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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Hello everyone.

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Welcome to today's episode of the Clinician Researcher.

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So I think I'm calling today Negotiation Mondays.

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I'm calling today Negotiation Mondays.

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Today I'm talking about why you negotiate value and not money.

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Alright let's talk about it.

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Why you negotiate value and not money.

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And I want to tell you that the stuff I'm going to tell you today is just the tip of

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the iceberg.

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There is so much to negotiating your academic career, and that is why we have a program

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called Academics Negotiate.

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And it is a 12-week boot camp to help you become a master negotiator in your academic

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career so that you can build the research program you want to build.

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And we talk not about just the big master negotiations like salary, which is very important.

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But I tell you that you will negotiate your salary just once.

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Or actually I don't recommend negotiating it once.

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I recommend negotiating it multiple times.

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But you'll negotiate your salary, big things like your salary, much less than you negotiate

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the small things in your academic career.

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How do you manage your daily schedule?

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How do you contain your wild clinic?

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How do you process requests that seem at first glance to be prestigious but on closer look

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to be grunt work?

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And those are the kinds of things we talk about negotiating in Negotiation Academy.

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And so if you check out our podcast website, clinicianresearcherpodcast.com, you'll see

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information about the next Negotiation Academy enrollment and Academics Negotiate is for

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you if you're building your research career.

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All right.

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I hope to see you there.

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All right.

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So when I first started my academic career, my first big negotiation was salary.

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It was one of my big negotiations.

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And to be honest, when you start to think about negotiations, you realize that all of

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your life is a negotiation.

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So you're always negotiating.

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But the point at which you come to a place where you're like, oh, this is a negotiation,

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you know, this just depends on your level of awareness.

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And the reality for academic clinicians, especially clinicians, is that you're always negotiating.

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And all the decisions you're making impact upon your ability to create value in your

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research.

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I'm going to say that again.

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All the things that you're negotiating and you're not recognizing that you're negotiating

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impact your ability to create value through your research.

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For example, somebody sends you an email.

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Oh, we just need three faculty to show up for 10 minutes to talk to medical students

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at 3 p.m.

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Just 10 minutes.

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Sounds innocuous, except that, you know what, smack dab in the middle of your writing time,

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your best writing time.

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And it's just it's just 10 minutes.

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Right.

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That's what they tell you.

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And it's probably a senior person who's like, I just need you for 10 minutes.

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But that 10 minutes will eliminate three hours of writing productivity.

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OK, that's a big negotiation.

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But you just missed it.

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You timed it at 10 minutes.

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And so I had been negotiating for a while.

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But the negotiation I finally recognized was the one where I was negotiating salaries.

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So that was my first big negotiation that I recognized.

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And in the negotiation, I was struggling over the dollar amounts.

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That's all I was negotiating.

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They would say, OK, this is the amount.

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I'm like, oh, this doesn't feel good to me.

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And then I would negotiate for a higher salary.

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And eventually I got to a salary that I guess was better than where I started.

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Still wasn't satisfactory to me, but I couldn't even name why it wasn't satisfactory.

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There was just a sense that it was too low, but I had no idea why.

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And now in retrospect, I understand why I felt like it was low.

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And some people would say it was like, oh, you didn't know your worth.

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You know how I feel about that statement.

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It's like, it's not about your worth.

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It's about what value can you create.

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It's because I recognized somewhere deep inside it was unspoken that I could create a lot

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more value than the dollar sign that I had just received next to my appointment.

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So now that I recognize better about how to negotiate and why negotiation is so important

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for clinicians, clinician researchers, I recognize that you don't waste time negotiating money.

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You negotiate value.

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And the value you create dictates really the kind of money that comes in to help create

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that value.

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Let's talk about that.

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Today I'm going to give you seven reasons you negotiate value and not money.

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And this is really important.

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Seven reasons that you negotiate value.

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And the first reason is that everything is irrelevant until it can create value.

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Number one, everything is irrelevant until it creates value.

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For example, you went to medical school.

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Good for you.

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You graduated and you went to residency.

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Oh my goodness, how amazing.

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And then you took the extra step.

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Oh, you did a fellowship maybe.

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And then some of you did a second fellowship.

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So you did a postdoc.

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You did a postdoctoral fellowship.

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And then you're like, I now want to launch my research career.

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And then you decide, well, you know, actually, I don't want to launch my research career.

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I want to travel the world.

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Okay.

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Everything you did, going to medical school, doing the residency program, doing the fellowship

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program is not relevant in the year that you take off traveling the world.

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And traveling the world is good.

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Oh, please do it.

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If you have time and opportunity, you should do it.

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But there is no value in your medicine and your medical training until you activate it.

