American Academy of Physician Assistants

Negotiating Your Contract


After you are offered a position, your next step is to define your role and benefits through contract negotiation. This is when you negotiate your salary, insurance coverage, continuing medical education expenses, annual leave time, etc.

You may feel uncomfortable negotiating because you want to begin your new position without any conflict. However, a good contract is critical to your livelihood and to your professional growth.

Also, an employer’s willingness to negotiate a contract in good faith is a good indicator of the professional relationship to come. Resistance or refusal to negotiate is a “red flag” of further problems down the road.

Pre-Employment Checklist

Here are the questions your should cover before signing the final contract:

Practice Matters

Hours and location
  • Number of office locations? Will you work in all?
  • Hours of operation?
  • Expected number of work hours per week?
  • On-call schedule: flexible?
  • How will holidays be covered?
  • Weekends begin and end at what time?
  • Type of work you want to do?
  • Physician's expectations of what you will do?
  • How will you and the physician interact? How will supervision be provided?
  • Availability of physician? Your relationship to others in the office? Any supervisory responsibilities?
  • Number of hospitals where physician is privileged? Will you be privileged there, too?
  • Your hospital responsibilities? (Rounds, ER, evaluations, deliveries, surgical assisting?)
  • Is hospital committee work a possibility?
  • Number of nursing homes where physician follows patients?
  • Your nursing home responsibilities?
Legal Matters
  • Necessary paperwork filed with state licensing board or department?
  • State statute and regulations reviewed with physician?
  • Rules, regulations and "gray areas" discussed?
  • Nursing home regulations reviewed?
  • Will there be a probationary period?
  • Written contract provided?
  • Physician's malpractice policy type and coverage reviewed and discussed with you?
  • Your malpractice policy type and coverage discussed and acquired?
  • Tail coverage provided, if needed? (See Insurance section below.)


  • Malpractice coverage? Type, limits of liability?
  • Personal, AAPA-endorsed occurrence policy (tail coverage not necessary), or
  • Personal claims-made policy with paid tail coverage, or
  • Rider on physician's policy?
  • Health insurance provided? For dependents?
  • Dental insurance provided? For dependents?
  • Life insurance provided?
  • Disability insurance provided?
  • Annual leave?
  • Name of each paid holiday?
  • Sick leave?
  • Maternity leave?
  • Family leave?
  • Unpaid leave policy?
  • Number of paid jury duty days?
Professional Expenses
  • Certification exam expense?
  • Recertification exam expense?
  • AAPA Annual PA conference expenses? Days off?
  • Chapter CME conference expenses? Days off?
  • CME program expenses? Dollar amount available?
  • AAPA annual membership dues?
  • Chapter annual membership dues?
  • Professional activity in local, state and national PA organizations permitted?
  • Malpractice insurance paid? (See Insurance, previous section.)
  • Base salary amount? How often paid? How often reviewed?
  • Partnership available?
  • Bonus plan available?
  • Profit-sharing plan available?
  • Pension provided?