Negotiating a Raise in Healthcare Private Practice

Asking for a raise can be scary, but proper planning can remove much of the anxiety about asking for more money.

Almost everyone, at some point in their career, is going to have to ask for a raise. It can feel especially daunting if you like your job; you don’t want to appear ungrateful, but you also don’t want to feel like you’re making sacrifices in your everyday life just so you can avoid an uncomfortable conversation.

Proper planning can help you, and your employer, get through this awkward but necessary part of your job.

According to a study conducted by Payscale.com only 30% of low-income workers are willing to even ask for a raise, compared to nearly 55% of their higher income counterparts. If you consider yourself on the lower side of the income scale, these numbers shouldn’t discourage you.

All this means is, even when you’re on the top of the income bracket, 45% of people are still too afraid to ask for a raise; you’re not alone. Be bolder than those people.

Your employer has absolutely no incentive to increase your pay if you’re willing to work for less.

You have to ask.

Step 1: Research What You’re Worth at Baseline.

Private practices often pay less than large HMO hospitals, and they do that for many reasons.

Private practices lack unions. The ability to negotiate that comes with a union is simply not available to you.
Private practices generally run on less funds. That means they have less money to go around (although often more than they would like you to believe).

The upside is that private practices offer more flexibility, both in your work duties and schedule. They can be a lot more pleasant to work for. This all puts you in a very good position to go above and beyond your job duties, which is what getting a raise is all about.

But I'm getting ahead of myself.

All the great hours and flexibility in the world doesn’t pay rent, so that’s not exactly a consolation. You need to start the negotiation process by doing your homework and seeing if you're being overpaid, underpaid, or paid at fair market value.

Start with websites like Glassdoor.com, Salary.com, or Payscale.com to see what the national average is, keeping in mind that where you live in the country might have a huge impact on what you can expect to hear in your role.

For this reason, also search locally. Check out local job postings and see what they’re offering.

Ask around and do some sleuthing in your city.

What are other offices in the area paying?
What are their benefits?
What are the expectations of those offices?
How much more do these employees earn when they have additional experience?

This last question can be important, because you may be searching “Medical Technician Salaries” but at a private practice, you’re often wearing multiple hats, you could be the surgery scheduler, which at a hospital is its own position, or also a surgical technician, or insurance biller.

You’re not asking to be paid two or three salaries, just one good one. And one that reflects the job you're doing.

Step 2: Decide What to Ask for in the Way of a Raise

You’re not going to just walk into your meeting, and announce “more money, please!” (or, you might, but it probably wouldn’t be very successful); you need to know what you want, and you need to have a basis to back that up.

The cost of living raise

We throw around the term “cost of living raise” a lot, but what does that really mean?

A “cost of living” raise is a raise that you deserve because time has passed, and everything is slightly more expensive than it was last year, and you need to maintain the same lifestyle.

For example, if your landlord raises your rent $100/month, you’re going to need to make $100 more a month at your job, otherwise you’re sliding backwards; literally bringing home less money than you did the year before.

You would need to make an additional $25 a week, after taxes (which can be complicated math) but figure somewhere between a raise of 75 cents and a dollar an hour. Now, feel free to put that into perspective for your employer. You’re asking for an additional $40 a week.

It’s not that much, but it’s going to help keep you in the same place as you were the year before.

All you're asking for, in this case, is the bare minimum.

Start your research by making a budget of all your expenses so you know what to ask for. There are endless amounts of websites and templates for budget creation, most online banking websites offer budget calculators somewhere on their website. Using free services like Mint.com can help you track your spending, and see how accurate your budget actually is (it may turn out you’re spending a lot more on services or going out to eat)

In most cases, a cost of living raise will generally boil down to 1% annually.

The merit raise

Now, if you want more than just a cost of living raise, there are also “merit raises” to consider.

A merit raise, also called a “pay for performance raise,” is a raise you deserve because you’re awesome at one or more components of your job. A merit raise is typically more like 3%-5% per year.

Unfortunately, in healthcare, it can be hard to justify a merit raise, because you’re not up-selling any sort of product (generally), and in many cases, your pay is directly determined by reimbursement rates, or other factors that are out of your control.

