Evaluating Physician Employment Contracts: How Do Your Benefits Measure Up?


From signing bonuses to relocation and continuing education allowances, your employment contract needs to provide more than a competitive salary.

Fam Pract Manag. 2017 Sep-Oct;24(5):9-11.

Author disclosures: The authors disclose that they are employed by a physician search firm; no other relevant financial affiliations disclosed.

The primary feature of most physician employment contracts is, of course, a base salary. A standard contract will typically stipulate a guaranteed amount that the physician will be paid and may also include a production bonus formula. Most production bonuses are based on relative value units (RVUs) or other volume-related metrics, although a growing number may include value-related metrics such as patient satisfaction scores, adherence to treatment protocols, or use of electronic health records (EHRs). Between the base salary and the production bonus outlined in the contract, physicians should be able to determine both the minimum amount they will earn during the contract period and the maximum they could achieve through the bonus.

Beyond the basic financials, physician employment contracts also generally include a range of other benefits, which we will describe in this article. It should be noted that this information is derived mostly from larger employers such as hospitals, health systems, large medical groups, and community health centers working with our search firm. The employment terms offered by smaller groups may vary from what is described.

Signing bonuses

Physician recruiting has become highly competitive because of an emerging physician shortage that is particu larly acute in primary care. Seventy percent of physicians receive 51 or more job solicitations during the course of their training, and 50 percent receive 100 or more. For primary care residents, the numbers are even higher, with 78 percent receiving 51 or more job solicitations and 55 percent receiving 100 or more.1

For the 11th year in a row, family medicine was the most requested type of search for our firm,2 and most family physicians are the focus of continuous recruiting activity.

To differentiate themselves, employers such as hospitals, medical groups, and others often offer physician candidates a signing bonus. Signing bonuses are intended to create a sense of urgency and commitment, and they can prove to be the extra impetus physicians need to put their name on a contract. Signing bonuses also provide physicians with a short-term financial infusion that can make a move more feasible and appealing.

A dozen years ago, fewer than half of our firm's search assignments featured a signing bonus. That number now stands at 76 percent.2 It would be higher, but some service sites that have proliferated rapidly in recent years, including urgent care centers and Federally Qualified Health Centers (FQHCs), usually do not offer signing bonuses. The average signing bonus for all physicians is currently $32,636.2 (See the range offered in “Signing bonuses, all physicians.”)

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About the Authors

Travis Singleton is senior vice president of Merritt Hawkins & Associates, a physician search and consulting firm and a part of AMN Healthcare. Phillip Miller is vice president of communications for Merritt Hawkins and Staff Care, both parts of AMN Healthcare.

Author disclosures: The authors disclose that they are employed by a physician search firm; no other relevant financial affiliations disclosed.



1. 2017 Survey of Final-Year Medical Residents. Dallas: Merritt Hawkins; 2017.

2. 2017 Review of Physician and Advanced Practitioner Recruiting Incentives. Dallas: Merritt Hawkins; 2017.

3. Healthcare provider move rates. SK&A website. http://www.skainfo.com/page/infographic-provider-move-rates. Updated October 2016. Accessed July 25, 2017.


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