2024 Review of Physician and Advanced Practitioner Recruiting Incentives An Overview of the Salaries, Bonuses, and Other Incentives Customarily Used to Recruit Physicians, Physician Assistants, Nurse Practitioners and CRNAs
2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Introduction The 2024 Review of Physician and Advanced Practitioner Recruiting Incentives is the latest in a series of annual reports produced by AMN Healthcare’s Physician Solutions division – formerly known as Merritt Hawkins. The Physician Solutions division of AMN Healthcare specializes in the recruitment of physicians in all medical specialties, physician leaders, and advanced practice professionals (APPs), including nurse practitioners (NPs,) physician assistants (PAs) and certified registered nurse anesthetists (CRNAs). Other divisions of AMN Healthcare, the nation’s largest publicly traded healthcare workforce solutions company, specialize in a wide range of nurse and allied healthcare professional staffing services, as well as healthcare workforce technology, management and revenue cycle solutions. This report marks AMN Healthcare/Merritt Hawkins’ 31st annual Review of the search and consulting engagements we conduct on behalf of our clients. The Review is the longest consecutively published and most comprehensive report on physician and APP recruiting incentives in the industry. Over the past 31 years the Review has become a standard benchmarking resource used by hospitals, medical groups and other healthcare facilities to determine which incentives are customary and competitive in physician and APP recruitment. The Review also has become a resource widely utilized by healthcare journalists, analysts, policy makers and others who track trends in physician supply, demand and compensation. Ongoing Thought Leadership Produced by AMN Healthcare’s Center for Workforce Research, the Review is part the company’s ongoing thought leadership initiatives, which include surveys, white papers, speaking presentations, blogs, webinars and podcasts. The 2024 Review is based on a representative sample of the 2,138 permanent physician and advanced practitioner search engagements that AMN Healthcare’s Physician Solutions division had ongoing or conducted during the 12-month period from April 1, 2023, to March 31, 2024. The intent of the Review is to quantify financial and other incentives offered by our clients to physician and APP candidates during the course of recruitment. Incentives cited in the Review are based on contracts or incentive packages used by hospitals, medical groups and other facilities in real-world recruiting engagements. A Key Differentiator
Unlike other physician compensation surveys, the Review tracks physician and APP starting salaries and other recruiting incentives, rather than total annual compensation. It therefore reflects the incentives physicians and APPs are offered to attract them to new practice settings rather than what they may actually earn and report on their tax returns. The range of incentives detailed in the Review may be used as benchmarks for evaluating which recruitment incentives are customary and competitive in today’s market. In addition, the Review is based on a national sample of search assignments and provides an indication of which physicians and APPs are currently in the greatest demand, as well as the types of medical settings into which physicians and APPs are being recruited. Following are several key findings of the 2024 Review .
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Key Findings AMN Healthcare’s 2024 Review of Physician and Advanced Practitioner Recruiting Incentives reveals a number of trends within the physician and APP recruiting market, including: • Average starting salaries for physicians and APPs
• The average starting salary for family physicians was up 6.27% year-over-year , from $255,000 last year to $271,000 this year. • Though family physicians continue to be in demand, overall demand for family physicians and other primary care physicians is down significantly over previous years. • AMN Healthcare now conducts more searches for APPs, including NPs, PAs, and CRNAs , than it does for primary care physicians, highlighting ongoing patient migration away from primary care practices toward retail clinics, urgent care centers and telemedicine providers. • Only 14% of AMN Healthcare’s search engagements this year were for primary care physicians , down from 17% last year, while 23% of search engagements were for APPs, up from 19% last year. • The majority of AMN Healthcare’s search engagements this year (63%) were for physician specialists, including obstetrician/gynecologists, gastroenterologists, radiologists, cardiologists and other specialists who remain in strong demand, reflecting the needs of an aging population that is reliant on specialty care. • OB/GYNs were 2nd on the list of AMN Healthcare’s most requested physician search engagements this year , up from 4th last year. Demand for OB/GYNs remains strong, while supply may be inhibited by the Supreme Court’s Dobbs vs. Jackson decision, after which fewer medical school graduates opted for OB/ GYN residency positions. • 71% of AMN Healthcare’s search engagements were located in communities of 100,000 people or more, indicating that demand for physicians and APPs is not limited to small and/or rural communities. Following is a breakout of the characteristics and metrics of AMN Healthcare’s 2023/24 recruiting engagements.
were generally up year-over-year , with increases seen in 13 of the 20 specialties tracked in the Review and decreases in only four (there is no comparison data for three of the 20 specialties). • Orthopedic surgeons are offered the highest average starting salary of physicians tracked in the Review at $686,000, while pediatricians are offered the lowest ($244,000). • In addition to starting salaries, many physicians and APPs are offered signing bonuses. The average signing bonus for physicians is $31,473, while the average signing bonus for NPs and PAs is $11,758. • Physicians and APPs also often receive relocation and continuing medical education (CME) allowances in addition to salaries and signing bonuses. The average relocation allowance for physicians is $11,284, while the average relocation allowance for NPs and PAs is $7,910. The average CME allowance for physicians is $3,969, while the average CME allowance for NPs and PAs is $2,195. • NPs continue to be in strong demand and topped the list of AMN Healthcare’s most requested physician and APP search engagements for the fourth consecutive year. NPs are filling needs created by the physician shortage, and are being used to staff a growing number of urgent care centers, retail clinics, and telemedicine platforms. In addition, more specialty medical practices are employing them. • The average starting salary for NPs was up 8.6% year-over-year , from $158,000 last year to $164,000 this year, underscoring the strong demand for advanced practice nurses. • Family physicians topped the list of AMN Healthcare’s physician search engagements for the 18th year in a row, second only to NPs among search engagements of all types.
