Negotiations 101

Negotiations are awkward. No one likes to talk money deals with a complete stranger, nor does anyone like to ask for more than what is offered... but if you want to get up to your financial earning potential... I say, "Get over it." You won't always get everything you ask for - in fact - sometimes you may get nothing, but the point is... if you don't ask, you'll never know. A few of my classmates negotiated their contracts - some successful, some not. To me, a successful negotiation means that you gained something that you didn't have before- even if it is only $1000 more or 1-2 extra vacation days- it is something extra that you didn't have before. They aren't going to take back your offer if you ask for more money (at least I've never heard of it) - they expect a negotiation.

As a new graduate, it is sometimes difficult to negotiate - but its not impossible. Below are some basic tips that I've learned through research and experience that should help you negotiate your first salary:

1. Do your research. You wouldn't dream of walking into your cardiology final without having studied up! Why walking into a negotiation without studying either?? Know what the going rate for new PAs in your geographic/specialty area are. How do you find out? AAPA and NP&PA Advance Mag (website) has some salary information, but I got the most helpful information by just asking. Many of my classmates were open about their base salary offers which was very helpful. I suggest that you are the same way with your classmates. It only helps everyone to know the playing field.
2. Know the going benefits packages. You should ask around to see which hospitals cover what as far as paying for CMEs, licensing costs, re-cert exam costs, etc. These things add up very quickly and are worth knowing. If your hospital is not covering any of your licensing or DEA fees, you are looking at approx $1500 of additional costs that you have to cover.
3. Know the demands of the position. CT surgery is notorious for having a crazy schedule, but that is one of the reasons that they are some of the best paid PAs. Will your job include nights/weekends/holidays/call? If so, think of if the salary they are offering you is taking that into consideration. Do you get paid extra for call? Night/weekend differential pay? Think about what is important to you by way of "work-life" balance. Some people are willing to work 80hrs a week to make money to help pay loans, others want an 8-5p type job with no call/wkends/holidays knowing that they will likely make less money. It is a personal decision.
4. Know the pay structure. Are you salary? Are you hourly? It makes a huge difference if you are scheduled for 40hr wks but are working 50hrs.
5. Know your worth. What can you offer to this position that perhaps some of the other new grad applicants couldn't? (aka, why did they pick you?!) If you are negotiating for an orthopedic position and you spent 5 yrs as an athletic trainer - use that in your negotiations! You are bringing several skills to the table that other new grads likely aren't. Do you have another degree in public health or business? Incorporate into negotiations how those extra skills may help advance the practice.
6. Never, and I mean NEVER, take the first offer. (Even if it is $10K more than you had expected!) When I had a negotiations discussion with some friends that work in business they all said they were taught never to accept the 1st offer. Why? Because businesses/hospitals almost never offer the ceiling salary upfront. Why would they? Healthcare providers aren't taught anything about negotiations. I have asked med school students, PA students, and nursing students - almost none of them have been truly taught how to negotiate.
7. Think in LONG term, not SHORT term. Your starting salary will dictate your next salary and your next salary when you switch jobs and start the negotiation process all over.
8. Be prepared. Have a list of "wants" and rank them in order of importance. This list is for your eyes only. It is not something you hand to the HR negotiator! For example, write down a salary that you plan on asking for - then ask - "Thank you for the generous offer... blah, blah... I was wondering if there was any room for negotiation on the salary?" If they say yes, give them a range. Based on their response you can move on from there, but what happens if they say "No"? Then you say, "Ok, then I was wondering if other aspect of the benefits package are negotiable such as _____." You can ask for whatever is next on your list of "wants" - more vacation time, more CME $, etc.
9. Know your limits. You are a professional, but in many cases you are also a mother/father, husband/wife, T-ball coach, etc - the point is that you wear many hats and have other time and financial responsibilities. Keep this in mind during negotiations. Most times you can come to an agreement and it all works out. Sometimes they just might not be willing or able to meet your wants/needs - know when to walk away. Don't take a job that is going to make you miserable or force you to eat Ramen noodles every night. You many not find the perfect job out of school - and that's ok - but you should at least enjoy it and get paid well to do it. Before walking into a negotiation, sit down with your finances (rent, loan repayments, bills, etc) and figure out what is the least amount that you could live on and then account for the fun things in life that you'd like to do - this should help you at least find a minimum salary that you could work for.
10. Ask for time to make a decision. Don't let any institution strong arm you into making a decision on the spot. It isn't standard practice and you shouldn't make such a large decision without some time to ponder. I asked for "48 hrs to consider this very important decision" - and most places are very amenable to that. Ultimately, the decision is yours but you should discuss with your significant other/family as your new job will likely affect them.

Good luck with the process. Don't be afraid of a little awkward conversation. It could pay off hugely in the end.