How to Negotiate Your Contract as a Physician Assistant

February 10, 2023
Maybe you’re accepting your first PA job offer or maybe you’ve had experience trying to take charge (and falling short) while negotiating your PA contract. Whatever the case, knowing how to effectively make your case during contract negotiations is an essential skill for any healthcare professional.

What Happens Before the Job Offer Gets to You?

The interview process for a physician assistant position can be lengthy. You will often go through multiple rounds of interviews, likely starting with a screening call from HR. While some employers are upfront in terms of salary, oftentimes you may not know exactly what a company is willing to offer you until you receive an official job offer. 

While an HR department may ask about your salary expectations initially, it is possible that the topic won’t arise during interviews. Many times, the salary negotiations and budget for the position are left up to the administration and therefore the people you interview with (often potential coworkers holding clinical positions) may not know exactly what you will be offered. 

This could mean weeks after first hearing from the company before you know what to expect. This can also cause it to be difficult to fully weigh the pros and cons of each position if you are balancing multiple potential job offers.

So, You Received Your First Offer. Now What?

When you receive an offer, it could be initially via phone call or email. This often involves a lot of information, including start date, salary, and other major benefits of the role (PTO, retirement matching, CME stipend, etc.). 

Get Your Offer In Writing

It is much easier to process and think through when this is all written down for you, so if this comes via phone call I would advise asking if they could email you the information. This allows you to better review the offer prior to accepting or declining. While accepting a verbal offer is not binding, it does look bad to rescind your verbal acceptance and could cause you to establish a poor relationship with that company or health system for future positions.

Making the Decision to Negotiate

So, what happens if when the time comes and you receive an offer you find yourself disappointed? Even if you love the position itself, you still want to be sure that you receive the appropriate compensation for that role. The first thing to know is that it is absolutely okay to negotiate when it comes to your salary.

While it may be easier to negotiate as an experienced clinician, you can also negotiate as a new graduate provider. In most cases, the recruiter who presents your offer should also be your person of contact during the negotiation process.

Negotiating Your Salary

As a new graduate provider, when I negotiated my salary I utilized the AAPA salary report. This report is updated yearly by the AAPA and it breaks down the average salary for physician assistants by specialty, years of experience, and location. This is an incredible resource to ensure that the offer you are receiving is what it should be.

I would aim to be in the 50th percentile for your specialty, experience level, and location—however, this is very situational. If you are working a position that includes things such as call shifts, longer days, overnight shifts, or weekend work you should make sure those are compensated additionally outside of the salary you are offered or that your salary is higher than average to reflect those commitments. 

Example Salary Negotiation

Below is an example of a salary negotiation outline for a new graduate physician assistant: 

Thank you so much for the opportunity to join your team! After reading the offer letter, I wanted to discuss the possibility of a higher starting salary. According to the AAPA salary report, new graduate physician assistants practicing in (state) and working in (specific specialty) are averaging about ($ insert 50th percentile salary). Is there any flexibility in the starting salary to more closely meet this average?

I believe I would be an excellent addition to your team, and I am eager to work with you. I look forward to hearing from you soon. Feel free to call me at (insert phone number) with any questions or to discuss this further.


(Name), PA-C

This is just one example of the many ways you can negotiate salary as a new graduate. If you have prior experience in a medical specialty that you think would make you a more valuable asset to the team, you should say that in your negotiation. 

The Impact of Experience on Salary

Of course, already practicing clinicians should also utilize their prior experience in negotiation. Whether or not you are provided a counteroffer is variable. 

Some organizations have strict criteria for salaries, especially for new graduate providers, and will be unable to offer you any more. However, asking for a higher salary is never a bad thing as long as it is done respectfully—recruiters are used to this and many may be ready to negotiate.

Evaluating and Negotiating Employee Benefits

As discussed in some of my prior blog posts, there is so much more to an offer outside of just the salary. If the employer is unwilling to negotiate salary, you could consider trying to expand in other areas. 

CME Funds

Depending on your CME fund availability you may want to consider asking for more coverage in those areas that will, at the end of the day, save you money. Keeping up with your licenses, especially DEA, can be expensive! You want to make sure you have enough to cover those funds (plus some) to actually spend on obtaining your CME credits. If your employee does not mention anything about CME, be sure to ask what they offer.

Raises and Employee Insurance

Another thing to be sure you ask about is the frequency of reviews and subsequent raises. This is especially important for those of you who may be applying to a position that you anticipate staying at for a long time. You want to be sure that, over time, your continued learning and experience will be compensated. 

In addition, you want to make sure you are receiving quality medical benefits. This is especially true if you believe you may have a spouse and/or dependents to add to your insurance. These costs add up and sacrificing some salary for better medical benefits may be worth it depending on your personal situation.

Accepting (or Rejecting) Your PA Contract

Before You Sign: Review, Review, Review

The only time your agreement becomes binding is following your review of and signature on a contract. This contract will outline all of the terms of your employment, including your salary. Be sure to thoroughly review this, as anything you sign you will likely be held to. 

For example, some positions may put a mandatory notice in a contract, meaning how long you need to notify the employer and continue working before leaving. In addition, the contract would be where you may find a non-compete clause which you should definitely be aware of before committing to a position.

As a reminder, verbal acceptance is non-binding—however, I recommend only accepting a verbal offer if you truly intend to take the position.

On the contrary, the written contract is binding and should be fully reviewed. This may not be presented to you for your review and signature until your first day. If you find yourself uncomfortable with the terms of a contract, review this with your manager before signing. 

Remember: It’s Okay to Say “No”

At the end of the day, the decision to accept or decline the offer is completely up to you—and it is definitely situational! You want to review everything thoroughly before accepting. If you wish to decline the verbal offer for any reason, do so respectfully and be sure to thank those involved in your interview for their time.

If there is no ability to make changes to the contract that you feel are necessary, it is okay to decline the position and refrain from signing the contract. Although this process likely wasted both your and the employer’s time, you want to make sure you do not sign any contract that could negatively impact you. 

Keep in mind that if you ask all of the important questions prior to the contract stage of the agreement, you should have absolutely no problem here. 

In summary, contract negotiations can be an intimidating prospect even for seasoned PAs who have been through the process several times over. It’s alright to feel nervous or unsure, but don’t be frightened into accepting an offer that will ultimately make you and your employer unhappy. Take this time to ensure that the offered position (and its benefits) is in line with what you’ll need to survive and thrive as a physician assistant. Happy job hunting!

Rosh Review is the leading Qbank provider for PA programs across the United States. Whether you’re a pre-PA student or PA-C, Rosh Review has something for you along your PA journey. Start a free trial today!

By Olivia Graham, PA-C

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