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AMN Healthcare 2024 Review of Physician and Advanced Practitioner Recruiting Incentives : Recruiting Engagement Characteristics and Metrics
1. Total Number of Physician/ Advanced Practitioner Search Assignments Represented
The 2024 Review is based on a representative sample of the 2,138 permanent physician and APP search engagements AMN Healthcare Physician Solutions had ongoing or was engaged to conduct during the 12-month period from April 1, 2023 to March 31, 2024.
2. Settings of Physician Search Assignments
2023/24 2022/23 2021/22 2020/21 2019/20 2018/19
Hospital
609 (28%)
939 (35%)
914 (34%) 487 (18%)
813 (33%) 714 (29%)
1,168 (36%) 1,065 (34%) 1,042 (32%) 877 (28%)
Group
547 (26%)
612 (23%)
Solo/partnership/Concierge
128 (6%)
52 (2%)
29 (1%)
70 (3%)
92 (3%)
31 (1%)
CHC/FQHC/IHS
101 (5%)
135 (5%)
219 (8%)
197 (8%)
199 (6%)
282 (9%)
Academics
462 (22%)
830 (31%)
911 (34%)
493 (20%)
591 (18%)
626 (20%)
Other (Urgent Care, HMO, Association, Home Health, etc.)
291 (13%)
108 (4%)
135 (5%)
171 (7%)
159 (5%)
250 (8%)
If Academics, what type of position? (Of 462 Academic Setting Positions)
2023/24 2022/23 2021/22 2020/21 2019/20 2018/19
Research Faculty
12 (3%)
8 (1%)
21 (2%)
6 (1%)
25 (4%)
21 (3%)
Leadership/Administration
63 (14%)
307 (37%) 515 (62%)
193 (21%)
105 (21%)
168 (28%)
143 (23%) 462 (74%)
Clinical Faculty
387 (83%)
697 (77%)
382 (78%)
398 (68%)
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
3. States Where Search Engagements Were Conducted
AMN Healthcare Physician Solutions conducted search engagements in all 50 states with the exception of Hawaii during the 2024 Review period, as well as Washington, D.C.
4. Number of Searches by Community Size
2023/24 2022/23 2021/22 2020/21 2019/20 2018/19
0-25,000
278 (13%)
293 (11%)
326 (12%)
549 (17%)
534 (17%)
612 (20%)
25,001-100,000
449 (21%)
510 (18%)
536 (20%)
588 (18%)
530 (17%)
545 (18%)
100,001+
1,411 (66%)
1,873 (71%)
1,833 (68%) 2,114 (65%) 2,067 (66%) 1,888 (62%)
5. Top 20 Most Requested Searches by Specialty
2023/24 2022/23 2021/22 2020/21 2019/20 2018/19
1. Nurse Practitioner
426
420 279 149 130
405 280 148 133
335 284
270
169 457
2. Family Medicine
188
448
3. Obstetrics/Gynecology
87
108
122
161
4. Internal Medicine 5. Gastroenterology
85 69
117
146
148
99
95
67
65
85
6. Radiology 7. Cardiology
61
155
162
136
163
148
60 55 44
99
100
63
56
97 70
8. Anesthesiology
139
117 63 86
78
72
9. Hospitalist
63
27
71
143
10. Hematology/Oncology
41
96
74
91
53
11. Psychiatry
40 38 35 34
138
153
124
182
199
12. CRNA
50
86 48
64
71
47
13. Urology
53
N/A
N/A
N/A
14. Orthopedics
46
51
45
55
73
15. General Surgery
31
N/A
N/A
N/A
N/A
N/A
16. Neurology
28 23 22 22 20
57 47
43 35
63 42
115
84 60
17. Dermatology
43
18. Otolaryngology (ENT) 19. Emergency Medicine
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A
22
20. Pediatrics
37
53
28
54
85
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
6. Other Specialty Recruitment Engagements
Allergy & Immunology Cardiothoracic Surgery Critical Care-Intensivist Medicine, Endolcrinology Endocrinology, Diabetes & Metabolism Geriatric Medicine Hospice and Palliative Medicine Infectious Disease Nephrology Pulmonary and Critical Care
Pathology, Hematology Pediatrics, Neonatal-Perinatal Medicine / Neonatology Pediatrics, Neurodevelopmental Disabilities Pediatrics, Endocrinology Physician Assistant Pediatric Gastroenterology Physical Medicine & Rehabilitation Physical Medicine & Rehabilitation, Pain Medicine Plastic Surgery Podiatrist Preventive Medicine, Occupational Medicine Psychologist Radiation Oncology Rheumatology Surgery, Breast Surgery, Colon & Rectal Surgery Surgery, Surgical Critical Care (Trauma Surgery) Surgery, Surgical Oncology
Pulmonary Disease Neurological Surgery Ophthalmology
Ophthalmology, Glaucoma Ophthalmology, Oculoplastic Ophthalmology, Retina Surgery Oral & Maxillofacial Surgery Pathology Pathology,Anatomic Pathology & Clinical Pathology Pathology, Clinical Pathology Pathology, Cytopathology
Vascular Surgery Thoracic Surgery Urgent Care
Pathology, Forensic Pathology Pathology, Gastroenterology
Academic Recruiting Engagements Advanced Practice Supervisor, Orthopaedic Surgery Assistant Dean, Osteopathic Practice and Principals
