New Grad Salary: Negotiations

[joanna.nola]

The place I really want to work--and who have basically stated they will hire me-- stated they have "no idea what PAs earn." These clinics (4 in area) are FQHC have mostly employed NPs (one PA a while back, but part time). I've ordered the AAPA salary document. I'm using this to come up with a number. I'm proposing the median "new grad" salary for my state (as you know, median means half above, half below) as well as the median "new grad" in the region, based on the area of medicine. I'm putting a little document together with the numbers to explain it to them. Does this seem like a reasonable approach? I think this number will be higher than what they'll want to pay (big surprise!)--it's actually almost exactly the national median for new grads even though we are lower-paid state. Is it okay to "go big," especially since I have the numbers to back it up??? At this point they'll have to come back and say, oh, actually instead of paying you the median salary based on these reports, we'd like to pay you what the bottom 10% of what new grads earn or even less or something to that effect (though, to be honest, I'd settle for bottom 25%).

Do you think this is a good approach? What was your approach when asked what you wanted for a salary?

[rev ronin]

If you think you deserve more than the median, don't be afraid to make a case for why you think you deserve more. You never get 100% of what you don't ask for, and if you're asking for something more than the median with a good argument to back it up (e.g., I already know your EHR), then you're subtly shifting the discussion upwards... which may backfire, of course, if they and you can't come to an agreement on price.

However, I wouldn't ever say in public that you'd take the 25th percentile. If the practice reads this and puts together who you are, you've effectively shot yourself in the foot.

[EMEDPA]

that is a good approach. expect to be offered less at a FQHC though. are you going to get loan repayment to work there? worth considering.
at my first job they offered me more than I expected so didn't make a counter offer. at most of my other jobs there has been a set rate of pay for everyone with X years experience so they just plugged me into a published schedule. at my current primary job there is only 1 pay schedule for pa's regardless of years of experience so a new grad makes as much as I do per hour although we also get production and in theory a more experienced provider is faster and gets more/hr in production.

[joanna.nola]

They are about to institute a productivity system, so I'm sure they will try to factor that into the negotiations. Obviously, as a new grad, I'd rather a higher base-salary. About the 25th percentile, I meant of all new grad PAs in the state, which includes specialties (Surgery etc) in addition to Family Med. That still puts me at a fairly high starting salary for Family Med at a FQHC (according to the AAPA report). But you are right, Rev, I probably should not, nor should anyone assume anonymity on this website I certainly won't let on that I'm willing to take less than what I present, at least at first.
I will have a chance at getting loan-repayment, and believe me, I do factor that in.
BUT, loan repayment is not a given, and it says it right on the NHSC website that they can't adjust their salary based on the loan repayment, so I'm acting like it isn't part of the negotiation....
Part of the unknown factor for me is that I'm in competition with NPs, and I have no idea what they make in our state.
I'm afraid they are going to say "Actually we pay our NPs 30K less than you are asking, so this really isn't going to work."

[buffchic]

Please forgive my ignorance, but what does FQHC stand for? This is part of NHSC?

Thanks for educating me!

[joanna.nola]

Federally Qualified Health Center. It does qualify for NHSC loan repayment (as do other clinics that similarly serve the uninsured etc.

[chatcat]

FQHC aren't going to have higher salaries especially if you will be getting loan repayment.
The rich clinical exposure for a new grad is golden~you will gain invaluable experience to build upon so you do have the experience to negotiate a higher salary down the road of your career. Good luck!

[KMD16]

FQHC aren't going to have higher salaries especially if you will be getting loan repayment.
The rich clinical exposure for a new grad is golden~you will gain invaluable experience to build upon so you do have the experience to negotiate a higher salary down the road of your career. Good luck!

Will take a $75-$80k/yr salary range + benefit in addition to $60k loan repayment from the NHSC for 2yrs service commitment as a new grad. my 0.02c

[joanna.nola]

Chatcat, I agree it'll be a great experience. But FQHC clinics cannot alter your salary based upon loan repayment. Loan repayment is not guaranteed at a FQHC. You apply for it after you've had the job, and depending on the cycle of application, up to a year after getting the job, and even then you may or may not get funding based upon the score of your clinic, amount of funding available etc. So I don't think I should go in expecting to make much less than anyone working in Family Medicine--certainly not $30K less.
KMD16, that is along the lines of what I'm asking. I really want to work at this clinic and realize I won't make what my classmates are making starting in Cardiology and other specialties. But, at the same time, I'm a decade older than most of my classmates and I think I'm worth a decent salary. I'm hoping to stay at this job for more than 2 years. This job is in my community and all the other providers are not from my community (they are excellent providers, don't get me wrong), but serving my community is why I went to PA school. Having said all that, I realize the market is the market. I'm up against TONS of NP new grads (we are in an urban area, not a rural area like many FQHC). I have no idea if they are going to come back to me and say: "Actually, we pay ou NPs (some crazy low number) starting" or something like that. Then I'm not sure I'll have much grounds for negotiation. I have no idea what NPs make in my state--I know there is a ton more of them than us. That is what I'm worried about. I've had a few meetings with management and will meet again with guy who does the hiring next week. They've already indicated they want me. I'm going to give him the little report I created explaining the numbers I'm requesting....and cross my fingers!!

