Can market and social norms work to your benefit during negotiations? What are common mistakes to avoid? How do you determine your worth as a doctor?

Dr. Josh Daily, a pediatric cardiologist and program director, and Jillian Vestal, a licensed attorney who specializes in doctor contracts explain the struggle many doctors face during contract negotiation and how to equip yourself for more advantageous outcomes. Dr. Daily and Jillian share practical tips for doctors to utilize during this phase.

Here are six takeaways from this episode:

1. Physicians Often Enter Contract Negotiations Unprepared

Many doctors, especially those fresh out of training, lack formal education in finance or contract negotiation. They often accept initial offers without understanding their market value or the implications of contract terms, simply because the salary seems high compared to their training income.

2. Medical Culture Discourages Self-Advocacy

The hierarchical and altruistic culture of medicine discourages doctors from advocating for themselves. Trainees are conditioned to follow orders and avoid conflict, which makes it difficult to shift into a negotiation mindset when transitioning to employment.

3. Clarification Is Not the Same as Negotiation

Doctors should always seek clarification on contract terms, even if they’re hesitant to negotiate. Asking questions about unclear or inconsistent terms is not confrontational—it’s essential. Negotiation, on the other hand, involves requesting changes or additional benefits.

4. Understanding Market Norms and BATNA Is Crucial

Doctors need to understand both market norms (e.g., salary data, job availability) and their own BATNA (Best Alternative to a Negotiated Agreement). This helps them gauge their leverage and make informed decisions. For example, a rare specialty in a rural area offers more negotiating power than a saturated field in a competitive city.

5. Use Third Parties to Navigate Awkward Power Dynamics

To ease the discomfort of negotiating with mentors or future bosses, doctors can reference third parties—such as a spouse, mentor, or contract attorney—as the source of negotiation pressure. This helps preserve relationships while advocating for better terms.

6. Practical Details Like Schedule and Call Coverage Matter Most

While doctors often focus on high-level legal terms, the most impactful issues are often practical ones—like work hours, call schedules, and administrative time. Misunderstandings in these areas frequently lead to dissatisfaction and burnout.

Transcript

Josh Daily:

There’s tremendous research out there that clearly defines the things that really make us happy in the long term. And I would encourage all listeners to spend a little bit of time, read some of that literature and then structure a negotiation in a way that allows you to emphasize and prioritize the things that are actually likely to…

Michael Jerkins:

Dr. Palmer, I think today we have an amazing topic that we’re going to go over. It’s going to help a lot of us. And it’s really about how to handle employment contracts as doctors. I’m curious about your experience with your first employment contract outside of residency, because mine was a little rough. I didn’t really know anything. I honestly didn’t even know the right questions to ask. I did find an attorney that kind of knew, but it was stressful. Was that similar to your situation?

Ned Palmer:

No, because you were smart enough to find a grownup to help you. I did the DIY method, which was a terrible way to go. I left fellowship and stayed in the same division. So who am I even negotiating against, right? I’m negotiating up against my bosses who had been my fellowship directors for the last several years. So I was given a contract and just took it. I didn’t negotiate CME. I didn’t negotiate shift structure. I was given a rubric and just kind of… I don’t even remember the details. It was that inconsequential, but it has been the driving contract for the last four or five years of my clinical practice. So you did the right thing in paying attention to it and trying to find a grownup.

MJ:

So it is going to be great today to talk to not only a doctor who gets asked a lot of questions about employment contracts, but also an actual attorney who specializes in employment contracts. I have a lot of questions, Ned. I know you do too. So let’s get to the interview.

NP:

Let’s get to it with our friends Josh Daly and Jillian Vest.

MJ:

We are very pleased to welcome two fantastic guests today to the podcast For Doctors, By Doctors. First is Dr. Josh Daly, who is a practicing pediatric cardiologist at Arkansas Children’s Hospital and the University of Arkansas for Medical Sciences. He serves there as the program director for the Pediatric Cardiology Fellowship. He also co-directs a medical student course, Personal and Professional Financial Essentials for Physicians, which equips fourth-year medical students with the essential knowledge and skills to manage their financial futures. He and his wife, Lauren, are parents to four children, Will, Caleb, Abby, and Ellie, ranging in age from 13 to three. Dr. Daly, we’re very excited to have you on the show today.

