Physician hiring incentives are moving beyond compensation, as candidates increasingly weigh family needs, spousal employment, and work-life balance
One of the most significant changes in physician recruiting is the impact a new role will have on a physician’s family.
So said Doug Lewis, vice president of talent acquisition at Sentara Health, and an integrated, not-for-profit health care delivery system based in the southeast. He shared his insights on a recent MGMA podcast with Daniel Williams, who hosts the organization’s podcast.
Doug is also a board member at the Association for Advancing Physician and Provider Recruitment (AAPPR). That’s worth noting because the AAPPR produces solid research reports that help to answer important questions, such as: How long does it take for a healthcare employer to fill a provider vacancy?
There was a time when compensation was perhaps the single most important factor in physician hiring. That’s true both from the provider’s perspective – and the employer’s perspective – especially as provider compensation has grown. Today, compensation alone is not enough to attract and retain providers.
Below are some of the trends that stood out to us from the conversation.
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1. How a role impacts a physician’s family is a key consideration
When a physician takes a new job, it often involves relocating across the country, which is a life-changing event for both the provider and their family. During the recruitment process, prospective candidates will often ask about the community, schools, churches, and outdoor activities, among other factors that go into the decision.
The local economy matters too, as many families these days have two working parents. A physician will take into account the employment opportunities for their spouse.
Some of the questions physician recruiters receive during engagements can be nuanced. Doug shared some examples he’s experienced. In one example, the candidates, who were a couple, wanted to know about the local chamber music scene in Seattle. In another case, a prospective hire was interested in Spanish immersion schools near the position they were considering.
Takeaways:
- Healthcare recruiters should focus on understanding what’s important to the candidate in the initial interview. Recruiters also need to be knowledgeable about their community and foster a network of connections to whom they can make introductions.
- Healthcare employers should think more strategically about complementary programs that support recruiting. For example, Doug indicated he had past success with a program that would take prospective providers on a tour of the local community as part of onsite visits.
2. Work-life balance weighs heavily on a decision
Candidate expectations have shifted sharply from compensation to lifestyle. The balance between work and life is far more important as the talent shortage persists and provider burnout is a real concern.
There are several different solutions to this like flextime and telehealth programs. The latter has become far more common following the pandemic in 2020, where telehealth moved from a nice-to-have option to a necessity.
Job sharing is another new trend worth considering. That’s when two or more part-time providers share responsibility for patient care. For example, a physician might be on duty two days a week, while a nurse practitioner (NP) shares duties during the other three.
Takeaways:
- Healthcare recruiters would do well to keep track of what’s resonating with candidates. Document the findings and aggregate them into data that can be shared with hiring managers and leaders. Initiatives like job sharing may also narrow the pool of candidates, as preferences will vary from candidate to candidate.
- Healthcare employers need to consider the findings presented by their recruiting team, select those that are feasible, and prepare the organization for changes. For example, the administration and managerial duties for job sharing will be quite different. That requires new policies, procedures, and leadership skills.
3. Employer decision times on new hires are slowing
One interesting twist that Doug noted is that decision times are slowing down. In other words, healthcare employers seem to be more measured and deliberate in hiring decisions.
This seems to be at odds with current trends. For example, according to AAPPR’s data, it already takes three months on average to fill a provider vacancy at a median cost of roughly $16,000 per search.
Further, conventional wisdom suggests that in a tight talent market, the bargaining power rests with the provider. There are more provider employment opportunities today, and the risk of losing a prospective candidate to a competitor may well be higher.
Yet Doug suggested health care employers are slowing down for a few pragmatic reasons. Health systems are evaluating roles more carefully for cultural fit, patient access, and the financial impact.
Takeaways:
- Healthcare recruiters need to be careful to communicate timelines and manage candidate expectations. That requires “checking in with the provider” and “keeping the candidate warm.” There are benefits, too. For example, this allows a “recruiter to have a higher personal touch with that candidate” and could benefit a candidate who is finishing up training.
- Healthcare employers should redouble their efforts to analyze workforce needs, so they aren’t leaving candidates waiting too long. This also has implications for access to care and the workload for existing providers.
4. Compensation isn’t just a “number” anymore
Candidates and employers alike used to enter the recruiting process with a “number” in mind – but that’s no longer true, according to the discussion. He suggested that provider compensation is both an art and a science.
Providers want to be fairly compensated, and employers want to ensure it’s realistic. It’s simply “unsustainable” to outbid competitors anymore. Two models mentioned during the show were:
- Base salary + RVU
- Base salary + RVU + outcomes
The MGMA 2024 provider compensation report demonstrated that on an RVU-basis productivity skyrocketed.
Takeaways:
- Healthcare recruiters must be transparent, so providers understand the compensation model from the outset.
- Healthcare employers have to find a balance to ensure providers are compensated fairly and aren’t competing on compensation alone. Doug noted that loan forgiveness is a popular alternative financial incentive as part of an overall package. An AMN Healthcare study we covered previously provided some benchmarks for educational allowances, as well as relocation allowances and signing bonuses that might be helpful.
5. Locum tenens outpacing permanent placement
Doug said locum tenens is a useful option for filling in gaps for provider coverage – but it’s not a viable long-term solution. He believes that when health stems are over-reliant on locum tenens, it “reflects a deeper structural workforce challenge.”
Takeaways:
- Both healthcare recruiters and healthcare employers should strive for better collaboration among leaders, operations, and recruiting. Recruiters should be striving to collect data to help hiring managers and leaders make decisions. Leaders can do a better job of coming up with a comprehensive workforce strategy based on that data.
Compensation alone isn’t enough anymore
The rate at which compensation has grown is financially unsustainable to compete on compensation alone anymore. At the same time, providers have an increased interest in work-life balance, flexibility, and effects on their family.
The full podcast lasts just under 25 minutes – listening options are available here: Recruiting Physicians in 2026: Doug Lewis on Changing Expectations and Workforce Strategy.
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