Think for a moment about the importance of negotiation skills. You negotiate with your friends for what to do or where to go socially; you negotiate with hosts on the ‘rules’ while staying at their place of residence; you negotiate with a home seller on the price of a house and an auto dealership on the price of the car; you negotiate with your supervisor for a potential raise or promotion; and there are many more opportunities. You basically negotiate every day. Wouldn’t it be nice to come out of most of those negotiations feeling satisfied?

An article in the Journal of Internal Medicine Berman and Gottlieb examined job negotiations in academic medicine.The authors state that enhancing negotiation competencies are important for everyone, and perhaps even more so for women and underrepresented minorities. They cite evidence suggesting that these individuals experience disparities in compensation and access to resources that are important for professional success, and that inequities begin immediately upon entry into the workforce.

The authors provide examples of key negotiation principles, including: appreciative inquiry to understand rationale, challenges, and interest of the other party by asking open-ended questions; reflective listening to acknowledge the motivation behind the other party’s interests; identifying options for mutual agreement; referencing available evidence to underscore the importance of the decision; and obtaining agreement to continue to discuss. The authors hone these into specific competencies for job searching and selection. This includes networking to bolster your presence and creating an initial standpoint for negotiation based upon your competence and track record. They then discuss identifying the “ask”, which includes more than just salary, especially for autonomous health care professionals, and being assertive yet flexible around other facets that which you can build important aspects of your job. They describe identifying a “BATNA”, which is a Best Alternative To a Negotiated Agreement, in the event of struggling or failing negotiations. Doing so requires considerable knowledge of the marketplace and the job, thus underscoring the need to do one’s homework with an external and internal environmental scan.
Finally, when negotiating, it is important to give oneself permission and encouragement to do so. One can use the same sort of skills employed when negotiating with a patient in hopes of promoting changes in their health behavior. Separating the person from the problem is very important.

Mentors can help those who are uncomfortable negotiating salary. The authors recommend negotiating by person or by phone rather than through email, and if negotiation comes to a standstill, ask for a break. If at a loss for words, ask open-ended questions. Negotiations take time. It is better to arrive at a positive outcome than to rush to an undesirable end.

Pharmacists and pharmacy managers would be well served by learning some finer points of negotiation. Negotiation outcomes can mean the difference in a successful career, the engagement of your patients, and whether you are able to secure stakeholders in a new business venture or paradigm of care.

Additional information about Negotiation Skills can be found in Pharmacy Management: Essentials for All Practice Settings, 4e.
Shane P. Desselle, RPh, PhD, FAPhA, Professor of Social/Behavioral Pharmacy at Touro University California.


Berman RA, Gottlieb AS. Job negotiations in academic medicine: Building a competency-based roadmap for residents and fellows. J Gen Intern Med. DOI: 10.1007/s11606-018-4632-2.