Chair, Medicine Chair, Neurosurgery Chair, Nuclear Medicine Chair, Obstetrics and Gynecology Chair, Ophthalmology & Visual Sciences Chair, Orthopedic Surgery and Physical Rehabilitation Chair, Osteopathic Manipulative Medicine Chair, Otolaryngology and Head & Neck Surgery Chair, Pediatrics Chair, Pharmacology Chair, Primary Care and Rural Medicine Chair, Psychiatry and Behavioral Sciences Chair, Psychiatry and Behavioral Sciences Chair, Surgery Chief Clinical Officer, Children & Women’s Hospitals Chief CRNA
Associate Chief Medical Officer Associate Chief of Clinical Affairs Associate Chief of Internal Medicine Associate Dean, Faculty Affairs
Associate Designated Institutional Official Associate Director of Population Sciences Associate Director, Community Outreach and Engagement Cancer Center Director and Physician Executive, Cancer Care Service Line Chair, Ben May Department for Cancer Research and Director, Ludwig Center
Chair, Cellular and Integrative Physiology Chair, Family and Community Medicine Chair, Infectious Diseases
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Chief Executive Officer, Pediatric Physician’s Organization Chief Medical Examiner Chief Medical Officer Chief Physician Executive Chief, Allergy & Immunology Chief, Breast Imaging Chief, Breast Medical Oncology Chief, Cardiac Imaging and Echocardiography Chief, Cardiology Chief, Clinical Pathology Chief, Developmental Behavioral Pediatrics Chief, Endocrinology, Diabetes and Metabolism Chief, Gastroenterology Chief, General Academic Pediatrics Chief, Geriatric Medicine Chief, GI Pathology Chief, Hematology Oncology Chief, Hematology, Oncology, Neuro-Oncology and Stem Cell Transplantation Chief, Hospital Medicine Chief, Maternal-Fetal Medicine Chief, Medical Physiology Chief, Neonatal-Perinatal Medicine Chief, Neurosurgery Chief, Obstetrics and Gynecology Chief, Orthopedic Hand & Upper Extremity Surgery Chief, Pediatric Anesthesiology Chief, Pediatric Cardiovascular Surgery Chief, Pediatric Emergency Medicine Chief, Pediatric Endocrinology Chief, Pediatric Genetics Chief, Pediatric Hematology Oncology Chief, Pediatric Infectious Disease Chief, Pediatric Neurology Chief, Pediatric Neurosurgery Chief, Pediatric Physical Medicine and Rehabilitation Chief, Pediatric Rheumatology Chief, Plastic Surgery Chief, Reproductive Endocrinology and Infertility Chief, Solid Tumor Chief, Vascular Surgery Chief, Women’s Health Pathology Clinical Chief, Endocrinology Clinical Director, Allergy, Asthma, Immunology Clinical Director, Gastroenterology
Clinical Director, Sarcoma Oncology Co-Director, Breast Center & Section Head, Breast Surgery Co-Director, Clinical Genetics Laboratory Co-Leader, Discovery & Developmental Therapeutics Research Program Dean, College of Medicine and Senior Vice President for Health Affairs Deputy Chief Medical Officer Director, Blood Disorders and Cell Therapy Center Director, Cancer Genetics Director, Center for Healthcare Policy and Research Director, Institutional Animal Care and Use Committee Director, Physician Assistant Training Program Executive Director, Cancer Network Executive Director, Digestive Diseases Institute Executive Medical Director, Oncology Clinical Research Unit Executive Vice Chair, Department of Medicine Executive Vice President, Chief Clinical Officer and Physician Executive Executive Vice President, Physician in Chief Fellowship Director, Cytology and Cytopathology Head Team Physician, Sports Medicine Medical Director, Adult Reconstructive Orthopaedic Surgery Medical Director, Ambulatory Anesthesiology Medical Director, Blood Banking Transfusion Pathology Medical Director, Bone Marrow Transplant Program Medical Director, Breast Surgery Medical Director, Cardiac Surgery Medical Director, Clinical Genetics Medical Director, Clinical Laboratories Medical Director, Employee Health and Urgent Care Medical Director, Family Medicine Medical Director, Fetal Intervention Program Medical Director, Glaucoma Ophthalmology Service Medical Director, Health Center for Student Care Medical Director, Neonatology Medical Director, Otolaryngology Medical Director, Pavilion Health Medical Director, Pediatric Ophthalmology Medical Director, Pediatric Radiology Medical Director, Physician Advisor Program Medical Director, Radiation Oncology Medical Director, Regional Psychiatric Program Medical Director, Renal Pathology Service and Electron Microscopy Laboratory Medical Director, Trauma Surgery
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
