Negotiating the Employment Contract
Negotiating an employment contract doesn't have to be a battle. If you feel as if you are about to engage in an adversarial process, then you are approaching it all wrong. Employment contracts shouldn't be viewed from a perspective that leads to a winner and a loser. In fact, the hallmark of a successful negotiation is that neither party will receive everything they want. So stop feeling as if you are going to war, and change your framework to an expectation that negotiating will simply be the act of coming to an agreement on your employment terms.
Your employer is not your enemy, and when they are hiring, they want exactly the same thing as you want: a reasonable and fair deal that works for both parties. Reputable employers won't try to take advantage of you. Employers want their employees to feel valued, and so most initial offers are going to be fair. If a prospective employer delivers an offer that is clearly out of line, you should understand it says more about the employer than it does about you. It doesn't bode well for your future job happiness when low-ball offers leave you feeling undervalued and insulted.
Large healthcare organizations have set salary schedules that apply to all employees across the board. Great effort and research has gone into determining the pay ranges based on job description and experience. What you must understand (and accept) is that an employer is not going to toss aside the pay scale they use for all their clinicians in order to hire you. Forget about it; it's not going to happen. There may be some small amount of wiggle room to negotiate into the upper end of the pay category or range you fall under but don't expect to have an employer agree to paying you a starting wage that is in the same category as someone who has been with the organization for years.
Salary is just one piece of the compensation pie. While there may not be much wiggle room as far as your wage, employers often have much more flexibility when it comes to your benefits package. I don't mean the price you pay for health insurance—by law, employers are prohibited from offering employee-specific rates on their healthcare. But it does mean you will have better luck when it comes to negotiating additional vacation, CME, or other benefits. These all add value to your compensation, too. I suggest you start thinking about what non-salary perks are most important to your job satisfaction now. Consider asking for reimbursement for your license or DEA fees. You might also ask for some funds to cover your membership in your state and national organizations.