[Paula]

Since you are from the community you have an advantage and should be used as a reason why you should be hired at the salary you want. If the other providers decide to move on after a few years, you will be the stable force for the clinic. Do the providers who live outside of the community have a high turnover rate? Do providers come to the clinic for a couple of years of experience, get their loans paid back, and then leave when that is accomplished? Is that your goal? If you are willing to be there long-term...if so...that is a great selling point? In your previous work life did you have skills that will be applicable to the clinic...i.e. management experience, ability to write policies/procedures or have input into them, supervisory capabilities, etc. All of these things may be helpful in negotiating your salary. My first job out of PA school was at an Indian Tribal Clinic also designated as a rural health center was fabulous. I was there 4 years, and received a state loan payback. I loved it, the things I learned were invaluable to me. I was 47 when I started my job there and I think my maturity was a big factor. I would still be there if my supervising physician hadn't been replaced with an IM physician. It restricted my scope of practice to Internal Medicine and as I was the only provider in a family practice clinic, I was forced to leave as I was a bit nervous about liability and state laws catching up to this most unfortunate event. I was replaced with an NP, so check out those type of issues, too. Is there a SP there who will cover your whole scope of practice for family medicine? What happens if your SP retires, moves on, etc? I re-read your post again and see it is urban, and that can be an advantage too if you know your community well as far as demographics, what you will expect to see for patients, understand the culture of your community. Sell yourself and don't undershoot your salary. I think the $80,000 is reasonable for a start and some places will start you on a one year base salary, then after you have built up a practice, switch to the production salary. Good Luck, let us know if you get the job.

[joanna.nola]

Hi Paula: Thank you so much for your reply. I do have significant previous experience that is not directly health-care related, but is related to the community I'm serving. I've worked with low-income people in my city for nearly a decade and helped start a non-profit community-based organization (still going strong, even though I'm no longer involved) after my city was devastated by an epic flood in 2005. I was the co-founder and wrote grants (over $150,000--the budget is now well over a million) to start this org (I had previous experience with grant-writing and non-profit Administration). I do think these skills are relevant, and it was heartening to see you mention the relevance of this. For one thing, they want to raise the profile of the clinic in the community, and I'd love to do outreach for this and come up with ideas for how we get people to see the clinic as the place they should establish a PCP. For instance, at the weekly Farmer's Market (where I bought a giant box of blueberries yesterday (yum!) and which is both near my house and the clinic), I thought, maybe we could have a booth here occasionally letting folks know about the clinic? (Not trying to take on extra work, but I can't not think like a community organizer!)
As far as the clinic goes, the SP I'm working with will cover my entire scope (he's family med--3 years out of residency--not sure if he's committed for the long haul, but also doesn't seem to plan to leave), there is also another doc (not full-time who has some more experience) who is IM/Peds. There is an NP who has 30 years experience and has been with them for at least 10. They don't have a ton of mid-levels in their 4 clinics (one just opened recently) and they are just expanding with mostly NPs.

[Paula]

God luck Joanna. I have grant writing experience, too and have written many in my pre-PA life. It has helped me in my position now and part of my salary is funded out of a diabetes grant. I am the main diabetes educator now. Let us know what happens. And remember...you are NOT a "mid-level" , you are an Advanced Practice Clinician/Associate!

[joanna.nola]

Thanks, Paula! I was wondering if I could get grant-funding down the line to do something like that. So exciting! Do you see all the complex patients w/ DM for your clinic? Your work/experience sounds great and I like how you've created your own way, defining what you want to do.
I hope to give the chielf operating officer my "report" from the AAPA re: salary this week. I'll let everyone know how it goes!

[chatcat]

I do have significant previous experience that is not directly health-care related, but is related to the community I'm serving. I've worked with low-income people in my city for nearly a decade and helped start a non-profit community-based organization (still going strong, even though I'm no longer involved) after my city was devastated by an epic flood in 2005. I was the co-founder and wrote grants (over $150,000--the budget is now well over a million) to start this org (I had previous experience with grant-writing and non-profit Administration). I do think these skills are relevant, and it was heartening to see you mention the relevance of this. For one thing, they want to raise the profile of the clinic in the community, and I'd love to do outreach for this and come up with ideas for how we get people to see the clinic as the place they should establish a PCP. For instance, at the weekly Farmer's Market (where I bought a giant box of blueberries yesterday (yum!) and which is both near my house and the clinic), I thought, maybe we could have a booth here occasionally letting folks know about the clinic?

I hope you are sharing these ideas with your potential employer because you do bring a unique perspective to the practice.Although you are no longer a community organizer, you do have skills that could be very beneficial to promoting this clinic via grants. Of course,this isn't how you will be earning your salary as a PA ~ and like all new grads you will experience a very steep learning curve. Back up your salary requirement with good data, let them know you would be a good investment as an employee and hopefully they will make a fair offer .
Hope this works out for you!

[joanna.nola]

Thanks Paula, Chat Cat and everyone! I needed a boost, and the forum did not fail me! I'll let you know how it goes...