For this reason, concrete quantification of your “worth” to the company can be difficult.

Aggregate evidence of your stellar performance

One of the ways you can show your worth is to physically type out your personal job description. If you still have your original job description on hand, great! Use it as a reference point, then create a list with all the additional or exceptional tasks you do that are above and beyond those of the average person doing your job.

Those are bonuses your employer receives from you, which should be rewarded accordingly, for example:

Accepting additional weekend and holiday coverage
Habitually staying after hours to assist support staff with locking up facility
Receiving glowing Yelp or feedback scores from patients (keep these on file!)
Following up with patients without being asked
Anything else that pertains to you going above and beyond your own role

Step 3: Find the Right Time

You may want to just get it over with, like pulling off a Band-Aid, and storm right into your boss’ office with your request- but hold back. If you stomp into their office, and close the door behind you they’re going to be immediately on the defense.

This needs to be a calm, rational, conversation.

Wait until the end of the day, maybe sometime in the beginning of the week, and let your boss know you’d like to schedule a time with them evaluate your position. If at all possible, schedule a concrete day and time, otherwise, work will get in the way and your meeting (and your possible raise) could to relayed for weeks.

Step 4: Be Prepared to Field Questions

Is there any reason why you shouldn’t get a raise? Be honest with yourself here, because you'll need to be prepared to defend yourself against possible pushback.

Do you show up on time?
Do you complete your tasks?
Is your work high-quality?
Do you provide excellent patient satisfaction?
Do you provide joy in the office, or do you always complain?
Did you just ask for a raise last month?

Understand that the negotiations could get complicated.

Get inside your boss’ head here a little bit. Employers sometimes underpay workers because they don't know any better. If people aren't complaining, bosses might have no idea that they're doing anything wrong.

Unfortunately, some bosses view underpaying workers, or skimping on benefits, as an easy way to increase their profits without harming their patient/client base. It might make you feel like you’re replaceable, but it's your job to show that it's in your employer's best interest to keep you around.

Because it turns out that it absolutely does harm their patients to have stressed out, disgruntled employees who are resentful of their job situation. It also hurts the practice, because turnover rates are higher, leading to understaffing - which in turn hurts the patient flow leads to under-training new staff, who then make mistakes.

Patients like to see the same people working the front desk, the same technicians bringing them back year after year. When there is constant turnover, they perceive something is wrong with the practice, and they’re right. A study conducted by Payscale.com found that employers, on average, spend 20% of an employee’s salary having to replace them, both in searching and loss of revenue, etc.

In unfortunate cases, your employer might take the defense:

Your boss might suggest the practice cannot afford to give you a raise.
Your employer might try to antagonize you.
Your employer might suggest that they do a lot for you, implying that asking for a raise is somehow stepping over a line.

It is CRUCIAL that you remind your boss that you’re not ungrateful, you do appreciate what they offer. This isn’t about that; it’s about adequate compensation for cost of living increases and for going above and beyond your job's description.

Do everything you can to keep the conversation calm, rational, and on task.

What if Your Boss Won't Give You a Raise?

Everyone’s situation is different. There may be some reason that comes up that becomes a road block.

If it becomes clear that they do not want to increase your salary, you have two options.

Option 1: You could ask them what you need to do to change their minds, or ask them when they think the situation will change. It's very possible that you inadvertently chose a poor time to ask for the raise because someone else asked on the same day or the practice recently lost a contract.

Option 2: You could thank your boss for his or her time, then plan an exit strategy.
In private practice, there tends to be a feeling of “we are all in this together”; you work together to keep the office afloat, and every person is valuable and needed.

But if your boss is the only person who can afford to live above the poverty line, and you’re struggling to choose between paying for your car insurance or your student loans, it’s time to move on.

It doesn’t matter how good a job is, or how much you like it if you can’t make your ends meet. Either they don’t believe you’re worth what you need to survive, or they legitimately can’t offer it to you,

In any case, you should be able to leave on good terms and find a place that can support you.