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Right?

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You activate it by saying, I'm ready to create value.

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And then you go and you look for a job that matches your ability to create value.

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Do you recognize what I'm saying?

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Your training, everything you've ever done is irrelevant until you get to the point where

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you're going to use it to create value.

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It's like the, you know, now we don't use desktop computers as much with the big towers.

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It's like the CD drive, right?

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If you use it to store your coffee, it's not what it's made for.

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And you break it.

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I mean, it's irrelevant that somebody spent hours and hours like putting it together or

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designing it because you don't recognize what it can, what kind of value it can create.

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And so nothing matters until it comes to the point of actually creating value.

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And that is why it doesn't matter how much time you went to medical school or how much

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time you spent in residency or how many fellowships you did or how many awards you got during

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your fellowship until you bring all of that to bear, then it's not relevant.

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And so value becomes important.

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Actually, value is always important, but what you've done becomes important only at the

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point at which it begins to create value.

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And that is why sometimes we're so focused as clinician researchers in what we don't

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have because we've just been going through the motions.

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We've just been going to medical school and going to residency and in going to fellowship

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and it doesn't always feel like it's really important.

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And it's not.

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It's not important until it creates value.

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Now I will tell you that it's been creating value all along the way if you recognize it

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because you're a transformed person.

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Whoever you were when you started medical school is not the person you are when you

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graduated fellowship.

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I guarantee you that you know that and the people in your life know that.

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So your training has been creating value the whole time.

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But where it really comes to the point of negotiation is the value all of that training

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comes together to create.

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Number two, the value negotiation depends on the one who can communicate it best.

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I said the value negotiation depends on the person who can communicate it best.

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Okay, we know you went to med school.

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We know you did your training.

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We know that you did a year or two in research.

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We know that you have written a grant or two.

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But how do you communicate the value you can create?

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How do you communicate it?

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And that's important.

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The person who does the best job communicating value is the person who owns the negotiation.

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I'll say that again.

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The person who does the best job communicating value is a person who owns the negotiation.

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Okay, yeah, there are hundreds of physicians here.

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Great.

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But none of them is like you.

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And so what is it about you that changes the value you create?

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Let me say this about being underrepresented in the academy.

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And I'm saying this as a hematologist.

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So people who do classical, we're calling it today, hematology are underrepresented

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in the academy.

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They absolutely are.

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If you are underrepresented, the kind of value you create is different.

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But do you understand that value?

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Some might just say, well, there's not enough of you because you're not important.

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That's not true.

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It's like you clearly need hematologists like me in the academy.

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Do you understand why?

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And so the person who's like, well, there's not enough of you because this specialty doesn't

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even matter.

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That's what they're communicating.

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That's why they win in the negotiation.

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That's why you're like, oh, wow, I'm a nothing.

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There's not enough of me because I'm a nothing.

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And it's not true.

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There's not enough of you because you're precious silver.

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You're like gold.

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Goodness, that means you rise in value.

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But do you understand that enough to communicate it?

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All right, think about that.

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The value negotiation depends on the one who can communicate it best.

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OK, number three is that the value negotiation depends on painting a clear picture of the

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future.

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It depends on creating a clear picture of what the future will look like.

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So here we are.

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You are a wonderfully, let's say, your newly minted graduate of a fellowship program applying

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for your first academic job.

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Now, the value you can create today as a clinician is big value.

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The value you can create as someone who understands at least the importance of research, that's

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a big value.

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And if you are coming to your academic job as someone who actually knows how to execute

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on a research question, that's big value.

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But the value you're going to create five years from now is going to be bigger than

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whatever you can create today.

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Because maybe today, you starting can get a K award.

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Five, six, seven years from now, you can get an R01.

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A few years from then, you can get a big U54, maybe even a huge PCORI grant.

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The value you're going to create gets bigger over time.

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Actually, it only gets bigger over time if you choose, right?

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You choose, it gets bigger over the time, then that's what it does.

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But your ability to paint a clear picture of what you will bring, it's like what I can

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create now, it's pretty awesome.

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You pay for that.

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But what I'm going to create seven years from now, eight years from now?

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It's really going to be dynamite.

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And the reason the negotiation belongs to the person who can paint a clear picture of the

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future, and that's you.

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I hope that's you.

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I hope you're not depending on somebody else to paint a clear picture of your future.

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The person who can create a clear picture of the future is able to amass the resources

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necessary to make that future possible, to make that future happen.

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If I can tell you that 10 years from now, I will be able to bring in amazing funding

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to the institution, that becomes important because I guarantee that I'm going to be able

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to do that by getting myself set up to do that, by getting myself the resources that

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I need to become the person 10 years from now who can create massive value in the institution

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and the kind of funding I can bring in.

