for clinicians, clinician researchers, I recognize that you don't waste time negotiating money.

5:41 You negotiate value. And the value you create dictates really the kind of money that comes in to help create that value. Let's talk about that. Today I'm going to give you seven reasons you negotiate value and not money. And this is really important. Seven reasons that you negotiate value. And the first reason is that everything is irrelevant until it can create value. Number one, everything is irrelevant until it creates value. For example, you went to medical school.

6:24 Good for you. You graduated and you went to residency. Oh my goodness, how amazing. And then you took the extra step. Oh, you did a fellowship maybe. And then some of you did a second fellowship. So you did a postdoc. You did a postdoctoral fellowship. And then you're like, I now want to launch my research career. And then you decide, well, you know, actually, I don't want to launch my research career. I want to travel the world. Okay. Everything you did, going to medical school, doing the residency program, doing the fellowship program is not relevant in the year that you take off traveling the world.

7:10 And traveling the world is good. Oh, please do it. If you have time and opportunity, you should do it. But there is no value in your medicine and your medical training until you activate it. Right? You activate it by saying, I'm ready to create value. And then you go and you look for a job that matches your ability to create value. Do you recognize what I'm saying? Your training, everything you've ever done is irrelevant until you get to the point where you're going to use it to create value. It's like the, you know, now we don't use desktop computers as much with the big towers. It's like the CD drive, right? If you use it to store your coffee, it's not what it's made for.

7:55 And you break it. I mean, it's irrelevant that somebody spent hours and hours like putting it together or designing it because you don't recognize what it can, what kind of value it can create. And so nothing matters until it comes to the point of actually creating value. And that is why it doesn't matter how much time you went to medical school or how much time you spent in residency or how many fellowships you did or how many awards you got during your fellowship until you bring all of that to bear, then it's not relevant. And so value becomes important. Actually, value is always important, but what you've done becomes important only at the point at which it begins to create value.

8:37 And that is why sometimes we're so focused as clinician researchers in what we don't have because we've just been going through the motions. We've just been going to medical school and going to residency and in going to fellowship and it doesn't always feel like it's really important. And it's not. It's not important until it creates value. Now I will tell you that it's been creating value all along the way if you recognize it because you're a transformed person. Whoever you were when you started medical school is not the person you are when you graduated fellowship. I guarantee you that you know that and the people in your life know that. So your training has been creating value the whole time. But where it really comes to the point of negotiation is the value all of that training comes together to create.

9:21 Number two, the value negotiation depends on the one who can communicate it best. I said the value negotiation depends on the person who can communicate it best. Okay, we know you went to med school. We know you did your training. We know that you did a year or two in research. We know that you have written a grant or two. But how do you communicate the value you can create? How do you communicate it? And that's important. The person who does the best job communicating value is the person who owns the negotiation. I'll say that again.

10:01 The person who does the best job communicating value is a person who owns the negotiation. Okay, yeah, there are hundreds of physicians here. Great. But none of them is like you. And so what is it about you that changes the value you create? Let me say this about being underrepresented in the academy. And I'm saying this as a hematologist. So people who do classical, we're calling it today, hematology are underrepresented in the academy. They absolutely are. If you are underrepresented, the kind of value you create is different. But do you understand that value?

10:44 Some might just say, well, there's not enough of you because you're not important. That's not true. It's like you clearly need hematologists like me in the academy. Do you understand why? And so the person who's like, well, there's not enough of you because this specialty doesn't even matter. That's what they're communicating. That's why they win in the negotiation. That's why you're like, oh, wow, I'm a nothing. There's not enough of me because I'm a nothing. And it's not true. There's not enough of you because you're precious silver. You're like gold. Goodness, that means you rise in value. But do you understand that enough to communicate it? All right, think about that. The value negotiation depends on the one who can communicate it best.

11:26 OK, number three is that the value negotiation depends on painting a clear picture of the future. It depends on creating a clear picture of what the future will look like. So here we are. You are a wonderfully, let's say, your newly minted graduate of a fellowship program applying for your first academic job. Now, the value you can create today as a clinician is big value. The value you can create as someone who understands at least the importance of research, that's a big value. And if you are coming to your academic job as someone who actually knows how to execute on a research question, that's big value.

12:16 But the value you're going to create five years from now is going to be bigger than whatever you can create today. Because maybe today, you starting can get a K award. Five, six, seven years from now, you can get an R01. A few years from then, you can get a big U54, maybe even a huge PCORI grant. The value you're going to create gets bigger over time. Actually, it only gets bigger over time if you choose, right? You choose, it gets bigger over the time, then that's what it does. But your ability to paint a clear picture of what you will bring, it's like what I can create now, it's pretty awesome.

