Ethan Nkana spent over a decade as a hospital executive negotiating contracts on behalf of health systems. He knew the inside playbook: how administrators calculated physician value, what mantras they used behind closed doors, and the quiet ways hospitals exploited physician professionalism. Then he switched sides. 

In this episode of How I Doctor, Dr. Graham Walker sits down with Ethan to explore medicine’s hidden business realities. From the stigma of being called “greedy,” to why the squeaky wheel gets the raise, Ethan unpacks how contracts are really written and how doctors can speak up without jeopardizing their careers. He shares the three buckets every physician should focus on - life balance, practice support, and fair pay - and the practical strategies that turn an uneven negotiation into a fair one.

He calls himself the “Jerry Maguire for physicians,” and in this conversation Ethan shares what every doctor needs to know before signing or renewing a contract.

What You’ll Learn in This Episode:

• Why “greedy” is a trap word and how to reframe fair pay as part of safe patient care
• The 3 contract buckets that matter most: life balance, practice support, and compensation
• What hospital executives really say behind closed doors about new physician hires
• Why the best physicians don’t always get paid the most—and who does
• Simple, non-adversarial scripts physicians can use to ask for what they need

Additional Resource for Physicians:

👉 Contract Negotiation Guide

 Before your next contract discussion, make sure you’ve gathered:

• Your actual weekly workload (clinical + after-hours documentation)
• Recent productivity metrics and patient satisfaction scores
• Evidence of non-revenue work (committees, teaching, outreach)
• Market data for your specialty and region
• A clear ask for at least one improvement in each bucket: life balance, practice support, fair pay\

Find out more about Rocky Mountain Physician Agency

Follow Ethan on Instagram at https://www.instagram.com/physicianagency/?hl=en 

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📝 For a full transcript of this episode click HERE

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