Close the Gap: Negotiation Skills For Women in Cardiology

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Over the past year, workplace inequity across many American industries has become a topic of national conversation. Gender disparity in medicine is becoming increasingly exposed, and cardiology has not been exempt from this spotlight. A recently published article in the Harvard Business Review outlined how a woman's requests for professional advancement is treated differently than a man's request. Inspired by the mounting evidence regarding gender differences in professional negotiation, the ACC Women in Cardiology (WIC) Pennsylvania Chapter hosted a free dinner program in Philadelphia entitled Close the Gap: Negotiation Skills for Women in Cardiology.

Smita Mukherjee, PhD, MBA, opened the evening with a primer on successful negotiation tactics. She encouraged attendees to abandon the concepts of "soft" and "hard" negotiation and instead embrace "principled negotiation," an approach popularized by the book Getting to Yes by Roger Fisher and William Ury. Principled negotiation includes four fundamental tenets:

  • Separate the people from the problem: Separate issues from ego to proceed without damaging personal relationships. Negotiators should try to understand the other party's viewpoint, avoid reacting emotionally or placing blame, and think about the long-term implications.
  • Focus on interests, not positions: Define the negotiation problem in terms of both parties' underlying interests. Negotiators should clearly explain their interests in a solution-focused manner and understand why the other party holds its position.
  • Invent options for mutual gain: Think broadly and creatively about the options on the table instead of being fixated on a single solution. To reach a mutually agreeable solution, focus on shared interests and identify items that are of low cost to you and high benefit to them.
  • Use objective criteria: Employ criteria such as legal precedent, scientific evidence and industry norms. Understanding market forces, existing salary standards and reimbursement structures could help a cardiologist achieve her negotiation goal.

Mukherjee then outlined the concept of BATNA, or "best alternative to a negotiated agreement," also coined by Fisher and Ury. BATNA is the course of action that a party engaged in negotiation will take if no agreement is reached. Mukherjee recommended being realistic and creative about your own BATNA and aware of the other parties' BATNA to maximize success. Female cardiologists should not focus solely on negotiating the base pay and instead consider benefits like administrative time, research time or funding, continuing education support, leadership titles, bonuses, housing, spouse employment search support, children's education support, and flexibility to work from home.

After the didactic portion, panelists Ritu Thamman, MD, FACC; Meryl S. Cohen, MD, FACC; Monika Sanghavi, MD; and Joyce W. Wald, DO, FACC, shared their personal experiences in negotiation and gender inequity in salary and promotion. I emceed the discussion using an online platform through which attendees submitted questions for the panelists in real time. Fellow and faculty attendees from academic, integrated and private practices chimed in throughout the hour, making the discussion interactive and representative of diverse perspectives.

The event also provided a rare opportunity for local female cardiologists to network and engage with new mentors and sponsors. We received tremendous local and national feedback about this inaugural topic-based WIC workshop and are already planning our next event for the ACC Year of the Woman.

This article was authored by Nosheen Reza, MD, adult cardiology Fellow in Training (FIT) at the University of Pennsylvania in Philadelphia, PA.