JD:

I’m excited to be here. Thanks so much for having me on.

MJ:

And we also are joined by another guest, Jillian Vestal, who is a licensed attorney that specializes in doctor employment contracting. She received her undergraduate degree in public relations from Harding University and then earned her JD at the University of Arkansas at Little Rock. She previously worked in the office for former Arkansas governor Mike Beebe and then for the State Department of Health. After leaving the public sector, Jillian worked in government relations for healthcare clients and later as a staff attorney for a health system. In that role, she was involved in compliance matters, fair market analysis, and contract review, among other things. Jillian has reviewed contracts for doctors across the country and various specialties, helping them better understand their contracts and negotiate the best deal for themselves. Jillian, welcome to the podcast.

Jillian Vestal:

Thank you for having me, glad to be here.

MJ:

So we have lots of questions, Ned and I, on doctors getting jobs, doctors agreeing to contracts, or not knowing what’s in them. We have lots of ground to cover. But maybe Josh, if we could start with you, I’d love to hear about your story as a physician and the issues you had with negotiating your first contract or looking at your first job. Tell us a little bit about that.

JD:

Sure. Like many of the listeners, I went straight into college and med school without taking a single finance course. I became interested in finance toward the end of fellowship and read a little bit, but still didn’t know much. When it came time to look for a job, I had only a vague sense of what was out there. At Cincinnati Children’s, where I trained, I knew I wanted to return to Arkansas. I interviewed, had a great experience, and was told they’d send me a contract in a month. We never talked about salary.

A month later, I got an email with an amount listed. It was far more than I made as a fellow, so I was excited, but I had no frame of reference for whether it was reasonable. I asked for $5,000 more—somewhat arbitrarily—and they gave it to me. That was the extent of my negotiation. I jumped into the job and have loved it, but over time, I realized I missed some opportunities in that negotiation.

As I progressed, I learned more about how physician compensation works—particularly in academia, where pay is tied to academic rank and RVU productivity. At first, I didn’t understand how RVUs factored into my pay, and when I asked, my chief simply said, “Don’t worry about it, you’re fine.” That was the extent of the explanation. I had to Google and figure things out myself.

Over time, I read extensively, taught myself finance, and began teaching residents, fellows, and med students. Eventually, I became the course director for our finance course at UAMS and even published academically on these topics. Residents consistently asked me: What should I actually ask for? What’s reasonable in pediatrics?

Now, I’m often the go-to person in our hospital for reviewing contracts and helping colleagues understand what’s reasonable. I even track down institutional salary data that doctors don’t seem to have access to, and I share it with others. This path wasn’t intentional—it developed out of necessity, curiosity, and a desire to help others navigate contracts more effectively.

MJ:

That resonates with me. My first job out of residency was similar—I didn’t counteroffer. It looked like a big number, and I was thrilled just to be making money instead of being in training. Jillian, I’m interested in your perspective. With all the doctors you’ve worked with across the country, how does Josh’s story compare to what you usually see?

JV:

The first part of Josh’s story is what I hear most often. The second part, where he dove deep into finance and contract review, is much less common. Most doctors get a number, feel it’s great compared to what they made in training, and they sign without asking many questions.

Part of that comes from medical training culture—residents and fellows are used to doing what they’re told, not asking too many questions, and not wanting to be seen as difficult. So they sign the contract, then later they’re confused when compensation changes, or they don’t understand how to resign, or even where exactly they’ll be working.

When I work with doctors who haven’t signed yet, a big part of my job is unraveling the contract—helping them understand what’s in it, and showing them what questions they should be asking. Much of it comes down to empowerment. Doctors need to know that it’s appropriate and necessary to ask questions. They don’t have to be scared to ask for clarification.

NP:

That’s great, but how do you reconcile that fear? Pediatricians, in particular, may be some of the least aggressive negotiators, partly because of geography. For example, Josh wanted to go back to Arkansas, which meant UAMS was essentially his only option. In concentrated subspecialties, there just aren’t many choices. So how do you know where to draw the line—when to advocate for yourself versus when you might risk closing a door?

