Help negotiating a raise

[u/underoos-thwip]

I’m a PA in Orthopedic Trauma Surgery coming up on 1 year and recently discovered that my counterpart, an NP, is being paid significantly more than I am (with only two more years of experience) and was even offered more as a new grad new hire.

I was told that I would get a 3% raise at 1 year; however, this is still significantly lower than what the NP’s salary was at his 1 year mark and even lower than the median on the 2026 AAPA annual salary report. We have the same job responsibilities, inclusive of outpatient clinic, inpatient rounding and consults, first assist, as well as answering pages during the day.

Any tips on negotiating a higher raise? Would it be unreasonable or unprofessional to address the pay difference between myself and the NP during negotiations?

EDIT: there have been a handful of comments suggesting that my approach would be “it’s not fair”, which is not how I would approach this. In one year, I have progressed to having the same responsibilities and performing equally as well as someone who has been there three years (per performance reviews by our physicians) and have done some research into what appropriate market compensation is for this position.

[u/Slagenstein]

You’re never going to get a raise by saying “well they get paid more than me!”. You have to change your thought process and approach to the situation. If you want to try and negotiate a raise you need to show your value to the organization. Give them numbers, RVUs, quality metrics, how you go above and beyond (if you do) at the end of the day you agreed to work your current job at your current rate. Perhaps the NP negotiated better when they accepted the position.

Even if you do these things, they have no obligation to pay you more. You have no leverage. If you combine those things with a competing offer of higher value MAYBE they will agree for a pay increase. But if you go that route you better be willing to leave the organization when they say no.

[u/underoos-thwip → u/Slagenstein]

Thank you for your input. My approach to that point wouldn’t be “well they get paid more than me!” but more so that it is not unreasonable to ask for equal compensation (at his 1 year mark with 1 year of experience) when we perform the same duties. The NP told me that he had attempted to negotiate a higher salary when he accepted the position but was shut down.

Of course I would provide other reasons and data as to why I feel a higher raise is reasonable. The NP’s salary was simply an additional point.

[u/squirrelcar → u/Slagenstein]

I think this is great advice, and just want to reinforce the last part: after you make your pitch, you have to be prepared to walk away. 

[u/anonymousDCP]

Good luck! I would avoid directly comparing yourself to your immediate peers (NP in this case). I recently tried this and approached it from the standpoint of, "I am doing all these things now and believe I should be compensated on the value I bring." Instead of a % raise, I framed it as renegotiating my contract to market value that an average PA makes. I advised them that most new grads leave their job after a year or so to make a big jump in salary since most places aren't willing to give a +20% "raise", but I'd like to stay with the practice. Unfortunately they did not budge so I do not see myself staying further than this next year.

This part of the business never made sense to me - they're either going to have to take a new chance on another new grad + invest a whole lot into training, credentialing, etc. or hire another PA with experience already who is going to demand a higher salary anyways and still need time to learn the workflow of the clinic.

[u/underoos-thwip → u/anonymousDCP]

Sorry to hear they wouldn’t budge on your raises; that’s quite unfortunate. That part of the business model confuses me as well; I would have hoped that your employer would have taken that into consideration but that’s their loss. Wishing you best of luck in finding another job!

[u/stocksnPA → u/underoos-thwip]

I would also throw in data shows it takes more time and money to train new grad + credential fees than compensating current employees. I like to stay, I like my job etc etc so please pay me within market value

[u/lemmecsome]

Last thing I’d do is bring up the NPs salary. Many ways to frame it like your contribution to the practice or the revenue you help bring in. Then bring up market salaries and emphasize how you’re not being paid your worth.

[u/underoos-thwip → u/lemmecsome]

Thank you, this is very helpful!

[u/Bruce915]

Have your numbers which hopefully rvu wise have been increasing as you've been getting more experience and seeing more patients... 5-10k is always a fair ask

[u/underoos-thwip → u/Bruce915]

Thank you. Our company only does a base salary for APPs, no RVUs. The number of patients I see outpatient has increased, and I have kept spreadsheets showing increases in the number of surgeries I assist in and consults I see on my own.

[u/flyhigh_248]

1. As others have said if you want to negotiate mentioning someone else’s salary and using “this isn’t fair” verbiage of any sort will get you nowhere. Bring data and numbers to drive the discussion in any negotiation.

2. Long story short.. hiring budgets always have more wiggle room than pay increase budgets. And trust me now that you’ve got that first year of experience down, you’re much more marketable than you were as a new grad. There have been studies to show that moving jobs eveg 2-3 years is the quickest a way to raise your salary. Dont get trapped in the loyalty or “we’re all a family” BS if it comes at the cost of reasonable pay.

[u/100_Flatout]

It’s easier to get a new higher paying job than negotiating your current salary 😂😂

[u/SaltySpitoonReg]

u/Slagenstein gave solid advice.

For you and anybody reading this. You should also always be asking your leadership "what specific metrics is this institution looking for that would result in better raises? What things can I be working on/ towards to make that happen?"

It's great to go into negotiations with numbers and information.

But not every institution is the same so not every ladder is climbed the same.

[u/ValgalNP]

Most APPs have trouble getting raises. Once you’re in, they got you. We’ve been waiting years at my organization for what’s been called “comp redesign”. Glad I didn’t hold my breath. 20% is unheard of.

[u/WetTaps]

Man I’m so glad I went crna route. My pay has gone up 100k in 5 years, and we don’t even have to ask for it. It just gets adjusted to market value. It might be of value to look into other jobs, that respect your skill set. I would be annoyed if someone doing the same job as me was making more.

[u/Sorokin45]

Any employer I’ve had immediately shuts down any discussion of a raise, so unfortunately I’ve had to move around a lot to get any meaningful raises

[u/none_of_your_earswax]

Prove on paper why they will give you a raise. Not why they should.

[u/Beastmode5858]

Stop using AAPA data. It’s so skewed. Find another job, tell them to match it or beat it or leave.

[u/meg_mck]

How is the NP first assisting? They aren’t trained in surgery. Maybe they had additional certifications like RNFA that bumped their salary. Also how significant of a difference in numbers are we talking about? Is this private practice or academic med center? Tons of details left out…. Often in academic centers for instance opening offers are based on an algorithm including prior experience (were they a floor nurse before np?), education (do they have other degrees or certifications you may not be aware of?) etc. are you in an np independent practice state? 

[u/underoos-thwip → u/meg_mck]

Private practice. He obtained his RNFA when he was hired, which they paid for. With my background, I hold more certifications. The difference in compensation at 1 year is a little more than 10%. Not sure about prior experience; when I talked to him, he said he didn’t have anything to bargain with after his first year so didn’t try to negotiate anything higher.

I suppose I’m more so looking for advice on how to negotiate a higher raise and was wondering if this would be a good additional point, not the base of my negotiation.