President and Chief Executive Officer, Cancer Institute President, Regional Medical Group Primary and Acute Care Medical Provider Manager, Student Health and Counseling Services Program Director, General Internal Medicine Substance Use Disorder Residency Program Director, Emergency Medicine Residency Program Director, Family Medicine Residency Program Director, Family Medicine Residency Program Director, Genetic Counseling Residency Program Director, Internal Medicine Residency Program Director, Obstetrics and Gynecology
Residency Program Director, Urology Senior Associate Dean Senior Associate Dean, Faculty Affairs and Faculty Development Senior Vice President and Dean, School of Medicine Service Medical Director, Molecular Genetics Laboratories Surgical Director, Heart Transplantation Surgical Director, Lung Transplantation System Director, Cardiothoracic Services System Medical Director, Orthopaedic Service Line Vice Chair, Clinical Pathology Vice Chair, Diversity, Equity, and Inclusion Vice Chair, Medical Education Vice Chair, Research in Orthopaedic Surgery
Residency Program Director, Pediatrics Residency Program Director, Psychiatry
7. Income Offered to Top 20 Most Recruited Physicians and APPs
(Base salary or guaranteed income only, does not include production bonus or benefits. Average salaries indicated for non-Academic and Academic positions in select specialties in which Academic salary data is most robust. All numbers rounded)
Nurse Practitioner
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$85,000
$164,000
$310,000
2023/24 (Non-Academic)
$85,000
$164,000
$310,000
2023/24 (Academic)
$120,000
$151,000
$220,000
2022/23
$115,000
$151,000
$271,000
2021/22 (All Positions)
$68,000
$138,000
$266,000
2021/22 (Non-Academic)
$68,000
$153,000
$266,000
2021/22 (Academic)
$75,000
$128,000
$174,000
2020/21
$90,000
$140,000
$275,000
2019/20
$90,000
$125,000
$234,000
2018/19
$90,000
$124,000
$200,000
YOY + 8.61% All Positions
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Family Medicine
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$120,000
$271,000
$460,000
2023/24 (Non-Academic)
$120,000
$274,000
$460,000
2023/24 (Academic)
$211,000
$249,000
$315,000
2022/23 (All Positions)
$120,000
$255,000
$375,000
2022/23 (Non-Academic)
$120,000
$255,000
$325,000
2022/23 (Academic)
$204,000
$259,000
$375,000
2021/22 (All Positions)
$185,000
$251,000
$322,000
2021/22 (Non-Academic)
$185,000
$251,000
$322,000
2021/22 (Academic)
$210,000
$263,000
$300,000
2020/21
$180,000
$243,000
$400,000
2019/20
$140,000
$240,000
$325,000
2018/19
$130,000
$239,000
$400,000
YOY change + 6.27% All Positions
Obstetrics/Gynecology
LOW
AVERAGE
HIGH
2023/24
$275,000
$389,000
$700,000
2022/23
$240,000
$367,000
$700,000
2021/22
$240,000
$332,000
$520,000
2020/21
$207,000
$291,000
$750,000
2019/20
$200,000
$327,000
$600,000
2018/19
$200,000
$318,000
$475,000
YOY change +5.99% All Positions
Internal Medicine
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$180,000
$271,000
$375,000
2023/24 (Non-Academic)
$180,000
$276,000
$375,000
2023/24 (Academic)
$230,000
$236,000
$250,000
2022/23
$168,000
$255,000
$350,000
2021/22 (All Positions)
$180,000
$255,000
$375,000
2021/22 (Non-Academic)
$180,000
$256,000
$375,000
2021/22 (Academic)
$201,000
$247,000
$300,000
2020/21
$170,000
$244,000
$500,000
2019/20
$175,000
$276,000
$400,000
2018/19
$184,000
$273,000
$400,000
YOY change +6.27% All Positions
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Gastroenterology
LOW
AVERAGE
HIGH
2023/24
$375,000
$531,000
$750,000
2022/23
$315,000
$506,000
$700,000
2021/22
$375,000
$486,000
$600,000
2020/21
$125,000
$453,000
$750,000
2019/20
$300,000
$457,000
$600,000
2018/19
$350,000
$495,000
$650,000
YOY change +4.94% All Positions
Radiology
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$365,000
$495,000
$750,000
2023/24 (Non-Academic)
$390,000
$508,000
$750,000
2023/24 (Academic)
$365,000
$422,000
$550,000
2023/24 (Teleradiology)
$375,000
$456,000
$690,000
2022/23 (All Positions)
$370,000
$472,000
$693,000
2022/23 (Non-Academic)
$120,000
$481,000
$693,000
2022/23 (Academic)
$374,000
$424,000
$470,000
2021/22 (All Positions)
$200,000
$455,000
$650,000
2021/22 (Non-Academic)
$200,000
$465,000
$650,000
2021/22 (Academic)
$340,000
$416,000
$500,000
2020/21
$150,000
$401,000
$825,000
2019/20
$275,000
$423,000
$577,000
2018/19
$245,000
$387,000
$550,000
YOY change + 4.87% All Positions
Cardiology (Non-Inv.)
