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Need Advice: contract renegotiation after a year of two specialties

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Tried to post this once and I don’t think it posted - apologies for duplicates. 

I’m in a bit of a complicated situation. I’ve been up for contract renegotiation since July after a year with a hospital based multi specialty  surgical group. I was originally hired as the first and only PA for two generals, a urologist and a GI. One general and the GI opted not to use me, so I split my time almost evenly between general surgery and urology in both clinic and OR. 

CURRENT CONTRACT DETAILS: Oklahoma, full time 10 days call/month, $105k salary, $2500 and 3 days CME, 26 days PTO including holidays, $10k annual student loan reimbursement, association/fellowship annual fee reimbursement, 401k, Roth IRA, cell phone $100/month, sub-optimal medical insurance options

My contract have been on extension for 3 months for various reasons and I’m trying to make sure I’m prepared when I finally get their offer. I was told in my first meeting that my “numbers from the last year just aren’t there”. I was told I would likely either stay at my current salary or switch to a productivity-based bonus that increases annually with a 5% decrease in salary annually...both of which I absolutely refuse to sign. 

I have spent the last 12 months expressing the concern that I was not receiving proper credit/RVUs for all of my work. My physicians have never had a PA and don’t know how to properly utilize me...I don’t even want to get started on billing correctly. The hospitals lack of knowledge with PA utilization is stunting my ability to negotiate 

ON TOP OF THIS...the other general surgeon is leaving and we are hiring two more who are interested in working with me in clinic and OR. This splits me between 3 general surgeons and 1 (needy) urologist and the hospital is very unlikely to be hiring a PA or NP any time soon. I love my job, corworkers, location, etc  but I’m not about to take a crap negotiation just to stay.

I am not experienced in negotiating and it’s getting overwhelming as I feel no one is listening to me regarding proper utilization. 

Any advice welcome. 

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#1 thing you can do is get another offer.

It will serve several purposes. The most important of which you will have bargaining power and confidence. If you are making demands in negotiation you have to be willing to walk.

It's also a not so subtle way to let them now what you're worth.

And you just find a better opportunity. I went looking for another job mostly to use as a bargaining chip because my negations weren't going well...I didn't want to leave... But I ended up finding a much better position.


Absolutely do not let them make you production based if you are seeing H&Ps and post ops

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