July 21, 2021
Negotiation, Negotiation, Negotiation
How best to respond to recent studies that show troubling indications of salary discrepancies between male and female PAs? A September 2017 study published in the Journal of Women’s Health Issues examined male and female PA salaries from 1998 to 2014 and found that female PAs are compensated 89 cents* for every dollar received by male PAs: an 11 percent income disparity. As the study states:
“There remain challenges to ensuring pay equality in the PA profession. Even when compensation-relevant factors such as experience, hours worked, specialty, postgraduate training, region, and call are controlled for, there is still a substantial gender disparity in PA compensation. Certain salary discrepancies remain between employed male and female PAs regardless of specialty, experience or other practice characteristics.”
The authors conclude with several possible remedies for gender pay disparity, including training of employers to make hiring and compensation aligned with pay equity, a de-emphasis on previous pay as criteria for salary, creating greater transparency about compensation within organizations, as well as continued advocacy on this issue on the part of PA professional organizations. These are all constructive ideas and will, taken in conjunction with vigorous self-advocacy on the part of individual female PAs, help create a new and necessary valuation of their work.
Women have a dual set of challenges to overcome in order to achieve pay equity: both the institutionalized, society-wide pay discrepancy and also the internalized social messages that can limit self-advocacy. A 2008 study published in the Journal of Physician Assistant Education found that new female PA program graduates had lower salary expectations than male peers—certainly a factor that would affect the outcome of salary negotiations. What’s more, starting off one’s career with a low salary can negatively affect lifetime earnings.
So how should female PAs negotiate effectively for income parity? In my years of advocating for PAs during salary and contract negotiations, I have seen that those with a willingness to negotiate rather than accept offers as given consistently achieve higher salaries and more ample benefits. In most cases, it is amazing to see what a positive difference asking for more can make. These PAs also benefit from a more firmly grounded and equitable employment relationship after negotiating and engaging in clarifying discussions with an employer about core job aspects: pay, benefits, clinical roles, schedules.
One effective strategy is to aim high by establishing salary targets—negotiation goals—that are based on accurate market research. AAPA’s annually updated Salary Report provides the latest data on PA compensation per state, specialty, and experience with clearly delineated salary ranges.
Within your self-defined target compensation range (and with “walk away” points clearly defined), negotiation can be framed as cooperative problem solving with a win/win approach, one that syncs well with PA’s team orientation. Present your goals and invite your negotiating counterpart to work with you to find a shared solution.
Constructive frames to use during the negotiation process might include: “How can we come to a consensus on this aspect of my pay/ benefits?”
“I’d like to share the latest research from my professional association on PA salaries and hope we can work towards a solution that reflects the data and will make us both happy.”
“I appreciate the opportunity to review this offer with you and would like to negotiate and clarify the terms you’ve offered with the intention of creating a long-lasting and mutually beneficial professional partnership.”
Be sure to look at the entirety of the compensation package, including benefits, as you assess a salary offer. Medical benefits, retirement options, vacation time and well-funded CME are all important aspects of the whole compensation picture and are generally areas open to negotiation.
Finally, make sure negotiated changes to the initial offer are reflected in the written contract, as it is fairly common to find discrepancies between what is agreed to in discussions and what ends up in print. What is on paper and signed is what’s binding and counts! In conclusion, negotiating from a belief in your value is good professional practice and builds a pathway to greater gender equity in the health professions.
*The article in Women’s Health Journal used 2016 AAPA Salary Report data, which found that female PAs are compensated 89 cents for every dollar received by male PAs. The 2017 AAPA Salary Report found that female PAs were still only being paid 93 cents for every dollar men were paid after controlling for a variety of factors.
Smith N, Cawley J, McCall T Examining the Pay Gap: Compensation Disparities Between Male and Female Physician Assistants Women’s Health Issues September 2017 27-5 607-613
Snyder J, Zorn J, Satterblom K. Anticipated salaries of physician assistant students. JPAEA. 2008;19(1):10–14.