LOW
AVERAGE
HIGH
2023/24
$120,000
$396,000
$750,000
2022/23
$281,000
$433,000
$584,000
2021/22
$300,000
$484,000
$1,000,000
2020/21
$350,000
$446,000
$700,000
2019/20
$300,000
$409,000
$575,000
2018/19
$325,000
$441,000
$620,000
2017/18
$300,000
$427,000
$580,000
YOY change -8.55% All Positions
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Anesthesiology
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$310,000
$460,000
$600,000
2022/23 (All Positions)
$260,000
$450,000
$600,000
2022/23 (Non-Academic)
$375,000
$496,000
$600,000
2022/23 (Academic)
$260,000
$397,000
$500,000
2021/22
$260,000
$400,000
$500,000
2020/21
$245,000
$367,000
$750,000
2019/20
$280,000
$399,000
$535,000
2018/19
$281,000
$404,000
$450,000
2017/18
$325,000
$371,000
$540,000
YOY change +5.99% All Positions
Hospitalist
LOW
AVERAGE
HIGH
2023/24
$182,000
$283,000
$425,000
2022/23
$217,000
$299,000
$480,000
2021/22
$203,000
$284,000
$376,000
YOY change -5.35% All Positions
Hematology/Oncology
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$300,000
$444,000
$650,000
2023/24 (Non-Academic)
$400,000
$497,000
$650,000
2023/24 (Academic)
$300,000
$414,000
$550,000
2022/23 (All Positions)
$246,000
$440,000
$600,000
2022/23 (Non-Academic)
$400,000
$494,000
$600,000
2022/23 (Academic)
$246,000
$391,000
$550,000
2021/22 (All Positions)
$215,000
$404,000
$590,000
2021/22 (Non-Academic)
$240,000
$426,000
$590,000
2021/22 (Academic)
$215,000
$267,000
$404,000
2020/21
$180,000
$385,000
$1,000,000
2019/20
$220,000
$403,000
$612,000
2018/19
$200,000
$393,000
$450,000
YOY change +0.91% All Positions
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Psychiatry
LOW
AVERAGE
HIGH
2023/24 (All Positions)
$105,000
$285000
$355,000
2023/24 (Non-Academic)
$209,000
$307,000
$355,000
2023/24 (Academic)
$105,000
$219,000
$338,000
2022/23 (All Positions)
$230,000
$356,000
$450,000
2022/23 (Non-Academic)
$196,000
$360,000
$450,000
2022/23 (Academic)
$252,000
$325,000
$450,000
2021/22 (All Positions)
$145,000
$299,000
$450,000
2021/22 (Non-Academic)
$255,000
$308,000
$450,000
2021/22 (Academic)
$145,000
$271,000
$338,000
2020/21
$185,000
$279,000
$400,000
2019/20
$185,000
$276,000
$400,000
2018/19
$184,000
$273,000
$400,000
YOY change -19.94% All Positions
CRNA
LOW
AVERAGE
HIGH
2023/24
$235,000
$279,000
$416,000
2022/23 (All Positions)
$163,000
$212,000
$280,000
2022/23 (Non-Academic)
$249,000
$266,000
$280,000
2022/23 (Academic)
$163,000
$184,000
$230,000
2021/22 (All Positions)
$163,000
$211,000
$270,000
2021/22 (Non-Academic)
$163,000
$245,000
$270,000
2021/22 (Academic)
$163,000
$170,000
$205,000
2020/21
$158,000
$222,000
$353,000
2019/20
$170,000
$215,000
$260,000
2018/19
$154,000
$197,000
$250,000
YOY change +31.6% All Positions
Urology
LOW
AVERAGE
HIGH
2023/24
$300,000
$496,000
$630,000
2022/23
$415,000
$540,000
$625,000
2021/22
$400,000
$510,000
$600,000
2020/21
N/A
$497,000
N/A
2019/20
$300,000
$477,000
$625,000
2018/19
$300,000
$464,000
$575,000
YOY change -8.15% All Positions
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Orthopedic Surgery
LOW
AVERAGE
HIGH
2023/24
$500,000
$686,000
$815,000
2022/23
$450,000
$633,000
$900,000
2021/22
$400,000
$565,000
$790,000
2020/21
$300,000
$546,000
$1,000,000
2019/20
$425,000
$626,000
$850,000
2018/19
$350,000
$536,000
$850,000
YOY change +8.37% All Positions
General Surgery
LOW
AVERAGE
HIGH
2023/24
$245,000
$419,000
$517,000
YOY change N/A
Neurology
LOW
AVERAGE
HIGH
2023/24
$217,000
$383,000
$475,000
2022/23
$267,000
$354,000
$525,000
2021/22
$275,000
$356,000
$525,000
2020/21
$215,000
$332,000
$850,000
2019/20
$255,000
$295,000
$450,000
2018/19
$250,000
$317,000
$400,000
YOY change +8.19% All Positions
Dermatology
LOW
AVERAGE
HIGH
2023/24
$250,000
$486,000
$700,000
2022/23
$340,000
$427,000
$600,000
2021/22
$250,000
$368,000
$450,000
2020/21
$200,000
$378,000
$1,000,000
2019/20
$300,000
$419,000
$850,000
2018/19
$250,000
$420,000
$850,000
YOY change +13.82% All Positions
Otolaryngology (ENT)
LOW
AVERAGE
HIGH
2023/24
$240,000
$358,000
$645,000
YOY change N/A
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Emergency Medicine
LOW
AVERAGE
HIGH
2023/24
$300,000
$404,000
$475,000
YOY change N/A
Pediatrics
LOW
AVERAGE
HIGH
2023/24
$191,000
$244,000
$425,000
2022/23
$190,000
$233,000
$276,000
2021/22
$200,000
$232,000
$412,000
2020/21
$180,000
$236,000
$400,000
2019/20
$170,000
$221,000
$300,000
2018/19
$140,000
$242,000
$400,000
YOY change +4.7% All Positions
8. Average Salaries for Five Top Most Requested Providers by Region
MIDWEST NORTHEAST SOUTHEAST SOUTHWEST
WEST
1. Nurse Practitioner
$149,200
$142,096
$147,111
$133,793
$177,005
