My first yearly salary as a medical resident was $21,000. I was training in the government system and didn't receive any payment for the first three months, although I was working 90-hour weeks. As soon as I had a few minutes to inquire about a higher salary, the government employee I spoke to laughed at me, saying: “Doctors are rich people, I know you will be fine till you get your first paycheck.” I was speechless. My husband and I were young doctors with two young children and we were living paycheck-to-paycheck while working hard.

Fast forward. I completed residency and went on to do a fellowship at the National Institutes of Health, where I stayed for a total of four years. The benefits of being a clinical researcher gave me expertise but not money in my pocket. I lived on a federal paycheck for the remainder of this time—with additional benefits as an officer in the US Public Health Service.

I was hired by a private company upon moving to Florida, was offered a nice salary (more than twice what I was making at the time), and didn't negotiate anything: I took what I was offered. I was glad to have received a generous salary with stock options. It was more than I had ever imagined. In the end, that job didn't work out and I had the opportunity to go into the pharmaceutical industry just four months later. They offered me about a 30% increase and stock option, which I also took with a smile on my face. 

My first performance appraisal came within a year. My boss was very happy with my performance and offered me a 15% salary increase. I later learned we were ranked for the increases and it was rare to receive two-digit salary increases within the company culture. I didn't negotiate the increase; I was just grateful for it. 

So far, my behavior was not unusual for a woman in business. Later, I learned that most of my colleagues had negotiated their initial salaries and salary increases. I rationalized that I hadn’t negotiated because I was very pleased with the initial offer. I honestly thought it was fair and I was happy.

The company almost quadrupled the group within a year. During my second appraisal, my boss appeared a bit more hesitant about offering me an increase. It was a weird interview. He kept pointing out the wonderful things Gaby had done as if Gaby was someone else… I came back to him with a list of my wins for the year and the value these accomplishments brought to everyone. Convinced that I had earned it, I received a second two-digit salary increase on year two.

That was my last employment. Since then, I’ve worked as a consultant, either charging hourly for my services (as a government subcontractor, for example) or per value of the project (for-profits). In the span of twenty years, I’ve experienced diverse opportunities to charge for the value of what I may bring in exchange for my best work. Sometimes this is hard. Doctors and Medicine have become a commodity so while the public feels we should charge for ten minutes of our time, how can we put a dollar value for saving someone’s life, even if I say something that made them change their mind and it took one second of my time?

The more experience we have, the more seamless the process, and the faster we’ll help resolve just about anything.

How can you negotiate your salary or business opportunities more effectively? 

1. Realize that you may be grossly undercharging: I like to advise people to mind their own business and to dismiss what others are charging for their services. Stop thinking of what you are doing for the other person but, instead, think of the positive results you are enhancing for them and for their organization. For example, if someone is extremely stressed out or burnt out and you bring them back to a state of peace, health, and wellness (my area of expertise), and these people can lead more effectively, make better decisions, generate more business opportunities, and make more money, think of that bigger picture rather than that “all you did” was suggest that they start exercising.

2. Be grateful for what you were offered if you feel satisfied, and avoid others’ criticism that you should have negotiated more, or that you accepted too fast, or that you were cutting yourself short. As in dating, if you are attracted to someone and that someone invites you out, your best bet is to say yes rather than think that someone more attractive or someone “better” may come along.

3. Give yourself time if you are in doubt: Many people think they have to accept immediately after an offer. This is true if the offer is great and you’ve been negotiating it for a while. If the offer is way below your expectations but you don't feel you are ready to discuss it yet, say you want to think about it and respond within a day. Reflect what you like or dislike about the offer and bring in a counteroffer if you are interested in the opportunity but want to fine-tune it. Keep it simple; there should be one to three points to discuss.

4. Don't ask for a raise too often: When people are unhappy with their salary—or work—they may ask for small raises instead of negotiating their desired ideal. When you ask for a raise too often, you lose power and may appear needy or clingy. Instead, when you come up with your ideal salary or benefits and bring your self-confidence to play, you gain power and assertiveness.

5. Think your strategy through prior to your negotiation: There are times when you won’t know the salary or benefits offered. Make sure you agree on the work first: What is expected from you? What’s your level of interest? What’s your level of competence? Once you both feel that you could partner and collaborate, then talk money. Money-talks should follow learning about one another, learning about the job itself, and learning about overall expectations and goals.

About the Author

Gabriela Cora, M.D., M.B.A.

Gabriela Cora, M.D., M.B.A., hosts Dr. Gaby's Take: Make Life Interesting. She’s a medical doctor with a master's in business administration.

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