3 Keys to NP and PA Salary Negotiations
By Author: Bethany Golden, MSN, RN, CNM
Editor: Elizabeth Moran, MSN, RN, CPNP-PC
In the acclaimed Broadway musical Hamilton, fearless leader and American founding father, Alexander Hamilton, exclaims: “I am not throwing away my shot.” This saying, popularized as his mantra, signifies determination and ambition in pursuit of success. Hamilton did not want to miss out on an opportunity—nor should you.
Let’s imagine that your new employer has chosen you and you have chosen them. You have done your due diligence to thoroughly think through choosing a clinical practice first, and you have determined that the offered position is the right fit. Well, almost… now comes the fun part: it is time to negotiate your salary and benefits package. This topic may have already come up during the interviewing process, or the discussion may start at the time the offer is extended. Either way, here are three keys to success!
1) Stay open. If you are told the salary at the start of the interview process and asked if it would work for you, say: “My thoughts about this will depend upon learning more about the duties and responsibilities of the position.”
2) Stay flexible. “Though salary is important, I will also consider the strength of the benefits package and workplace.”
3) Stay hungry. NP and PA negotiations are a reflection of how you value yourself and what you will bring to the job.
Before you enter the negotiations conversation as a PA or an NP, you should know that most people underestimate their worth and settle for what they are offered. We’re here to encourage you not to settle.
In this article, we will explore setting your base salary so that it matches your value. However, keep in mind, it may not only be dollars that make you happier, healthier, and more productive at work. Compensation is salary plus benefits. Therefore, we’ll also discuss other unique ways to increase your compensation package. In fact, benefits can equal approximately 25-30 percent of your total compensation—which is why it is vital that you ask for the full benefits package when you receive your offer. *Note: this article may not be as applicable for those in unionized positions and/or those in a hospital-based salary structure where the employer does not negotiate for salary.
When considering what to negotiate it is easy to think of salary simply as dollars earned but to get the best package you need to think broadly in terms of total compensation. The most negotiated benefits are a relocation allowance, sign-on bonus, time and money for continuing education, licensing and certification reimbursement, and sometimes even medical benefits. Additionally, a newer benefit that your NP and PA peers are now more commonly asking for is protected time; that is, time allocated to engage in quality improvement initiatives, education, research, and efficiency projects. It could, perhaps even be time to get creative! Consider what else would be part of the ideal compensation for you. Try to envision other things besides money that you value. Some examples include paid time off to teach or spend time with family and friends, flexible start time or nontraditional hours to avoid traffic, mid-day breaks to go to the gym, additional funds for leadership development or another degree, more administrative time to complete charting, or even time allocated to write articles and promote your practice on social media. How can you sculpt this opportunity to both promote your future goals and design the work-life balance you desire?
However, even though salary shouldn’t be your old consideration, it is still important to negotiate the highest base salary possible since it will impact your future as a nurse practitioner or physician assistant at this institution and beyond. Your initial base salary will not only determine how much you take home each month but also sets the foundation for compensation for the rest of your professional course. Future employers will likely inquire about how much you made in your prior position and thus, future offers will be shaped by the initial salary you are willing to accept. Also, raises are often determined as a percentage of your salary, usually in a set range around 2-5%. Know that while renegotiating your base salary after a few years is rare, it is not impossible—especially if you have received a promotion, new title, or have taken on additional duties and responsibilities.
Not so fast if you thought your homework ended with graduation! Below, we’ve listed the necessary homework for you to complete prior to your NP and PA salary negotiation. When it comes to the security of your financial future, this might be your most important assignment yet.
Step 1: Create a personal budget.
This can easily be done online via apps, websites, or a bank/credit union.). Choose the method that is best for you from various options of household budget tools! Using one of these will help you to gain a more clear understanding of what your household typically spends, as well as how much you need to save to meet your short and long term goals. If you want to even further personalize your budget and goals, you could also consider seeing a personal financial advisor (many will provide a complimentary first session!). Keep in mind that your take-home, or net pay, will be your salary minus taxes, FICA deductions for social security and medicare, and employee contribution to things like health 401k, health insurance, and any additional benefits. By figuring out your monthly costs for housing, transportation, food, education, etc., you will also be able to more accurately factor in how much you can afford to save each month. Though having emergency savings in case of an unforeseen emergency is one reason to save, you may also want to consider other needs such as money for a property, your children’s education, retirement, a new car, or your next vacation.
Step 2: Determine your worth by Investigating salary norms in your region.
There are many ways to find out the regional average salary for nurse practitioners or physician assistant. Here is a recent article for a nurse practitioner by state. Even more valuable is to find out the typical compensation for the particular institution you are considering joining. Melnic provides a highly valued salary survey where you can find much of this information. Another great source for understanding your value is to speak to a Melnic recruiter who has frequent dealings with organizations and is very informative on salary norms and ranges all across the country.