12:58 You pay for that. But what I'm going to create seven years from now, eight years from now? It's really going to be dynamite. And the reason the negotiation belongs to the person who can paint a clear picture of the future, and that's you. I hope that's you. I hope you're not depending on somebody else to paint a clear picture of your future. The person who can create a clear picture of the future is able to amass the resources necessary to make that future possible, to make that future happen. If I can tell you that 10 years from now, I will be able to bring in amazing funding to the institution, that becomes important because I guarantee that I'm going to be able to do that by getting myself set up to do that, by getting myself the resources that I need to become the person 10 years from now who can create massive value in the institution and the kind of funding I can bring in.

13:57 But that all depends on having a clear picture of what the future looks like so that you can negotiate what it takes to create that kind of future. Number four, value negotiation thrives in the place of clarity. Clarity about who you are right now and what kind of value you can create, and clarity in who you can become or who you will become in the future and the kind of value that it creates. Many times we're kind of lost. I'm like, well, I'm not sure what I want to do because I really like clinical and my patients are so awesome and I really want to do some research and you know, I'm not sure, I'm not sure.

14:45 And I have to tell you that you can't sell value when you're not sure. I'm not asking you to make up a story. What I'm asking you to do is get clear on what you're coming to create. And it takes time to get clarity. And getting clarity requires disconnecting from the distractions of life, right? Many times in our clinical careers and our research careers, we're just going, going, going. We're just doing and then we do the next thing. We do the next thing. We do the next thing. And there isn't much time to stop to think, where am I going exactly? What am I creating with all the things I'm doing?

15:26 And the people who spend more time gaining clarity are the people who are able to more clearly communicate value. I'll say that one more time. People who take time to create space for clarity are people who are able to strongly negotiate value. Because I always say that you cannot negotiate the value you do not understand. You do not understand value. You cannot negotiate value. And to understand value, you need time and space to recognize it for what it is. And when you can dedicate time and space to recognize value, you have clarity.

16:09 You can negotiate well. So whatever it is in your life that takes you away from time for reflection, I want you to fight against it. And take time to create spaces to have clarity. Number five. Whenever it comes to working with people who do not recognize your value, it's risky. And it doesn't matter how much they pay you, it is a risky proposition. OK. Let's think about this. In academic medicine, there are many distractions that people call patient care.

16:51 There are many distractions that people call patient care. For example, calling on the phone to make an appointment is a distraction. It is not patient care. And the reason it's a distraction is because the highest paid person in the organization, or should I say, the class of persons who can bring in revenue clinically to the extent that physicians can, is the class of people that should not be on the phone making phone calls. OK. Because somebody else can make that phone call. The phone call is important. It still needs to happen. And there's a group of people who do that well and who know the tricks for like avoiding the music on the phone.

17:35 And that's not you. And everything you do that keeps you talking on the phone or keeps you on the phone listening to music is an undervaluing of you in your abilities as a clinician investigator. OK. And so anytime that you are in an environment where people prioritize things that you do that do not create value, as a clinician, create value in seeing patients, as a researcher, create value in producing research products, anything, anytime you're in an environment where they don't recognize that.

18:19 And they're going to use you to do things that don't bring or create value. And that is a problem for you. And so it doesn't matter how much they pay you. If they're like, oh, I pay you $400,000 a year. But you're going to make all your own phone calls. It's risky. Because you know what you don't thrive? Once you've mastered the first or the second phone call, you're a very high achiever. You're very high. Like you have capacity to learn well. And so anything you can master easily and then you have to keep doing it over and over again drains you. And so it doesn't matter how much they pay you. Learning may be good, but you're just feeling like blah, because you're not challenged.

19:04 But when they recognize your value, they create space for you to manifest your value. Oh, that's such a great environment, because you can just go from like value creation to value creation to value creation to value creation. But when you have to fight with people over your ability to create value, when you have to say, excuse me, I need an MA in my clinic, that's a sign that they don't recognize value. And I want to ask you to be very, very careful of accepting being in environments where people do not recognize your need to be supported to create the value that you create well. I want you to prepare to say no to any environment in which people do not recognize your value.

19:46 Now, it is your job to communicate your value and have them communicate it back to you so you know that they got what you said, right? So that you know that they understand, or at least can verbalize for you the value that you came to create. And hopefully you've given them a clue of what that is. But if they have a sense of understanding the value and they still insist on you mailing your own letters, okay, I want you to just be careful. If you choose that environment, you've got to have other things that you think that environment will help you create value through, because you're only as good to that environment as the value that you're actually creating. And if for whatever reason they're not creating space for you to create that value very soon, you do not have value to that environment.