2. Family Medicine
$252,219
$275,714
$258,071
$279,642
$279,687
3. OBGYN
$431,750
$325,833
$399,571
$389,500
$403,620
4. Internal Medicine
$266,444
$266,625
$260,000
$258,800
$287,000
5. Gastroenterology
$645,333
$441,667
$504,500
$599,218
$501,000
9. Type of Contract Offered
SALARY WITH BONUS
INCOME GUARANTEE
SALARY
OTHER
2023/24
684 (32%)
1,327 (62%)
107 (5%)
20 (1%)
2022/23
859 (32%)
1,656 (62%)
108 (4%)
53 (2%)
2021/22
886 (33%)
1,647 (61%)
104 (4%)
58 (2%)
2020/21
856 (35%)
1,503 (61%)
47 (2%)
52 (2%)
2019/20
809 (25%)
2349 (72%)
21 (<1%)
72 (2%)
2018/19
686 (22%)
2,198 (70%)
61(2%)
184 (6%)
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
10. If Salary Plus Production Bonus, on Which Types of Metrics was the Bonus Based? (Of 1,327 Searches Offering Salary Plus Bonus – Multiple Responses Possible)
NET COLLECTIONS
GROSS BILLINGS
PATIENT ENCOUNTERS
QUALITY
OTHER
RVU BASED
2023/24
57%
13%
1%
3%
26%
0%
2022/23
59%
20%
1%
5%
25%
0%
2021/22
58%
22%
2%
5%
31%
0%
2020/21
57%
23%
2%
10%
23%
0%
2019/20
73%
13%
2%
12%
64%
0%
2018/19
70%
18%
3%
9%
56%
0%
11. If Quality Factors Were Included in the Production Bonus, About What Percent Of Physician’s Total Compensation Determined by Quality?
2023/24
10%
2022/23
14%
2021/22
11%
2020/21
10%
2019/20
11%
2018/19
11%
12. Searches Offering Relocation Allowance
YES
NO
2023/24
1,176 (55%)
962 (45%)
2022/23
1,663 (62%)
1,013 (38%)
2021/22
2,106 (78%)
589 (22%)
2020/21
1,821 (74%)
637 (26%)
2019/20
3,147 (97%)
104 (3%)
2018/19
3,064 (98%)
67 (2%)
13. Amount of Relocation Allowance (Physicians Only)
LOW AVERAGE HIGH
2023/24
$3,000
$11,284
$100,000
2022/23
$3,000
$12,778
$150,000
2021/22
$2,000
$10,718
$30,000
2020/21
$2,000
$10,634
$75,000
2019/20
$1,000
$10,553
$40,000
2018/19
$2,000
$10,393
$30,000
© AMN Healthcare 2024
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
14. Amount of Relocation Allowance (NPs and PAs Only)
LOW AVERAGE HIGH
2023/24
$2,000
$7,910
$20,000
2022/23
$2,000
$7,997
$25,000
2021/22
$1,000
$8,542
$25,000
2020/21
$2,000
$8,363
$15,000
2019/20
$2,000
$7,114
$15,000
2018/19
$2,500
$7,067
$15,000
15. Searches Offering Signing Bonus
YES
NO
2023/24
1,086 (51%)
1,052 (49%)
2022/23
1,689 (63%)
987 (37%)
2021/22
2,475 (92%)
220 (8%)
2020/21
1,505 (61%)
953 (39%)
2019/20
2,344 (72%)
907 (28%)
2018/19
2,220 (71%)
911 (29%)
16. Amount of Signing Bonus Offered (Physicians Only)
LOW AVERAGE HIGH
2023/24
$3,000
$31,473
$325,000
2022/23
$500
$37,473
$570,000
2021/22
$5,000
$31,000
$400,000
2020/21
$1,000
$29,656
$240,000
2019/20
$2,500
$27,893
$100,000
2018/19
$3,000
$32,692
$225,000
17. Amount of Signing Bonus Offered (NPs and PAs Only)
LOW AVERAGE HIGH
2023/24
$2,000
$11,758
$160,000
2022/23
$2,000
$8,355
$25,000
2021/22
$2,500
$9,000
$48,000
2020/21
$3,000
$7,233
$50,000
2019/20
$2,500
$8,500
$35,000
2018/19
$2,500
$9,000
$25,000
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
18. Amount of Signing
LOW AVERAGE HIGH
1. Nurse Practitioner
$1,100
$11,037
$160,000
Bonus Offered for Top 5 Most Requested
2. Family Medicine
$5,000
$30,013
$100,000
3. OB/GYN
$10,000
$38,281
$100,000
4. Internal Medicine
$10,000
$32,205
$100,000
5. Gastroenterology
$15,000
$46,040
$100,000
19. Searches Offering to Pay Continuing Medical Education (CME)
YES
NO
2023/24
1,904 (89%)
234 (11%)
2022/23
2,491 (93%)
185 (7%)
2021/22
2,481 (92%)
214 (8%)
2020/21
2,306 (94%)
152 (6%)
2019/20
3,124 (96%)
127 (4%)
2018/19
2,966 (95%)
154 (5%)
20. Amount of CME Pay Offered (Physicians Only)
LOW AVERAGE HIGH
2023/24
$300
$3,969
$55,000
2022/23
$3,000
$3,840
$45,000
2021/22
$1,000
$3,691
$35,000
2020/21
$1,000
$3,695
$50,000
2019/20
$800
$4,166
$20,000
2018/19
$1,000
$3,620
$35,000
21. Amount of CME Pay Offered (NPs and PAs Only)
LOW AVERAGE HIGH
2023/24
$500
$2,195
$5,000
2022/23
$1,000
$2,299
$5,000
2021/22
$750
$2,537
$5,200
2020/21
$1,000
$2,956
$30,000
2019/20
$1,000
$2,313
$5,000
2018/19
$1,000
$2,862
$5,000
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
22. Searches Offering to Pay Additional Benefits
2023/24 2022/23 2021/22 2020/21
Health Insurance
66%
65%
68%
78%
Malpractice
66%
63%
66%
76%
Retirement /401K
56%
58%
61%
68%
Disability
66%
57%
61%
70%
Educational Forgiveness
17%
18%
16%
21%
23. If Educational Loan Forgiveness was Offered, What was the Term (Of 364 Searches Offering Loan Forgiveness)
2023/24 2022/23 2021/22 2020/21 2019/20 2018/19
One Year
25 (7%)
24 (5%)
35 (8%)
45 (9%)
72 (9%)
N/A
Two Years
22 (6%)
53 (11%)
67 (15%)
109 (21%)
184 (24%)
N/A
Three Years Plus
317 (87%)
404 (84%)
332 (77%)
360 (70%)
528 (67%)
N/A
24. If Education Loan Forgiveness Was Offered, What Was the Amount? (Physicians Only)
