Merritt Hawkins’ 2021 Review of Physician and Advanced Practitioner Recruiting Incentives

The Merritt Hawkins’ 2021 Review addresses several important factors such as salaries, bonuses, and other incentives used to recruit physicians, physician assistants, nurse practitioners and CRNAs. This resource focuses on physician compensation trends, physician burnout, and physician shortages within the Review.

Physician Compensation Trends

Several specialty salaries were reported in the 2021 Review. Surgical specialties within this study include oral maxillofacial surgery and orthopedic surgery.

	LOW	AVERAGE	HIGH
Oral Maxillofacial Surgery	$275,000	$349,000	$1,200,000
Orthopedic Surgery	$300,000	$546,000	$1,000,000

The review also assessed physician compensation and contract structures. Topics under this purview included:

Base salary
Productivity bonus structures
Quality incentives
Signing bonuses
Relocation allowance
Medical education loan repayment

Currently, the RVU remains the primary way employers measure physician volume-based productivity. Accordingly, RVUs were featured in 57% of physician employment contracts offering a salary and production bonus within the Review.

The majority of searches in this study offered a relocation expense allowance. However, fewer searches offered relocation allowance when compared to the previous year. In the 2019/2020 period 97% of medical practices offered relocation allowance to physicians, in contrast to 74% in the 2020/2021 period. The amount of relocation allowance varied widely.

Amount of Relocation Allowance

	LOW	AVERAGE	HIGH
2020/21	$2,000	$10,634	$75,000
2019/20	$1,000	$10,553	$40,000
2018/19	$2,000	$10,393	$30,000
2017/18	$2,500	$9,441	$25,000
2016/17	$2,500	$10,072	$44,000
2015/16	$2,500	$10,226	$30,000

In addition, signing bonuses were offered by a majority (61%) of medical practices. Similarly, the amount of signing bonus offered varied with a low of $1,000 and a high of $240,000 in 2020/2021.

Amount of Signing Bonus Offered

	LOW	AVERAGE	HIGH
2020/21	$1,000	$29,656	$240,000
2019/20	$2,500	$27,893	$100,000
2018/19	$3,000	$32,692	$225,000
2017/18	$2,500	$33,707	$180,000
2016/17	$2,500	$32,636	$275,000
2015/16	$1,000	$26,889	$350,000

According to the Review, signing bonuses remain a common recruiting incentive among hospitals and medical groups, though they may not be part of incentive packages offered by academic medical centers, direct pay/concierge practices, urgent care centers, some FQHCs, Indian Health and other settings.

CME expense allowance and educational forgiveness are additional incentives used to recruit physicians. In this review, 94% of searches offered to pay continuing medical education (CME) while 21% of searches offered to pay for educational forgiveness.

Physician Burnout & Physician Shortage

Two major factor driving the physicians shortage are burnout and the number of physicians nearing retirement age. Close to 30% of active physicians are 60 or older in the United States.

Further, COVID-19 has exacerbated the physician shortage. In the 2020 Survey of America’s Physicians 11% of respondents indicated they switched jobs or moved into a non-clinical role as a result of COVID-19.

In this survey 38% of physicians indicated they would like to retire in the next year, including 21% of physicians 45 years old or younger.

These results are relevant to physician wellbeing as well as physician negotiation power. Physician burnout must be addressed by physicians and hospital practices to maintain well-being. Determining and reviewing your cultural fit before and after accepting a job is necessary to prevent burnout. Luckily, the growing shortage means physicians have greater leverage to negotiate duties and compensation.

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