8 ways to win physician recruits when you can't match the signing bonus

The average physician signing bonus reached $49,306 in the past year, up from $38,215, and bonuses appeared in 87 percent of the searches tracked in AMN Healthcare's 2026 Review of Physician and Advanced Practitioner Recruiting Incentives. Average starting base pay hit $419,000. Hospitals were the largest setting in AMN's search work, at 38 percent of engagements, and they can spread recruiting costs across a balance sheet most independent practices don't have.

Searches are also dragging on. Half of physician searches were still open as of Dec. 31, 2025, and the median search took 119 days to fill, according to benchmarking data from the Association for Advancing Physician and Provider Recruitment. Meanwhile, the proposed 2027 Medicare Physician Fee Schedule would cut the conversion factor 1.68 percent for physicians who aren't qualifying APM participants, as a one-year 2.5 percent increase expires. The final rule typically arrives in early November.

Trimming offers to absorb the cut isn't a realistic answer either, said Andy Swanson, chief customer success officer at the Medical Group Management Association. "If you're recruiting one of those hard-to-recruit specialties, decreasing that starting salary is probably not going to land you the top-quality candidate," Swanson said in a June interview with Physicians Practice. The better play is to compete on what a health system can't or won't match: ownership, flexibility, clarity and speed. Here are eight places to start.