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Notes on Negotiation

Negotiation is not just for business people. As a skill, the ability to reach agreements affects every area of your life. It’s about more than just persuasion. It’s about understanding the wants and needs of the other party and reaching a win-win solution, if at all possible. For this reason, negotiation is an important non-technical skill in healthcare. In fact, a 2017 White Paper from the US identified negotiation skills as one of the five key interpersonal skills needed for an effective healthcare culture.

Negotiation is rarely taught formally at medical school, so this week we’re giving you a run down of some basic concepts in negotiation. Of course, some of this will come naturally, particularly if you have experience managing teams or working in groups, but knowing negotiation first principles and theory will help you upskill quickly.

Communication & Building Trust

Much like lots of other non-technical skills, like teamwork and leadership, effective communication is important for negotiations to be successful. The key is to ensure that you avoid confusion by being clearer than you think you need to be. Subterfuge and complicated messaging could break down trust between parties and lead to negotiations failing.

Building trust between parties can help facilitate negotiations. In short term relationships, it may be tempting to break trust in order to secure gains for your party. But particularly in settings like healthcare, long term relationships matter. Read more about how you can use social dynamics to help build trust when negotiating here.

Practicing active listening can also help build rapport between negotiating parties.


This stands for best alternative to negotiated agreement. This is the best outcome that can be achieved if the negotiations are to fail and an agreement not be reached. It’s important to identify your BATNA, preferably before you enter negotiations. If you can take any measures to improve your BATNA, these should be done before you start negotiating. Making sure you start from the best possible position gives you negotiating power, as the other party will know that you can walk away from negotiations and not necessarily be worse off.


ZOPA stands for the zone of possible agreement. This refers to the overlap between negotiating parties’ priorities. For example, if Party A has a product they would like to sell for between £500 and £1000, and Party B is willing to pay up to £700 for the product, the ZOPA is between £500 and £700.

Understanding your opposite parties’ ZOPA and other priorities allows you to come to the negotiating table with a realistic idea of the best outcome that can be negotiated for both parties.

“If you want to learn about negotiation, talk to a five year old” – Johann Malawana, CEO Medics.Academy


Anchoring is the concept that the first offer on the table becomes the reference point for subsequent offers.

Negotiating parties need to be aware of this, as by making the first offer they ‘anchor’ the idea of that particular set of circumstances as the information from which the rest of the negotiation stems. By making too low an initial offer, you can undersell throughout the rest of the negotiating process.


Concessions are extras you are able to offer in addition to your main offer. For example, you may be able to offer the opposite party access to services as well as a financial offer – to ‘sweeten the deal.’ Concessions should be discussed and agreed by all members of the negotiating party before negotiations start.

Negotiating in teams

Negotiating in teams is well established, particularly when brokering larger deals, like the recent Junior Doctor Contract negotiations.

Effective negotiation in teams requires intimate knowledge of the skillset of each team member, and the allocation of tasks based on these skills. Importantly, roles should stay consistent throughout the negotiation process.

Further resources

  1. Getting to Yes: Negotiating an Agreement Without Giving In by Roger Fisher and William Ury

  2. Thinking, Fast and Slow by Daniel Kahneman

Do you feel your negotiation skills could use developing? Do you think a structured training course on negotiation skills targeted to healthcare professionals would be useful for you? Medics.Academy is partnering with Christer Mjaset to produce a course on negotiation skills for those working in healthcare.

For now, take a look at our Human Factors course, which outlines the non-technical skills that are needed to build effective healthcare teams.


About the Author

Anna Harvey is a final year medical student and Medics.Academy Fellow. She is interested in women’s health, education and journalism. You can find her tweeting about writing, music and running at @a_c_harvey

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