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But that all depends on having a clear picture of what the future looks like so that you

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can negotiate what it takes to create that kind of future.

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Number four, value negotiation thrives in the place of clarity.

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Clarity about who you are right now and what kind of value you can create, and clarity

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in who you can become or who you will become in the future and the kind of value that it

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creates.

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Many times we're kind of lost.

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I'm like, well, I'm not sure what I want to do because I really like clinical and my

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patients are so awesome and I really want to do some research and you know, I'm not

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sure, I'm not sure.

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And I have to tell you that you can't sell value when you're not sure.

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I'm not asking you to make up a story.

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What I'm asking you to do is get clear on what you're coming to create.

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And it takes time to get clarity.

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And getting clarity requires disconnecting from the distractions of life, right?

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Many times in our clinical careers and our research careers, we're just going, going,

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going.

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We're just doing and then we do the next thing.

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We do the next thing.

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We do the next thing.

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And there isn't much time to stop to think, where am I going exactly?

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What am I creating with all the things I'm doing?

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And the people who spend more time gaining clarity are the people who are able to more

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clearly communicate value.

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I'll say that one more time.

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People who take time to create space for clarity are people who are able to strongly negotiate

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value.

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Because I always say that you cannot negotiate the value you do not understand.

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You do not understand value.

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You cannot negotiate value.

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And to understand value, you need time and space to recognize it for what it is.

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And when you can dedicate time and space to recognize value, you have clarity.

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You can negotiate well.

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So whatever it is in your life that takes you away from time for reflection, I want

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you to fight against it.

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And take time to create spaces to have clarity.

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Number five.

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Whenever it comes to working with people who do not recognize your value, it's risky.

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And it doesn't matter how much they pay you, it is a risky proposition.

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OK.

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Let's think about this.

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In academic medicine, there are many distractions that people call patient care.

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There are many distractions that people call patient care.

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For example, calling on the phone to make an appointment is a distraction.

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It is not patient care.

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And the reason it's a distraction is because the highest paid person in the organization,

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or should I say, the class of persons who can bring in revenue clinically to the extent

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that physicians can, is the class of people that should not be on the phone making phone

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calls.

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OK.

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Because somebody else can make that phone call.

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The phone call is important.

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It still needs to happen.

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And there's a group of people who do that well and who know the tricks for like avoiding

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the music on the phone.

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And that's not you.

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And everything you do that keeps you talking on the phone or keeps you on the phone listening

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to music is an undervaluing of you in your abilities as a clinician investigator.

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OK.

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And so anytime that you are in an environment where people prioritize things that you do

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that do not create value, as a clinician, create value in seeing patients, as a researcher,

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create value in producing research products, anything, anytime you're in an environment

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where they don't recognize that.

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And they're going to use you to do things that don't bring or create value.

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And that is a problem for you.

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And so it doesn't matter how much they pay you.

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If they're like, oh, I pay you $400,000 a year.

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But you're going to make all your own phone calls.

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It's risky.

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Because you know what you don't thrive?

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Once you've mastered the first or the second phone call, you're a very high achiever.

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You're very high.

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Like you have capacity to learn well.

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And so anything you can master easily and then you have to keep doing it over and over

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again drains you.

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And so it doesn't matter how much they pay you.

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Learning may be good, but you're just feeling like blah, because you're not challenged.

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But when they recognize your value, they create space for you to manifest your value.

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Oh, that's such a great environment, because you can just go from like value creation to

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value creation to value creation to value creation.

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But when you have to fight with people over your ability to create value, when you have

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to say, excuse me, I need an MA in my clinic, that's a sign that they don't recognize value.

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And I want to ask you to be very, very careful of accepting being in environments where people

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do not recognize your need to be supported to create the value that you create well.

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I want you to prepare to say no to any environment in which people do not recognize your value.

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Now, it is your job to communicate your value and have them communicate it back to you so

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you know that they got what you said, right?

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So that you know that they understand, or at least can verbalize for you the value that

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you came to create.

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And hopefully you've given them a clue of what that is.

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But if they have a sense of understanding the value and they still insist on you mailing

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your own letters, okay, I want you to just be careful.

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If you choose that environment, you've got to have other things that you think that environment

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will help you create value through, because you're only as good to that environment as

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the value that you're actually creating.

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And if for whatever reason they're not creating space for you to create that value very soon,

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you do not have value to that environment.

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So if you are hired to be a clinician researcher and you cannot create the value that clinician

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researchers create because you're so busy trying to mop up after clinic, over time you

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lose the value that the institution hired you to create.