JV:

That’s a great question. First, it’s important to distinguish between clarification and negotiation. Doctors often worry about asking too many questions, but you should always clarify. If something in your contract doesn’t make sense, or doesn’t match your initial conversations, ask about it. That’s not negotiation—that’s making sure you know what you’re signing.

Negotiation is different. That’s when you ask for more money, changes in schedule, tail coverage, relocation assistance, and so on. And here’s what I emphasize: I’ve reviewed countless contracts, and I’ve only seen an offer rescinded once—and that was an extreme situation caused more by the employer than the physician.

The fear that “if I ask, they’ll take the offer away” is very common, but it’s almost never true. The worst-case scenario is usually that they say “no.” Of course, if they offer $300,000 and you demand $1 million, yes, they may walk away. But asking for a few thousand more, or different call coverage terms? They may say no, but they won’t usually pull the offer.

NP:

Yeah. I mean, I’d love to spend a few minutes talking about, frankly, some of the psychology of medical training. I know this is a thing that Josh and I have spoken about, Michael and I as well—of like, why are we poorly positioned for this specific moment? I think there are systems. I’ll use my own example, I use this one all the time. Our group renegotiated, and at a pediatric hospital we were told that if we pay you more, the children get less. So you’re up against trained negotiators who will use emotional manipulation and tactics against you.

But there’s certainly something about the field itself, and the training. Josh, I know this is something you and I have spoken about before. I’d love to hear your thoughts—are physicians in this position where they can be almost afraid to advocate for themselves?

JD:

I think there are multiple factors that contribute to that. Some of those are deeply embedded in the culture of medicine, in which there’s this belief that all doctors enter medicine primarily to help others—which is true—but that it’s inappropriate to think about our own self-interest, to advocate for ourselves, or to talk about money. The idea is, “Don’t worry, you’ll be taken care of—you’re really doing this for your patients.” And in our case, for the kids, which makes it even harder to argue.

So there’s some embarrassment about talking about these subjects. Even if it’s not said outright, the culture clearly suggests it’s inappropriate to ask. That gets reinforced by the hierarchy within medicine: as a trainee you are taught to do whatever you’re told—work a 24-hour shift, stay late, see an extra patient with a smile, don’t complain, don’t push back. You certainly don’t ask for more compensation.

Then suddenly you’re at the end of training. The same boss you’ve been indoctrinated to obey says, “Here’s this offer.” It’s a lot more money than you’ve ever made, and you feel no freedom to push back. That plays a huge role.

There’s also an interesting psychology that Dan Ariely proposed: the idea of social norms versus market norms. We all intuitively understand it, but it explains so much about why trainees feel uncomfortable asking for things.

For example, Michael—imagine you and I are in residency together and you need help moving. You ask your buddies, including me. I’ll come over and help. I’m not going to ask for a contract, hourly wage, or injury coverage. You’ll probably buy pizza, and that’s that. Later, when I need to move, I’ll ask you, and you’ll feel obligated to help. Reciprocity drives those social interactions.

But if you hire movers, that’s market norms: contract, hourly rate, insurance, and maybe a tip. Completely different rules.

Some situations are clearly one or the other. But job negotiations often sit in the gray zone—you’re talking with your boss, someone with whom you have a social relationship, but you’re discussing money and contracts. That tension makes it really uncomfortable.

You have to be intentional about which space you’re in, and avoid sending mixed signals. Companies often get in trouble when they say “we’re family” (social norms) but then treat employees according to contracts (market norms). That mismatch breeds resentment.

For trainees, navigating this gray area is critical. For example, if you’re negotiating with your mentor-turned-boss, you can lean into social norms: “I appreciate your mentorship—if you were in my shoes, what would you ask for?” That frames the negotiation within the mentorship dynamic and may even bring up things you hadn’t considered, like signing bonuses, funding for a degree, or other benefits.

That overarching lens of two different sets of norms really helps explain the tension—and helps trainees find thoughtful ways to negotiate.

MJ:

Those are great little life hacks—very practical ways to navigate awkward situations with former program directors or fellowship directors who suddenly become your boss. It’s super weird.