LOW AVERAGE HIGH
2023/24
$10,000
$117,217
$420,000
2022/23
$10,000
$98,665
$400,000
2021/22
$10,000
$101,572
$400,000
2020/21
$2,500
$104,630
$800,000
2019/20
$40,000
$101,590
$300,000
2018/19
$10,000
$101,571
$300,000
25. If Education Loan Forgiveness Was Offered, What Was the Amount? (NPs and PAs Only)
LOW AVERAGE HIGH
2023/24
$10,000
$78,333
$250,000
2022/23
$10,000
$70,769
$140,000
2021/22
$1,650
$55,950
$90,000
2020/21
$60,000
$80,000
$100,000
2019/20
$40,000
$68,323
$90,000
2018/19
$20,000
$61,250
$100,000
© AMN Healthcare 2024
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Trends and Observations
AMN Healthcare’s annual Review of Physician and Advanced Practitioner Recruiting Incentive s, now in its 31 st year, tracks three key physician and advanced practitioner recruiting trends: Based on the recruiting engagements AMN Healthcare is contracted to conduct, the Review indicates which types of physicians and APPs are in the greatest demand and which are the most challenging to recruit. The Review indicates the types of practice settings into which physicians and APPs are being recruited (hospitals, medical groups, solo practice, etc.) and the types of communities that are recruiting them based on population size. The Review indicates the types of financial and other incentives that are being used to recruit physicians and APPs. Each of these trends is discussed below, following an overview of the current market in which recruitment of physicians and APPs is taking place. 3 1 2
The Current Physician and APP Recruiting Market: Continued Shortages and Provider Burnout
There are various sources and metrics that can be used to assess physician supply and demand trends and to evaluate the current job market for physicians. Key among them is a periodic report issued by the Association of American Medical Colleges (AAMC). In its 2021 report, the AAMC forecast a shortage of up to 124,000 physicians by 2034, including approximately 47,000 too few primary care physicians and an even greater shortage of approximately 77,000 specialists. The AAMC’s April 2024 report downgrades this forecast to a projected shortage of 86,000 physicians by 2036 ( The Complexities of Physician Supply and Demand: Projections From 2021 to 2036. AAMC. April 2024 ). However, the report cautions that the reduced shortage numbers are based on “the hypothetical future growth in the number of medical residency positions nationwide.” Should this growth not materialize, the forecasted shortages could be significantly higher. The AAMC report further notes that “if communities underserved by the nation’s health care system could obtain care at the same rate as populations with better access to care, the nation would need approximately 202,800 more physicians as of 2021.” In effect, the AAMC suggests that it is only the low rate at which residents of financially challenged or isolated communities are able to obtain physician services that keeps the physician shortage from being exponentially worse. In a national address last year, American Medical Association (AMA) president Jesse M. Ehrenfeld stated, “The physician shortage that we have long feared – and warned was on the horizon – is already here. It’s an urgent crisis.” ( AMA President Sounds Alarm on National Physician Shortage. AMN News, October 25, 2023 )
© AMN Healthcare 2024
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
Population Growth and Graying The longstanding factors that drive demand for doctors continue to be population growth and population aging:
• By 2036, the U.S. population is projected to grow by 8.4%, while the population aged 65 and older is projected to grow by 34.1% and the population 75 and older is projected to grow by 54.7%, according to the AAMC. People 65 and older visit physicians at three times the rate of younger people and account for a disproportionally large number of tests and procedures. • Physicians also are aging. Physicians aged 65 and older represent 20% of physicians in active patient care, while those 55 and older represent 42% of active physicians, according to the AAMC. A wave of physician retirements can be expected in the next decade which already is beginning to materialize due to both physician aging and physician burnout. As a result of these and related trends, the AAMC is supporting passage of the Resident Physician Shortage Reduction Act, bipartisan legislation that would increase the number of Medicare-backed residency positions by 14,000 over seven years. A number of states are promoting similar measures to increase the access their residents have to physicians.