Another way to ensure you are being appropriately compensated for your work is simply to ask around! Friends, friends of friends, acquaintances, colleagues, and/or fellow alum who have worked at the same institution can be a great resource for valuable information and advice. Though at first the idea of asking these questions may feel uncomfortable, we urge you not to be shy! Be honest with this individual that you received an offer and would love to hear about their experience working there, including any thoughts that they have about the compensation and benefits package.
It is also worthwhile to ask this person if the organization offers any incentives or annual bonuses. In the healthcare industry, bonuses are common and may be given at the holidays, at the time of sign-on, or annually based on your productivity. If they use productivity to determine the annual bonus, ask how it is measured for clinicians. Though this all may sound like a lot of detective work, there is nothing worse than learning down the line that your colleague who has the same job makes more than you do for the exact same work—and likely because he or she wasn’t afraid to negotiate!
Step 3. Negotiate!
For many of us, the topic of money and finances is uncomfortable—but it doesn’t need to be. In order to effectively negotiate, you need to feel confident in your pitch and put aside feelings of awkwardness. If you are feeling apprehensive, pretend you are negotiating on behalf of a peer or friend whom you know is deserving of a high salary.
If a potential employer states a number right away, avoid eagerly reacting. First, pause. Then, let the employer know that you need some time to think about and research how this number compares to typical salaries. Alternatively, if the employer asks you what salary you are looking for, say that you are going to do some research but in the meantime, can they share their range? Now your negotiating power as a nurse practitioner or physician assistant has gone way up! The more information you have about the people you are negotiating with, the more likely you will reach a satisfactory agreement. In addition, when stating your research and requests, be sure to use an exact salary range—the more precise the better. For example, rather than using rounded numbers such as $97,000 to $100,000, use $91,350 to $100,899. This level of precision will show your future employer that you did your research, reports Columbia Business School.
Once you have done your research and understand the institution’s range, the next step is to write down or verbally express your request. You can make a list of bullet points, write it as you would a letter, or ask the employer to schedule a time to discuss it in person or by phone. Even if you choose to do the negotiating verbally, be sure to have written yourself a script beforehand. Practice the conversation with a friend, family member, or colleague. Repeat, repeat, repeat. Practice until the pitch is second nature and you can confidently lay out the terms. This will calm nerves and help you to feel empowered. Are you feeling ready?
In the best-case scenario, your employer has the flexibility to meet your requests. However, know that this won’t always happen. Once you have stated your requests, remember that “no” may be to specific to the amount you asked for, not all potential salaries and compensation requests. If you get a “no” when you ask your potential employer for the number at the top of the range identified, you still have other options. Either ask if you can start the job at the bottom number and see if they will agree to move to the top salary number in six months after you are up and running, or come down on your ask and renegotiate for a salary amount in the middle of your range. Be firm with yourself, as well as the employer, in deciding what salary would be too low, and be ready to walk away if that is their final offer. By saying “no” you may be making the best decision, and there will surely be another opportunity around the corner soon.
Most of all, know that as a Nurse Practitioner or Physician Assistant your negotiations are not over until you walk away or reach an agreement. Give it time, listen to what is important to them, know what is important to you, openly and honestly discuss all facets of the agreement, and always think creatively about what else the employer could do to make an offer more attractive to you. And perhaps most importantly, if and when you reach an agreement, make sure all of this is written in the contract before you sign it.
Bethany Golden is a nurse-midwife and healthcare strategist. As a member of reproductive health clinical and research teams in New York City, Bay Area, Chicago, Fiji, and Nicaragua, she has cared for underserved families in a variety of settings: community health clinics, hospitals, private practice, Planned Parenthood, and rural villages. She consults for reproductive healthcare not for profits and tech companies on healthcare operations, strategy and partnership formation identifying key stakeholders. In 2002, she co-founded and continues to operate ICAS/Juntos Adelante, a not-for-profit that focuses on health and human rights in Nicaragua that partner from local leaders who identify community-initiated/grassroots projects that strengthen the health infrastructure. She earned her BA in History from Brown University in 1995 and her MSN and Certificate in Nurse-Midwifery from Yale University in 2003.
Co Authors :
Elizabeth Moran joined the Melnic team in 2019 as a Copy Editor Contractor. She uniquely holds a Bachelor of Arts in English from the University of Connecticut and a Master of Science in Nursing from Boston College. She is currently working fulltime as a Pediatric Primary Care Nurse Practitioner in Boston.
Prior to becoming a nurse practitioner, Liz worked for a number of years in clinical research where she participated in the writing and editing of grants, protocols, and scientific articles for publication. She also has experience copy editing and proofreading for a nonprofit. Liz is excited to now blend her English and healthcare background at Melnic Consulting Group.