And it’s tough, because no one in academic medicine really teaches this. Most faculty don’t know it themselves. I’m curious, Jillian—do you see differences between physicians straight out of training versus those mid-career? Are the latter more comfortable negotiating? Have they broken some of those habits?

JV:

I wholeheartedly agree with what Josh said—he explained the tension so well. I do see a lot of doctors later in their careers who’ve learned more about the process—sometimes the hard way. They’ve been burned: maybe they believed “we’re all family here,” only to discover when something went wrong that they weren’t. Or they trusted a verbal assurance that didn’t make it into the contract.

So yes, many mid-career doctors have learned, sometimes painfully, to be more careful. But ironically, if they’ve always been treated well, they may not be any better prepared for their next negotiation.

I often hear: “The contract says 40 hours per week, no protected admin time—but my program director told me I’d have eight hours.” And they struggle with going back to their mentor and saying, “I need that in writing,” because it feels like mistrust.

That tension is very real. I really like Josh’s approach—asking mentors how they’d handle it, making it conversational. I give similar advice: don’t go in guns blazing. Sometimes doctors overcompensate for their uncertainty and come across too aggressively.

Instead, treat it as a conversation. For example, instead of demanding a signing bonus, explain: “I’ve got a lot of moving expenses and family costs—does the hospital offer anything to offset that?” Even if they can’t provide a signing bonus, they may offer relocation assistance, loan repayment, or other programs you wouldn’t know about otherwise.

It’s about expressing your needs and letting them meet you halfway, rather than handing over a list of demands.

MJ:

And Jillian, since you’ve worked in health systems, can you give us a glimpse behind the curtain? Where do employers typically have flexibility, and where do they hold firm?

NP:

I’ll just say—you’re already in the top 1% of physician negotiators, Josh.

JD:

Thanks for that.

MJ:

But seriously—most of us as doctors don’t know what’s negotiable. You’ve seen it from the other side. Where’s the wiggle room?

JV:

Well, Josh, I can tell you they were thrilled when you only asked for $5,000. That’s very modest. Employers usually expect some negotiation, and there’s often low-hanging fruit.

A common mistake doctors make is dismissing the recruiter. They think, “This person can’t do anything—I want to talk to the real decision-maker.” But that’s a big error. Recruiters want the deal to work, and some of their pay may depend on it. They can advocate for you and often approve things directly—like relocation bonuses—without escalating.

It’s also important to understand the type of practice. In private practice, you’re not going to get protected research time. At an academic center, you probably won’t see a collections-based bonus. Sometimes doctors just don’t understand what’s realistic in different contexts, and that can hurt their negotiations.

The market matters too. If you’re one of many pediatricians applying to the same city, you’ll have less leverage. If you’re a specialist heading to a rural area, you’ll likely have far more room to negotiate—maybe even significant incentives.

Understanding the employer’s environment and what’s typical for that practice setting is crucial before making asks.

JD:

You have to know what you’re worth. And I don’t mean what your mom says, or what you feel like you provide, or that you’re a really caring or compassionate pediatrician, or that you made certain grades in school. I mean what you’re worth in the market. You need to know the normative salary data, the knowledge and skills you bring, and the income that generates. A realistic understanding of that is critical, because your negotiation approach depends on where you fall on that spectrum.

For example, in pediatric cardiology, if you’re a cath doc coming out and there are only two jobs like yours in the nation, you have almost no room for negotiation—you take what you’re offered. Conversely, if you’re a heart transplant/heart failure specialist and there are 25 jobs available, you have tremendous room to negotiate.

This illustrates a principle called BATNA—best alternative to a negotiated agreement. In any negotiation, the party with the stronger BATNA has more leverage. If I’m committed to returning to Arkansas and there’s only one pediatric cardiology group, I have a weak BATNA. The employer, however, might have multiple applicants—a strong BATNA on their side. Knowing where both sides fall helps guide negotiation strategy.

From a poker perspective, know the quality of your hand. A strong hand? Play confidently. A weak hand? Play differently. Many physicians, especially men, tend to overestimate themselves and negotiate aggressively even without a strong BATNA—they risk losing out. Conversely, if your skills are rare and you undervalue yourself, you leave money on the table. Recognizing your position, and the employer’s, informs how to approach negotiations.