20:33 So if you are hired to be a clinician researcher and you cannot create the value that clinician researchers create because you're so busy trying to mop up after clinic, over time you lose the value that the institution hired you to create. Okay. Number six is that your job in the negotiation is to identify the understanding of the people with whom, of the people with whom you're about to entrust your career. Okay, you're negotiating a new job and they say they want you to come in and be a clinician researcher, do they understand what kind of value you can create and are they going to support you to create that value?

21:20 If they say yes, come in, you become a clinician researcher and here's 80% worth of clinical time, do they get the value and are they willing to make change so that they can support the value? Now I will tell you that if somebody gives you 80% clinical time and all of that time is spent in like a resident clinic where the residents are doing most of the work, okay, you might be able to make a clinical research career out of that or your career as a clinician scientist because you're well supported. But if it's an 80% clinical position and it's just you, no MA, no administrative staff, then you have to find out do they understand the value that you're going to create because if they don't, it doesn't matter how prestigious the institution, please don't go there because you're going to struggle to create value and then your ability to create value is going to diminish over time and then it kind of is a job opportunity that hurts you, doesn't enhance you.

22:26 So I think the summary of number six is to never take a job where your value is not going to be enhanced. Okay, number seven, if you're going to negotiate value well, you need a good mirror because negotiating value is really about looking in the mirror, it's reflecting and recognizing the kind of value that you can create. And sometimes that's hard to see. It's hard to see how beautiful you are, how handsome you are until you look in a mirror. And the same thing goes for creating value. Over time of looking in a mirror, over time, you may not need a mirror as much.

23:08 The more you've looked in a mirror, the less you need to look in a mirror because you're like, I know what I look like. However, you're changing over time. And so if the last time you looked at a mirror was 75 years ago, you've changed a little bit since that time. You were pretty cute and your face was really smooth and now it's not so smooth. And so you need a good mirror and that is someone reflecting to you the kind of value you create because what happens is that your value creation potential changes over time. The more career development opportunities you've gotten, the more career development awards you've gotten, the more grant opportunities you've gotten, the more grants you've written, the more value you can create. And sometimes you miss that and you really do need a good mirror.

23:52 I had an opportunity yesterday to be a mirror for somebody yesterday who was just calling herself names. And after a while, I had to pause and say, I keep hearing you call yourself this name. Where does that come from? And it took her time to pause and to recognize that the name she was calling herself was the wrong name. What she was pointing to was the fact that she's a thoughtful person who likes to be prepared. It's not worthy of calling yourself a poor name, but it took me to be her mirror for her to recognize that what she was thinking of as a disadvantage was actually a super awesome advantage. You need a good mirror. And I offer it to you that you should get a coach who can be your mirror.

24:37 Does it have to be a coach? It doesn't have to be a coach, but it does need to be somebody who is a coaching, who is in a coaching style. So sometimes people are like, oh, my mentor can do that. If a mentor is a coach as well, if they are coaching you as part of their mentoring, then they can be a mirror to you. But really, many mentors are kind of just reflecting themselves back to you. They're like, this is who I am. A lot of times around them, it's like, this is who I am. This is who I am. And they're pretty awesome. And if you do what they do, you'll do well. But your greatest value is becoming more of yourself. It's creating more of you.

25:17 And that's why having a coach who reflects back to you because you need to improve. The goal of the coach is your improvement. You're playing a better game. And so mirroring you back to you. Maybe you have a good peer mentoring group where you coach each other. All I'm saying is that if you're going to negotiate value well, you need to have a good mirror to help you reflect the kind of value you create, especially as the value creation proposition changes over time. OK, I told you seven things, seven reasons you negotiate value. Everything is irrelevant until it can create value.

25:57 Number two, the value negotiation depends on the one who can communicate it best. Number three, the value negotiation depends on painting a clear picture of the future. Number four, value negotiation thrives in the place of clarity. Number five, working with people who do not recognize value is risky no matter how much they can pay you. Number six, your job in the negotiation is to identify the understanding of the people with whom you're about to entrust your career. Number seven, if you're going to negotiate well, you need a good mirror. All right, those are the seven reasons to negotiate value. I'm excited to have brought to you Negotiation Mondays brought to you by Academics Negotiate. I hope you will share this episode with somebody else who needs to understand they're not just negotiating salary.

26:40 They're not just negotiating money. What they're really doing is being clear about the value that they create. All right, it's been a pleasure talking with you today. I look forward to talking with you again the next time. Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it.

27:24 As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.