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Okay.

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Number six is that your job in the negotiation is to identify the understanding of the people

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with whom, of the people with whom you're about to entrust your career.

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Okay, you're negotiating a new job and they say they want you to come in and be a clinician

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researcher, do they understand what kind of value you can create and are they going to

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support you to create that value?

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If they say yes, come in, you become a clinician researcher and here's 80% worth of clinical

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time, do they get the value and are they willing to make change so that they can support the

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value?

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Now I will tell you that if somebody gives you 80% clinical time and all of that time

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is spent in like a resident clinic where the residents are doing most of the work, okay,

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you might be able to make a clinical research career out of that or your career as a clinician

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scientist because you're well supported.

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But if it's an 80% clinical position and it's just you, no MA, no administrative staff,

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then you have to find out do they understand the value that you're going to create because

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if they don't, it doesn't matter how prestigious the institution, please don't go there because

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you're going to struggle to create value and then your ability to create value is going

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to diminish over time and then it kind of is a job opportunity that hurts you, doesn't

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enhance you.

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So I think the summary of number six is to never take a job where your value is not going

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to be enhanced.

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Okay, number seven, if you're going to negotiate value well, you need a good mirror because

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negotiating value is really about looking in the mirror, it's reflecting and recognizing

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the kind of value that you can create.

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And sometimes that's hard to see.

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It's hard to see how beautiful you are, how handsome you are until you look in a mirror.

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And the same thing goes for creating value.

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Over time of looking in a mirror, over time, you may not need a mirror as much.

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The more you've looked in a mirror, the less you need to look in a mirror because you're

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like, I know what I look like.

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However, you're changing over time.

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And so if the last time you looked at a mirror was 75 years ago, you've changed a little

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bit since that time.

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You were pretty cute and your face was really smooth and now it's not so smooth.

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And so you need a good mirror and that is someone reflecting to you the kind of value

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you create because what happens is that your value creation potential changes over time.

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The more career development opportunities you've gotten, the more career development

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awards you've gotten, the more grant opportunities you've gotten, the more grants you've written,

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the more value you can create.

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And sometimes you miss that and you really do need a good mirror.

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I had an opportunity yesterday to be a mirror for somebody yesterday who was just calling

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herself names.

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And after a while, I had to pause and say, I keep hearing you call yourself this name.

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Where does that come from?

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And it took her time to pause and to recognize that the name she was calling herself was

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the wrong name.

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What she was pointing to was the fact that she's a thoughtful person who likes to be

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prepared.

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It's not worthy of calling yourself a poor name, but it took me to be her mirror for

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her to recognize that what she was thinking of as a disadvantage was actually a super

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awesome advantage.

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You need a good mirror.

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And I offer it to you that you should get a coach who can be your mirror.

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Does it have to be a coach?

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It doesn't have to be a coach, but it does need to be somebody who is a coaching, who

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is in a coaching style.

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So sometimes people are like, oh, my mentor can do that.

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If a mentor is a coach as well, if they are coaching you as part of their mentoring, then

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they can be a mirror to you.

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But really, many mentors are kind of just reflecting themselves back to you.

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They're like, this is who I am.

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A lot of times around them, it's like, this is who I am.

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This is who I am.

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And they're pretty awesome.

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And if you do what they do, you'll do well.

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But your greatest value is becoming more of yourself.

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It's creating more of you.

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And that's why having a coach who reflects back to you because you need to improve.

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The goal of the coach is your improvement.

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You're playing a better game.

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And so mirroring you back to you.

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Maybe you have a good peer mentoring group where you coach each other.

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All I'm saying is that if you're going to negotiate value well, you need to have a good

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mirror to help you reflect the kind of value you create, especially as the value creation

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proposition changes over time.

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OK, I told you seven things, seven reasons you negotiate value.

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Everything is irrelevant until it can create value.

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Number two, the value negotiation depends on the one who can communicate it best.

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Number three, the value negotiation depends on painting a clear picture of the future.

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Number four, value negotiation thrives in the place of clarity.

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Number five, working with people who do not recognize value is risky no matter how much

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they can pay you.

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Number six, your job in the negotiation is to identify the understanding of the people

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with whom you're about to entrust your career.

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Number seven, if you're going to negotiate well, you need a good mirror.

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All right, those are the seven reasons to negotiate value.

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I'm excited to have brought to you Negotiation Mondays brought to you by Academics Negotiate.

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I hope you will share this episode with somebody else who needs to understand they're not just

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negotiating salary.

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They're not just negotiating money.

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What they're really doing is being clear about the value that they create.

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All right, it's been a pleasure talking with you today.

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I look forward to talking with you again the next time.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.