JV:

I worked with a physician about a year ago in a specialty that isn’t scarce. He was very specific about location, and there was only one employer hiring there. He disliked the restrictive non-compete. He kept asking, “What can I do?” I had to have a hard conversation: there aren’t many options—either sign this contract or find another job elsewhere. You have to understand the market and your realistic options.

MJ:

What can I do?

JV:

Exactly—delivering that news is hard, but it’s important. Market context matters—even a small metro area requires understanding availability. Otherwise, you risk walking away with nothing to fall back on.

NP:

There’s often a disconnect among physicians themselves. For example, in the match, submitting only one site was considered risky. Years later, the same physician expects a full package with little competition. It’s a structural disconnect—“I’ve arrived, now shower me with rewards”—which isn’t realistic, especially in uncompetitive specialties.

Josh, you emphasized understanding the current job market, and Jillian, you highlighted knowing your worth. Those are two separate data sets. Where do you get market analysis, and where do you get data to understand your own value? How can a doctor know their worth to a health system?

JD:

Speaking as an academic pediatric cardiologist, there’s a huge asymmetry in access to data. In my field, the primary source is AAAP salary data—used by most pediatric hospitals—but you can’t Google it. Only institutions have it. I had to call and “harass” my institution to access it. On the other side of negotiation, higher-ups already have this data—most trainees don’t.

Every specialty has its own data set. Glassdoor or Medscape provides limited info, but primary sources are specialty-specific. That’s where someone like Jillian is invaluable—she knows what’s reasonable and reliable in your situation.

JV:

I agree. Having an experienced reviewer is crucial. Surveys exist for every specialty, but the data isn’t readily accessible and is often complex. For example, total compensation varies—what’s included in benefits, valuation, etc. This data is a starting point, not the answer.

We look at factors that adjust compensation up or down. Collections? Median collections matter. RVU or production targets? If they’re far above the 90th percentile, that’s a red flag—are others in the practice meeting it, or is this unrealistic? Data helps identify those nuances.

Knowing your own worth also involves job-specific factors. How long has the role been open? A GI doc being recruited for 18 months is more valuable. Are you opening a new service line? Serving as medical director? Supervising mid-level providers? Bilingual or experienced with a large local demographic? Those add value. You need to combine market data with your unique contributions to set expectations.

MJ:

That’s a great point—we’re more than a spreadsheet. Many colleagues look at only one opportunity, not comparing offers or even talking to recruiters. Going back to BATNA: one job, no fallback, no leverage. Not only is data hard to find, but not having alternatives limits negotiation. Josh, do you see that in trainees?

JD:

Definitely. There’s a broader issue: effective forecasting error—we do a poor job predicting what will make us happy. We accurately predict valence—happy or sad—but poorly estimate intensity and duration. In choosing jobs, we overemphasize passion: “If I do this one thing I love, I’ll be happy.” But the research on long-term satisfaction—using self-determination theory—shows three primary determinants: autonomy, competence, and relatedness.

Autonomy: control over your job. Competence: meaningful work in a domain aligned with your skills. Relatedness: quality of relationships. Trainees often undervalue the latter. I encourage focusing on skills and negotiations that prioritize those three elements.

For example, at a recent convention, a fellow was focused on a niche pediatric cardiology role in San Francisco. She didn’t know how many jobs existed or compensation structures. We discussed ensuring her echo skills were marketable to supplement palliative care work. Training rarely provides this perspective. Medicine emphasizes evidence-based practice, but rarely evidence-based career decision-making. There’s plenty of research on what contributes to long-term happiness—trainees should read it and structure negotiations accordingly.

JV:

So on a really practical level, I have seen that play out so often and where I see it most frequently is around the schedule. I’m talking to these people who, you know, a lot of them have just finished training and they have put years and years and more dollars than I want to think about into all of this effort. I’m like, okay, so how many hours a week are you going to…

And they’re almost offended. They’re really taken aback. And like, that’s not what this is. And everybody pitches that. And I hear all of these things: “Well, what about Paul?” “Well, I think it’s probably only going to be X, Y, or Z.” They just have all of this fake language about it. And I tell them so often, this is going to be the thing that matters to you. You think you’re going to have every Friday off.

