Thank you for this weeks guest post from Savanna Perry over at www.thepaplatform.com.
A Dermatology Physician Assistant Shares Her Negotiation Experience
To preface this post, it’s important to note that I work in dermatology, and the pay structure can vary greatly since it’s a procedure based specialty. My model consists of a base salary and a commission or bonus based on my productivity and the collections that I bring into the practice; basically once I double my salary in collections, I get a percentage of anything additional that comes in. (So I pay for myself and my overhead!) I was so excited to get into dermatology as a new grad that I initially took a base salary that was less than the national average for a fresh PA, but I’ve learned a lot since then, and I hope that my negotiation story will help you as well.
When I received my offer at my job, the conversation went pretty quickly. “This is what we’re willing to offer. Do you accept?” As I looked over the one page contract, I meekly mentioned that the salary was slightly lower than what I was expecting, and I was shut down and told that this was what they had done for a previous PA and it was a take it or leave it situation. They also mentioned that I likely wouldn’t bonus my first year while I was still training.
While that was slightly disheartening, dermatology had been my goal before going into PA school and even from one day of shadowing, I knew that I would have a great supervising physician. In the back of my mind, I also knew that they didn’t yet know how hard of a worker I am.
Fast forward to one year later, and a lot had changed. In the past three years, I’ve learned the importance of being flexible and going with the flow. Our practice gained 3 more providers, we moved locations, and both of my supervising physicians had been out on maternity leave. That meant that I had to step up. The previous PA had seen around 20 patients each day, and my schedule consistently had 30-35 patients. I do my best to stay on time and make sure that I am efficient so that I’m able to handle a tough patient load. I also have a dedicated medical assistant which helps.
When it came time for negotiations, I knew that I was being undervalued and I had adequately shown my capabilities at this point. So going into that meeting I knew what I wanted and I was well prepared. I used the AAPA Salary Guide, the SDPA’s resources, podcasts, Google, other dermatology PAs, and any resources I could find. That first year my salary, bonus, and benefits were around 15% of what I was bringing in to the practice and the standard for a dermatology position is around 30-40% typically.
I can say that it was a tough couple of weeks with a lot of tension in the office. After multiple discussions, I came to find out that the practice accountant was providing numbers based on a primary care PA, which can be a much different structure. And any recalculations they gave kept giving me the same outcomes.
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It came to a point where I had to make a choice. I had to basically let them know that if I was already maxed out after my first year, ultimately I wouldn’t be able to stay there long term. And that was a tough decision because I loved my job! But I also knew how much I was worth, and I still do. With making that decision, my husband asked if I would be willing to leave if they came back and said no, which really put things into perspective. And at the end of the day, the answer was yes because why would I keep working this hard if it wasn’t going to pay off? Being a PA is certainly not all about the money, but it can be an exhausting job and it has to be worth it.
My practice has always been extremely fair, and I think this was just new territory for them. The last PA never even asked about her collections! I had to readjust the way they were thinking about my salary by asking, “What percentage of my collections do you want?” When I was just asking for 30%, it was more difficult for them to say that they wanted 80%.
Thankfully, we were able to come to an agreement, and we actually set up a pay structure for the next 5 years so that we don’t have to go through that again any time soon. It may need to be revisited if I ever want to adjust my schedule, but they also have a structure in place for any future PAs too.
There are often mentions of taking a training salary or medical assistant salary when just getting started in a specialty like dermatology, and that is something I do not agree with. You have a degree as a physician assistant, and you deserve to be treated and paid like one. That being said, it may take a year or two to know your worth and be able to use that information to back up your negotiations, which is why I was okay with taking a slightly lower salary my first year. It paid off and I don’t foresee any changes in my career anytime soon.
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Savanna Perry, PA-C is a full-time dermatology physician assistant and the founder of The PA Platform, a website for hopeful, future, and current PAs. If you would like to contact her directly, you can email her at savanna@thePAplatform.com
