Motivational Negotiating: 8 Ways to Advance in the Workplace

Heidi Posey, PA-C


December 07, 2022

I previously discussed some issues with workplace efficiency, but many of us struggle to get other needs met within our organization. Of course, everyone's needs are different, as evidenced by one of the most famous first lines in literature, in Leo Tolstoy's Anna Karenina: "All happy families are alike; each unhappy family is unhappy in its own way."

We often get into a cycle of just accepting situations as they are. There is no universal solution for workplace efficiency, but there are ways of approaching issues to make them more likely to be considered and to make improvements happen.

As a physician assistant (PA), this is something I see all of the time. We are trained clinically and under the medical model to give the best patient care but often neglect matters in the work environment that are inconvenient or make our lives miserable.

We know that motivational interviewing is an incredibly effective tool in helping our patients help themselves. The same is true in workplace relationships. Here are eight tips that can be applied to most office situations to help foster better relationships and lead to meaningful advances in the workplace.


Follow proper chain of command: You may have heard the adage: "You don't quit your job; you quit your boss." As a PA, we often have many bosses. They could be an office manager, CEO, medical director, department director, or even a collaborating physician.

Make sure that you are bringing your ideas for change to the right people, whether it be requesting more medical assistant time, needing a change in hours, or negotiating a raise. There are often real and perceived power differences in our office relationships; you don't want to waste anyone's time or yours.

Research your company: If you want to improve workplace relationships, take some time to really get to know the organization's values and mission statement and how it wants to be perceived. Later, you will be able to show how your goals are in line with the organization's objectives.

Study personalities: You need to know how each individual makes decisions. Are they spur-of-the-moment or team-based decision-makers? Do they make decisions based primarily on emotions or only when they have enough evidence to justify change?

Know how they communicate. Do they prefer calls, emails, or advance scheduling? Do they have an open-door policy?

Know what their motivation is. Do they want to bring in more income for the organization or have the best work environment? Are they driven their own desire for a promotion?

Get to know them personally. What are their interests outside work? What brings them joy? Even though you share a workplace, everyone wants to be seen as a person, not just for their role at work. It might be helpful to consider the last time they said "yes," especially to a big change. How was it addressed, by whom, and when? After all, the best predictor of the future is the past.

Knowing these will help you to find and use the congruencies between what they want to see happen and what you want, too.

Recognize your character traits: We often think we know ourselves, but when trying to communicate in an effective manner it is important to really know how and why you approach issues. If you've ever taken a Myers-Briggs assessment, you may have been surprised by some of your personality traits, but these can change over time.

How do you make decisions? What are your motivators? What do you want for yourself outside of the work environment? If you're trying to get your needs met, adjust your communication style to align with whomever you are negotiating. It is also on you to find common ground.

Know your goal: Determining what it is you want is also going to help meet the needs of your boss or organization. For example, there are great articles on how an organization wins financially if clinicians have more medical assistant help. The clinician has a lower administrative burden, improved job satisfaction, and is able to see more patients, ultimately increasing revenue above and beyond the cost of the extra support. Some of the same strategies apply when you are negotiating a contract. Find a perspective on the situation that is mutually beneficial. People are always more willing to help you if they get something out of it.

You can now set up a framework to make change happen. Based on the decision-maker's communication style, set up a meeting, a walking lunch, for example, or start with an email.

Present solutions: The difference between whining and winning is presenting a problem with potential solutions. If you don't have a single solution or your solution ultimately isn't a viable option, let them know that you are stuck and ask them for advice: "How would you recommend this be handled?"

People love it when you ask for their opinions. This can provide another level of insight. Summarize their comments and reflect their concerns back to make sure they know they are being heard and that you understand potential barriers.

However the meeting goes, always leave on a positive note. This reinforces rapport, and people are often much more willing to follow through when there is a good interpersonal relationship.

Set realistic expectations: When trying to make changes, it is important to consider what is realistic. If there are many items you'd like to see changed, it's often best to prioritize what's most likely to be accomplished.

Plan follow-up: From the very first interaction, always schedule the next step or meeting. Otherwise, it's likely to be just a lofty idea you want to float by someone. We all get busy, so if it's not scheduled, things often fall by the wayside. Make sure you have clear, defined ideas of what should change, but also be open to other perspectives.

Using some of these tools, and understanding the motivation of our organizations, gives us a common ground to get you more of what you need to sustain healthy work environments and relationships.

Using these techniques, I have been able to successfully negotiate changes in my schedule, limit how many points of contact that I have for any given clinic, and have set medical assistants for certain clinicians. I've been at a new clinic the last year; it was a small startup with three clinicians but has grown to 10 in that time. It is all telehealth, and we really didn't have a need for medical assistants but were feeling the growing pains and I have started building my framework to take to our administrative team, to negotiate using medical assistants and what this will look like. I'd be interested to hear what has worked for you in your organization to affect change.


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