If you get there and you don’t, you’re going to be really upset about it. If you think you’ll have one weekend a quarter and that becomes one weekend a month of call, that affects your quality of life. And nobody wants to talk about it. It’s not sort of the interesting, deep, meaningful contract negotiation issue, but it is so frequently the thing that really gets people hung up. Because then on the other end they come back to me and go, “I’ve got to get out of this job, I’m taking call all the time.” Okay, well, what did your contract say about that? “Well, it just says I’ll take call when they tell me to.” Okay, well then we could have avoided this, right?

So, you know, it’s absolutely true that everybody kind of wants to go after these big lofty issues: “I want to talk about indemnification.” Okay, great, I see that. A schedule matters a hundred times more than I see indemnification matter in a contract. Not to say that they’re not both important issues, but it’s those really nitty-gritty day-to-day things that are going to matter. And I have a hard time convincing people to care about those in their contract.

MJ:

Well, I think about, Josh, what you said about passion, follow your dreams. No one really writes their med school, dental school, or vet school application thinking, “I want to make a really good salary and find meaning.” And those three things that you mentioned, I don’t think would get you into any school. To a degree, okay, we obviously care about what we do. We care about patient care. Otherwise, we probably wouldn’t do this. But at the end of the day, it is a job—you need to perform a duty or task and get paid for it.

So there’s aspects of that you have to navigate. And I think that goes back to a couple of things both of you have said: One, we’re not used to doing this. Two, we feel guilty because if we treat it as a job market norm, then that might not be looked upon well within our training program, because this is a passion, not just a job. And if you ask those questions, it’s not necessarily going to be looked upon favorably and could be used against you later when asking for a job at that same institution.

I just wanted to say something to you, though. You talked about specializing in internal medicine, and I just want to tell you that I think you’re special, and I think MedPeds is special. I don’t want that to get lost on our listeners.

NP:

Integration. That’s… I mean, you mentioned earlier that it’s what our worth is now. Well, my mother thinks my worth is not what Michael thinks my worth is. I need an objective data set here.

JD:

Tell them that Michael said you were special.

MJ:

Something, hopefully.

NP:

I want to go back to some of the negotiation tactics because you mentioned BATNA, which is a great one. We talked about adding other things to the negotiation pot and not getting stuck on any one thing. But how specifically can you negotiate the challenges of that awkwardness? If you’re a passionate, driven individual negotiating with somebody who’s been variably a boss, mentor, or disciplinarian. How do you negotiate that awkward dance between social norms, market norms, and the hierarchical structure of medicine?

JD:

One is difficult, but there are a couple of specific techniques you can employ. One in particular is to utilize a non-present third party and basically blame things on them.

NP:

We bring Jayco into the conversation and blame everything on them, right?

JD:

Or what’s often the case is you can bring your spouse into the discussion. Say, “I’d love to stay here. This would be a great fit for me. If I come home and tell my wife that I took this job at the 25th percentile, she’s going to kill me.” That’s a reasonable request in the social norm category. You’re not saying, “Hey, this is ridiculous, why are you making me this offer?”

So you could utilize a spouse or even better, someone like Jillian. You can hire someone like Jillian who can give non-biased advice from a place of knowledge and expertise. Then you can come to your boss and say, “I really want to stay here. However, Jillian, who has reviewed everything for me and is really an expert in this space, has said there is no way I should take this offer. That it would be inappropriate for me to do this.” You maintain your relationship while blaming a third party. That’s one of the greatest benefits of hiring someone like Jillian.

JV:

And I tell doctors that a lot: make me the bad guy. I am more than happy to be the one, like you said, to tell them, “You can’t possibly sign it without asking for a signing bonus,” or whatever that looks like. Having somebody review your contract not only gives you more information, but also gives you a cover to say, “Hey, this person’s really kind of forcing the issue here, and I’ve got to dig deeper.”

