How to negotiate your contract, like a boss.
Now that I’m entering the double digits of my graduation countdown, it’s time to start planning for the rush of things about to come. Finding a job, studying for the PANCE, passing the PANCE, actually being a real PA. It hit me the other day, there is A LOT happening in the next few months. I have been waiting to have my “big girl job” for so long and it is finally about to happen. But what actually happens once I get offered a job? I have never had a professional job or contract. I have never had to negotiate a salary or benefits. I realized I know nothing about the process and it’s time I figure it out.
So you got a job offer. AMAZING! Now what??
I reached out to Savanna Perry of The PA Platform to see if she had any advice about the process. She was so gracious in answering some questions for me and I wanted to share them with you. While this is tailored to PAs and practitioners, most of the information in this guide also applies to non-medical professionals!
- Should you have a lawyer look over your contract before signing?
This can be controversial, and you will find PAs who would definitely say yes. My opinion is you only need a lawyer to review the contract if there’s a part you feel could be unfair or illegal. If you have reservations, it’s better to address it before you sign. An example would be a non-compete clause, which is a requirement stating if you were to leave the position you wouldn’t be allowed to get a new job in the same field within X number of miles. This is usually seen as unreasonable, and in some states it is not legal and could not be upheld. If you do have a lawyer assess your contract, try to find one that has experience in contract review, and even better if they have experience reviewing PA contracts.
- How to ask for changes?
You’ll never know until you ask! Your supervising physician may not know what should be included in a PA contract. If there is something that is missing or is really important to you, bring it up and see what happens. For example, loan repayment. It may be worth asking if you commit to a certain amount of time, would there be an option for some loan repayment. The worse thing that can happen is they say no. You want to be reasonable with your requests, but know your deal-breakers going into negotiations, and if there’s resistance to reasonable changes, then that may not be the position you want to take.
- How/when to negotiate your salary?
This is also a little controversial. If you’re looking for a job as a new graduate, you need to be open to the offers you receive, and sometimes that means looking beyond the number of the salary. As a new grad, you’re going to require training and you haven’t proven yourself yet, so it will be more difficult to ask for more money. Make sure to include any productivity-based commission, yearly bonuses, and the monetary value of your CME, licensing, insurance and other fees into account when you’re calculating how much a contract is worth.
When you’re establishing your initial contract, consider trying to include an evaluation period either biannually or annually so you can sit down with your SP and office manager/HR to make sure you’re meeting expectations and reevaluate your contract. I did this after my first year, and since I was able to prove how valuable I was to the practice in that first year, we set up the structure for how my pay would change from there forward and I had much more negotiating power at that point.
- What is a non-compete clause and what is reasonable to expect?
I mentioned a non-compete clause earlier, and it’s basically a clause that would prevent you from getting a job in a similar area if you were to leave your job. In most people’s minds, this is unreasonable. What if you don’t get along with your SP? What if you’re fired with little or no notice? In small towns there may only be 2 practices within a 50 mile radius, so to get outside of that you would have to drive a ridiculous amount or move. That is unreasonable. This was not an issue in any of my negotiations, but it would have been a deal-breaker for me.
- If on salary, should there be an hourly cap? For example, what if you are required to work 40 hours a week vs. 60 hours?
For a salary position, you should have the amount of hours you are expected to work written in your contract. Usually this will be a range. I work 4.5 days each week, and my contract expects me to work 35-40 hours weekly. Although it’s rare, sometimes I end up having to stay a little bit late or put in extra time for trainings, but I don’t think I’ve ever gone over 40 hours.
If you’re working in a hospital setting, it will be easier to go over your expected hours. If an expected 40 hour job turns into one that you’re working 60 hours because that is what is being requested, then you need to have a conversation with your supervising physician and the office manager to come up with a solution. If you’re working that much extra simply because you can’t get your work done, then you still need to talk to them, but you may also need to reevaluate your patient load and what you are able to handle. It’s ok to be humble because being able to provide high-quality patient care should not be compromised.
- Is it acceptable/appropriate to ask other employees about their contract?
There is a huge movement right now for “workplace transparency” when it comes to salary and contracts. While it’s not illegal to discuss your contract, it can be inappropriate at times. My office asks that I don’t share or flaunt my contract. I think the more professional approach to talk to your office manager or SP if you feel like something is unfair. While sometimes uncomfortable, those are important conversations to have and you need to seek clarifications.
For example, I didn’t start working a half Friday until I had been at my practice for about 6 months. I would occasionally take Fridays off, and I noticed that my vacation days were dwindling. Since I was on salary, they had been counting a Friday a full vacation day. It ended up being a big misunderstanding, and by going to the office manager and asking about it, we were able to rectify the situation.
- What is tail coverage and do you need it?
You definitely need this! Tail coverage is a specific type of malpractice insurance that basically “covers your tail” if something was to come up down the road when you have left your current job and the malpractice that was covering you in that position. So for example, let’s say your first job is in cardiology and you are there for 1 year. After that year, you move and start a different job. 6 months into your new job, a malpractice claim is made against you from your previous position. If you have tail coverage, this will be covered, but if not, you’ll be responsible for all expenses in that lawsuit because your previous malpractice only covered you while in that job.
Tail coverage should be part of your contract and included in your malpractice insurance. Some PAs will have an additional policy outside of the one provided, but this is really only necessary if you are going to be changing jobs frequently or just want the extra security.
- Is it reasonable to ask for CMEs and licensing expense coverage?
Yes, it is definitely reasonable, and also expected. Most of the “housekeeping” expenses of being a PA should be included in your contract. This includes licensing fees, testing fees, equipment, and CME. There should be both monetary allowances and time off allowances provided for attaining your CME. The AAPA Salary Guide reports on these areas of the contracts at well, but I would shoot for $1000-2000 and 5 days of CME time.
- Should a contract include specific job duties and/or the supervising physician’s expectations?
When discussing your contract, you want to make sure the expectations are clear, and it’s best if you can get it in writing. What is expected of you on a daily basis? What paperwork are you responsible for, and what is the staff’s expectations? Will you have any help, like a dedicated MA or nurse? Who do you need to ask for help? Is there a set training period, or when do they expect you to be practicing independently? Is there a certain number of patients you will be expected to see?
The more you are able to go over before you start, the easier the transition will be. There will be some growing pains on the job, but don’t be afraid to ask your supervising physician for clarification of their expectations whenever necessary.
- Any advice about the negotiation/re-negotiation process as a whole?
Negotiations, and more specifically re-negotiations, can be painful. While I took the first offer I was given initially, when it came time to renegotiate, I had a specific idea of what I wanted my contract to look like moving forward. I had proven my worth to the practice, done my research on comparing what other PAs in the area and the country were receiving, and I was ready to stand my ground. There were about 2 stressful weeks of back and forth, but we were able to come up with a formula that worked for everyone, and now that structure is in place for any new PAs that will come on board.
What was tough in my situation is that I work in dermatology and the structure is different than some other specialties, so I provided my practice with articles, and we worked on it until we found something that was fair across the board. My last tip would be to go into negotiations looking for a fair offer, and not being greedy. Also, know when to walk away even if that might be extremely difficult.
A huge thank you to Savanna for answering some questions about contract negotiations. She brought up many good points I hadn’t even thought of before. Hopefully this process will go a little smoother being informed!
Savanna is currently practicing full-time in dermatology, while also running The PA Platform, which is a site that provides information about the PA profession and helps hopeful Pre-PA students achieve their goals. While Savanna has personal experience in contracts and negotiating, all opinions in this interview are her own, and any legal advice should be discussed with an attorney.