A short introductory paragraph extending a warm welcome to the potential employee is included at the beginning of the letter. This is followed by:

LOCATION OF EMPLOYMENT – If more than one hospital.

COMPENSATION – Base Salary plus Production – This includes the amount of the base salary per year and how it will be paid (weekly, biweekly, etc.). Production Pay includes the production percentage on what services (there can be several different percentages on various services depending upon the hospital) and how it will be paid.

ESTIMATED STARTING DATE

SIGNING/RELOCATION BONUS – This will include an amount, the date(s) that it will be paid and any stipulations as to why the candidate might need to repay it (i.e., the employee ceases to work for the hospital before a specified date).

TIME OFF – Paid time off and the option for unpaid time off. If the employee will be studying for boards, the amount of time allotted for this and the compensation during this time will be described.

BENEFITS – Brief description of what benefits are provided and for programs the employee is eligible for. Typically, a benefits summary is attached.

CONTINUING EDUCATION – A specified amount of money for continuing education programs and the time allotted. It is important to know if this is included in the PTO benefit mentioned previously.

DUES AND FEES – This will include an amount for dues and fees. Some hospitals delineate this as “discretionary funds.”

NON-COMPETE – This will include a length of time and a radius in miles by which you must agree not to compete with this employer.

• Prioritize what you would like to negotiate. Have an idea of where you would like to end up.
• Start with negotiating your salary first and then move on to the benefits, one element at a time.
• It is important to know that you usually cannot negotiate the entire job offer.
• Begin at the top of your predetermined salary range. Aim high, but be realistic.
• Remember that negotiation is about listening to each other and respecting the needs of both parties.
• Avoid demands, threats, and defensive behavior. The outcome should benefit both parties.
• Respect the other’s position. Make sure you hear them clearly.
• The tone should be conversational and not confrontational.
• Never give an ultimatum.
• Never back the hospital into a corner.
• It is best to take at least 24 hours to reflect upon the offer.
• It is best to negotiate over the phone, not via email.

• Always acknowledge that you have received the offer and thank them for it.
• Make positive comments about the hospital, the position, and the team.
• Highlight your enthusiasm for the position.
• State clearly what you have questions about in the offer. Provide insight as to why you would like to make the change(s).
• Negotiate one point at a time.
• Start with the salary.
• Reinforce the value you will bring to the company, the impact you will make and the potential revenue you will generate.
• If the hospital is reluctant to meet your salary request and you are still within your minimum range move on to other aspects of the compensation package.
• Be sure to include a few benefits in your proposal that are less important to you and that can be dropped as a concession to the employer as salary negotiations continue.
• If the employer cannot initially agree to your compensation requests you can discuss and agree on a guaranteed review within a specific time period, usually three or six months. This salary review should be stated in writing as part of the job offer.
• Know when to stop and consider the best offer on the table. To carry on beyond this point could cause ill-feeling and damage any future relationship. 
• Get the final offer in writing and make sure it is signed by the appropriate person who has the authority to make the offer.