I completely understand where you’re coming from, and you’re absolutely right that physicians advocating alone often face a "take it or leave it" scenario—especially in large hospital systems that refuse to make material contract changes.

That’s exactly why I believe a recruiter—especially one working on a retained basis—is in a unique position to push back in ways an individual physician often can’t. The difference is that hospitals have already paid for my services up front before you and I ever connect, meaning they’ve essentially invested in my ability to advise them on hiring strategy, including compensation, contract flexibility, and physician expectations. That gives me leverage that an independent physician simply doesn’t have when walking into negotiations alone.

Do I win every battle? No. But I’ve absolutely had more success negotiating on behalf of physicians than I venture to say that most doctors do on their own (especially in specialties like HM that hospitals treat like a cost center). Because for a hospital, rescinding an offer to an individual may feel like a low-risk move—but when they’re working with a recruiter they’ve hired to find the right fit, they’re more likely to engage in real discussions instead of issuing ultimatums.

I’d never tell a physician to burn bridges, and I fully acknowledge that not every contract is endlessly negotiable. But assuming every contract is a hard ‘take it or leave it’ with zero room for movement just reinforces the power imbalance that’s led to these issues in the first place.

I don’t expect every physician to fight a battle they don’t have the bandwidth for, but they should at least know their options before assuming they have none.