Using your BRAIN to negotiate with the doctor

Two of my most common refrains on negotiation are these: Much of life is a negotiation, and a negotiator’s success depends on what they do before negotiating. These two conclusions come together in a common negotiation we all face routinely: a trip to the doctor’s office. Simply put, understanding a doctor’s visit as a negotiation and preparing for it accordingly can make life negotiable.

But wait—why’s a doctor’s visit a negotiation? Because anytime we depend on others to achieve our goals, we’re negotiating. Since we surely depend on the doctor to achieve one of our most important goals—our own health—it’s a negotiation. And if a doctor’s visit is a negotiation, then you need to prepare for it for the same reason you’d prepare for any negotiation: because much of the outcome is predetermined by how well you understand the situation beforehand. But here’s the good news: the same acronym you’d use to prepare for any negotiation—BRAIN—applies to a doctor’s visit in spades. To see why, let’s consider each of the five letters in turn:

  • B=BATNA (best alternative): What’s your alternative to this particular doctor if you don’t get a satisfactory diagnosis or treatment? Seek another doctor, thereby spending more money, taking more time, and generating more incomprehensible bills in your mailbox? Unless you’re seeking to solve a serious medical issue, that doesn’t sound like a very attractive BATNA. So you’d better do what you can to achieve your objectives in this visit.
  • R=Reservation price (bottom line): What’s the least satisfactory outcome you’d accept from this doctor before seeking out another? If he or she suggests watchful waiting instead of active treatment, will you consent? If he or she is too busy to offer an adequate answer to your most important question, is that gonna work for you? Either way, you’d better ask beforehand to avoid walking out in a state of severe dissatisfaction.
  • A=Aspiration (goal): What’s the best possible outcome you could hope to obtain from this visit? Are you shooting for a particular medication, referral, or treatment plan? You need to know beforehand because the doctor may not think of it or be motivated to offer it unless you ask.
  • I=Interests (underlying motivations): What do you fundamentally need to achieve from this visit? Is it really the specific medication, referral, or treatment plan, or are you ultimately seeking to fix the aching shoulder, wobbly ankle, or elevated blood pressure? It’s important to keep your focus on the underlying problem rather than the surface-level solutions, as the doctor may well offer an even better solution. If so, you should probably listen rather than sticking slavishly to a suboptimal solution.
  • N=Negotiation counterpart (the doctor): How’s the doctor likely to answer the preceding questions? In particular, what’s their alternative to you? Probably to see the next patient. And what’s their bottom line in response to your requests? They’d probably refuse to offer you something risky, ineffective, or likely to require undue effort on your part or theirs. And what does the doctor hope to achieve in your visit? Probably to reach a quick diagnosis and make a simple recommendation that helps you our immensely. And finally, what’s the doctor’s underlying interest? For good doctors, hopefully to make you as healthy as possible. So you see, by putting these answers together, that the doctor surely wants to help but probably prefers to do so not just effectively but efficiently. And that should you immensely in framing your requests.

So visiting a doctor is not so different from buying a car or negotiating a raise. In all cases, you need something important from someone else. And in all cases, using your BRAIN beforehand is critical to achieving your objectives, be it fancy wheels, a fat salary, or a healthy you.