PA and NP Contract Negotiations
I have had the opportunity to negotiate many high stake’s situations during my physician assistant and private equity career--sometimes for potential seven-figure deals. Fortunately, I have been guided by incredibly successful and experienced business coaches. Not all of my negotiation conversations ended in the way that I had hoped but I sure learned a lot from the ones that did.
Before learning advanced negotiation and business skills, I was nervous about discussing money with my employer and naively just made a list of “wants” before stepping into a negotiation conversation. Many falsely believe that a successful negotiation outcome means getting all, or most, of what is on their “wish” list. What most don’t realize is that a truly successful negotiation is when both parties benefit. If only one party “gets what they want” without the other party benefitting, long-term outcomes will likely be limited and strained. In essence, you could be leaving money (or time) “on the table” by focusing only on your wants rather than appreciating the wants and needs of the other party. Here are five items to help structure and guide negations towards mutually-beneficial outcomes:
#1 Goals must be aligned. You and the other party must have the same vision and goal for you and the business. If you have a different vision for your role (duties, procedures, time invested, etc.) than the other party, it will be very difficult to find a common ground for a win-win outcome.
#2 “How Can I help You?” This is the fundamental mindset for a successful negotiation outcome. Presenting how you have helped the practice or organization succeed or grow, and how you will continue contributing to success (what you are presenting must be things that the other party cares about) is vital before focusing on your requests. This is the most powerful way to have the end result exceed your predicted outcome!
#3 Know your X Factor. In business, the X factor is what makes a product or service different and/or better than the competition. The same principle applies during PA/NP negotiations. What is your X factor? How are you different, or better, than other clinicians (particularly in areas your employer recognizes and appreciates)? Remember that employers differ by the value they place on different things. For example, academic centers place a lot of value on education regardless of productivity; while private equity groups might place more value on volume and productivity. It is important to pay attention to what your employer values and show them how you are (or can) fulfill those needs. In short, demonstrate to them that you are the “X factor” they value and can’t do without.
#4 Understand the Business Model and Owner Mindset. Do you truly understand what makes your boss “tick”? What things that work well within the business and what things can be improved in the eyes of your employer? What are the long-term goals of the business owner? You need to accurately understand and articulate these goals during contract discussions; and then demonstrate that you are a committed, long-term team player that is essential to making their dreams a reality? Focus on how you make the practice more efficient or profitable, how you improve patient outcomes and satisfaction, or perhaps how you can help expand services offered or facilitate a practice expansion. Paint a picture of the future that includes you as a vital contributor and sustainer of the employer’s business dreams. This strategy allows your role and salary to grow with the short-term and long-term successes of the company.
#5 Know when to go, but exit gracefully. If you recognize that your talents and long-term career goals do not match those of your employer, or if you disagree with business decisions, ethics, or culture, then it might be time to seek other opportunities. Planning your exit doesn’t have to be emotional, it is simply a business decision made to guide your career and personal life. Long or stressful discussions are not needed to make a graceful exit. In general, less is more! Simply let the practice know that you have decided to explore opportunities that are more in line with your long-term personal and professional goals. Do not feel obligated to disclose details about your next job and avoid criticizing or offering opinions/advice to the business owner or manager as you head out the door. Medicine is a small industry, so demonstrate your professional integrity and excellence to the very end and leave every work environment knowing that you were 100% respectful and professional.
Negotiations don’t have to be an overwhelming and stressful process. If you are functioning as a team in your practice, and everyone is truly considering the needs and benefits of others, then the negotiation process is simply a conversation about improving the business in ways that benefit everyone. It may sound cliché, but “team work makes the dreamwork” is true even in medicine and finding win-win solutions that benefit you and the practice can take you and your practice to heights you never imagined.
Kasey D’Amato, MPAP, PA-C is a Dermatology PA, Entrepreneur, and Career Coach for PAs. Kasey is President of Certified PA Consulting and coaches PAs on how find clinical or non-clinical career success and fulfillment. When not in clinic or helping other PAs, Kasey enjoys spending time on the beach, golf course, or boat in her Maine and Florida homes with her husband and bulldog or traveling the globe looking for new and exciting adventures.www.certifiedpaconsulting.com