JD:

One of the things I do as a mentor is I let trainees blame me because most of them aren’t hiring someone like Jillian. So I tell them, “Say you talked to Dr. Daley,” everyone knows I’m kind of the finance expert, “and he said you have to do this. It’d be ridiculous not to.” And if they’re going to their boss, and I’m their colleague and mentor, that’s understandable within the social domain.

There’s a related principle worth mentioning: if you make a request and have any rationale for it, you’re far more likely to receive it. Even if the rationale is only loosely related, don’t just ask for $5,000. Come up with a rationale, e.g., “I just had my second kid, moving down there, a lot of additional costs. Would you increase my salary by $10,000?” It’s more likely to be received, especially in the social norm category, than just saying, “I want more money.” Couple a request with a rationale, based on data from Jillian or unique personal variables.

JV:

It also shows you are educated about it. When you say, “I’ve talked to Dr. Daley, or an attorney, and this is what they suggest,” it signals you understand what’s going on. “This $10,000 signing bonus is low, we need to up that,” or “You’re offering the 25th percentile—that’s a no-go.” Employers are aware of these imbalances and willing to use that to their advantage. This shows you’re doing your due diligence.

NP:

It changes the level set of the game, who they approach, and how. I like the non-present third party idea—it’s brilliant. What is one thing you’ve changed your mind about recently?

JV:

That’s tough and not one a lawyer likes to answer. Recently, I’ve changed my mind about the future of non-competes. Earlier this year, the FTC issued a rule essentially doing away with non-competes. That immediately was challenged in a couple of states. I was convinced we’d see a big shift, but that rule has now been enjoined in one federal district court, under review in another. Looking at the opinions and Supreme Court rulings, I now think it’s not going to happen. Unfortunately, non-competes will be around a little longer.

NP:

We could do a whole other episode on non-competes in healthcare.

JV:

Absolutely. Probably need another episode. They’ll be around a lot.

NP:

Josh, how about you?

JD:

The area I’ve been humbled and changed my mind the most is parenting. Looking back at the version of myself from 10 years ago, I would have judged my current approach harshly. Recently, the book Anxious Generation influenced me, particularly thinking about my 13- and 10-year-olds. We’ve been far too risk-tolerant in the virtual space and too risk-averse in the physical world—letting them play outside, walk to school, handle minor physical risks. It’s painful sometimes, but essential for development. Meanwhile, I hold the line on devices and internet access. It’s an evolving area.

MJ:

That’s excellent. How much do we let information influence our opinions? I love hearing that from both of you. Josh, where can people learn more about your work in personal finance and educating doctors?

JD:

You can email me, or Google my name and UAMS. I’ve written academic articles, searchable on PubMed. At the moment, our course materials aren’t publicly available, but I hope to change that soon.

MJ:

Jillian, for doctors needing contract advice, how should they find you?

JV:

Email me at [email protected] or visit Panacea.Legal. You can fill out a form to get more info or sign up for a review.

MJ:

Awesome. Thank you both for joining us. Really practical, hands-on information. I wish I’d known this coming out of residency.

NP:

I wish I’d had access to this information or people like Josh and Jillian to answer these questions. A world where I didn’t know what I didn’t know—I love this conversation and the tangible takeaways for doctors navigating new jobs and negotiations.

MJ:

Josh is a go-to for his program, but he can’t go through every contract for everyone. It’s nice to couple that with someone whose vocation is contracts law.

NP:

Josh has expertise from hundreds of contracts. Jillian has seen thousands. Specialists are needed—someone understands pediatric cardiology nuances, someone else understands contract law across 51 states. The marriage of those perspectives is invaluable.

MJ:

The more information doctors have, the better decisions they make, the happier they are, and the better care they deliver. There’s a big power dynamic with employers and information asymmetry. Specialists help bridge that gap.

NP:

Absolutely. Thank you, Dr. Daley and Jillian, and thanks to all listeners for joining us.

MJ:

We’ll see you next time.

NP:

You can catch For Doctors by Doctors on Apple, Spotify, YouTube, and all major podcast platforms. Please rate and subscribe so you don’t miss an episode. Next time you see a doctor, maybe prescribe this podcast. See you next time.

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