Negotiating Your Contract
Congratulations on being offered a position! Now’s the time to negotiate your contract, which will include details on your salary, insurance coverage, schedules, CME expenses, and annual leave.
Tip: Don’t be uncomfortable negotiating. In reality, a good contract, based on clear, diplomatic, communication of your interests is critical to your professional growth and a solid employment relationship. A well-written contract safeguards your clinical practice (and peace of mind) from being undermined by poor or uncertain compensation, unrealistic scheduling, or a deficiency of key employment benefits.
Interactive Tool: Anatomy of a Contract
We’ve outlined the major components and key elements typically found in PA employment contracts. This resource offers advice for what to expect, ask for, and be wary of, in each section you might find in your own contract.
Checklist: Contract Assessment & Negotiation
Negotiate a contract that empowers you, fits your needs, and protects you. Start with this thorough checklist to assess an employer’s contract for how well it meets your needs — and to identify areas for negotiation.
PA Career Coach
Jennifer Hohman has helped hundreds of PAs get their dream jobs and offers personalized guidance to new and experienced PAs in the areas of career navigation, resume and professional materials preparation, interviewing, and contract negotiation. Put her expertise to work for you!
Negotiation Basics
We’ve got some tips to help you negotiate or renegotiate a compensation package.
Determine your salary and benefits targets, including the minimum salary you would accept from an employer before you enter the negotiation process. Resist a tendency to sell yourself short.
You can base your compensation targets on a variety of factors, including years of practice, specialty, cost of living, and your salary history. The AAPA Salary Report offers in-depth research on PA salaries and benefits and is an excellent resource for contract negotiation.
PA compensation plans vary widely. The safest option is a straight salary. There are other alternatives to consider, however, with varying degrees of risk. Increasingly, PAs are negotiating compensation that includes salary plus a percentage of revenues, bonuses, or other forms of incentive pay. Other compensation structures include on-call pay, overtime pay, and profit sharing. It is often best to negotiate a fair base salary for peace of mind and consider any productivity-based compensation as a bonus and an incentive to work harder, to see that extra patient, or to stay longer at the end of the day.
Having an accurate idea of how much revenue you bring in or how much work you are providing will help your position when renegotiating your compensation package. If you cannot obtain this information directly from your employer, keep track of your patient load and encounters for a few weeks or months and then estimate the billing for those services. If you do not know the typical amounts billed for the medical services you provide, request a list of charges from your state Medicare carrier to give you a general idea. You can use the Centers for Medicare & Medicaid Services website for payment and work Relative Value Unit (RVU) data to help you make your case.
If you accept a compensation plan with a productivity element, you will need full access to your productivity data. Unless you can accurately ascertain that all of your work is attributed to you, is appropriately valued, and is incorporated into the data used to calculate your productivity, you (or the employer) may be sold short.
Proceed with caution: If productivity is to be part of your compensation, access to your data should be guaranteed in your employment contract, as should the details of the compensation plan. Be sure both you and the employer understand how your contributions will be measured.
Additional Aspects of Contract Negotiation
Benefits are essential to your professional (and personal) quality of life.
AAPA conducts research on the types of benefits commonly offered to PAs including paid leave for vacation, family leave, illness, and CME. This data is helpful for researching national norms and making sure your contract reflects them.
Try to ensure that your PTO is in keeping with the median to higher end percentiles in the AAPA Salary Report and that vacation, CME, and sick leave are counted separately. You would not want a bout of flu to cut your vacation time in half, nor should your required CME activities be equated with personal leave.
Other key fringe benefits to secure in your contract include CME funding, professional liability insurance, term life insurance, retirement funding, state license fees, DEA registration fees, NCCPA fees, credentialing fees, health insurance for you and your family, vision and dental insurance, AAPA and state or specialty PA organization membership, relocation assistance, and student loan repayment assistance.
To make the most of your benefits negotiation, it’s a good idea to assess which benefits are the most and least important to you – both so that your contract will reflect your personal priorities and so that you can identify some potential “trade off” items where you show flexibility.
In addition to the contract, most employers have an employee handbook. If they do not offer you a copy, you should ask for one. If you are to be an employee, assume that everything in the employee handbook applies to you, unless your contract states otherwise. For example, the amount of vacation time you negotiate may differ from what the employee handbook states, but be sure that the negotiated agreement is noted in your contract. Assume any document you sign is enforceable in a court of law.
Additional Reading:
Getting the Most Out of Your Benefits Package
Along with a written contract, a written position description — a practice agreement — that outlines your clinical roles and responsibilities is an excellent idea (and is required in many states). Practice agreements can help ensure that the employer and PA have aligned their clinical practice expectations.
There are many variables involved in writing a job description, including state laws and regulations, type of practice, experience and expertise of the PA, needs of the practice or institution, and wishes of physician partners. In settings that have had PAs in your position before, there may already be a job description to use, at least as a starting point. Consider talking to colleagues in your specialty for help in writing a position description that will support an interesting and full range of duties. Taking part in the drafting of your practice agreement is an effective way to make sure a job reflects your clinical interests and passions.
Some states provide their own template for practice agreements. You can find them on your state medical board site.
An attorney’s role is to help you reach a clear understanding of the responsibilities and expectations outlined in the employment contract and to negotiate any problematic areas. Your attorney should live in or near the area of your practice so that he or she is familiar with the local laws governing the area. It also is helpful to know if this individual has handled PA contracts before and how many years of experience he or she has had in the area of contract law.
Questions to ask a prospective attorney:
- Have you handled contracts for PAs before?
- What are the possible outcomes of the negotiations?
- How long do negotiations typically take?
- Will anyone else in the law practice be working on this matter?
- How are your services charged (hourly, fixed rate, contingency fee)?
- What is an estimated figure for the total bill for this type of service?
- Do you typically work on behalf of employers or employees?
Sources of lawyers with expertise in healthcare contracting
- PAs or physician colleagues
- State and county bar associations; state and county medical associations
- PA or physician specialty societies
- American Health Lawyers Association
- LawInfo.com