of active physicians are 55 and older 42%
Opening the Door to IMGs and Non-Residency Matching Physicians Tennessee recently passed a law to become effective in July 2024 that will make it the first state to allow international medical graduates (IMGs) to practice in the U.S. without having to complete a U.S.-based residency training program. The Tennessee law comes on the heels of the Physician Workforce Act passed in Alabama last year, a state in which almost every county is a federally designated medically underserved area. The Alabama law removes a testing requirement for out- of-state physicians seeking to work in Alabama, allows IMGs to apply for a license a year earlier, and creates an apprenticeship program for medical residents who don’t match into a residency so they can begin training under a physician and apply their skills to patient care. Other states, such as Missouri, have created the position of Assistant Physician, which allows medical school graduates who did not match to a residency to work in patient care. An Illinois law to take effect on January 1, 2025 would allow IMGs without a U.S. residency to practice in the state provided they work in an underserved area. Florida, Virginia, Idaho and Wisconsin are considering similar legislation, underscoring continuing physician shortages around the country. More Types of Physician Employers, Limited Candidate Pool The difficulty many patients have accessing medical services has created an opportunity for organizations that have not traditionally been active in significant levels of physician and APP recruiting. These organizations are developing models of care intended to improve patient access and to enhance patient experience. All of them now actively recruit a growing number of physicians and APPs from a limited group of candidates. These entities include retail chains such as CVS/Aetna, Walgreens, and others, urgent care centers, telehealth platforms, insurance companies such as United Health/Optum, and private equity-owned medical groups. Traditional healthcare providers, such as acute care hospitals, hospital systems, and physician-owned medical groups, now are competing with a growing number of “market disruptors” in the recruitment of physicians and APPs.
© AMN Healthcare 2024
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
of physicians are employed 77%
of residents had been contacted 100+ times 56%
77% of Physicians Now Employed More than two-thirds of physicians (77%) now are employed by hospitals, health systems or other corporate entities, according to a report from the Physicians Advocacy Institute (PAI) and Avalere Health ( Physician Employment Trends/PAI/Avalere Health. April 25, 2024 ). Today, there are three distinct types of medical groups: health system or hospital-owned, corporate owned, and physician-owned. Their reasons for recruiting physicians may vary, from community need considerations to more financially based considerations. Regardless of their business model or motivations, many of these medial groups are actively seeking physicians and APPs. Competition for Physicians Heats Up In its periodic Survey of Final-Year Medical Residents , AMN Healthcare’s Physician Solutions division tracks the number of times physicians in their final year of training are contacted by recruiters about job offers. In its 2023 survey, the majority of residents (56%) said they had been contacted 100 or more times, the highest percent receiving 100 or more job solicitations since the survey was first conducted in 1991 (see below).
FINAL-YEAR RESIDENTS RECEIVING MORE THAN 100 JOB SOLICITATIONS
56%
50%
46%
45%
30%
2014
2017
2019
2021
2023
Source: Survey of Final-Year Medical Residents. AMN Healthcare. 2023.
© AMN Healthcare 2024
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2024 Review of Physician and Advanced Practitioner Recruiting Incentives
The Engines That Drive Revenue Competition for physicians and APPs has grown as the number of organizations providing care has grown. Competition also is driven by the key role physicians and APPs play in healthcare economics as revenue generators. The revenue-generating potential of physicians and APPs is captured in AMN Healthcare’s 2023 Physician Billing Report , which tracks annual billing by physicians in 18 medical specialties to commercial payors. The annual average for all specialties tracked in the report is $3.8 million, though billing varies by specialty (see below):
AVERAGE ANNUAL PHYSICIAN BILLING BY SPECIALTY TO COMMERCIAL PAYORS 1. General Surgery $11,669,016 2. Orthopedic Surgery $9,809,514 3. Critical Care (Intensivist) $6,677,319 4. Urology $5,886,763 5. Gastroenterology $5,530,221 6. Otolaryngology $4,190,555 7. Obstetrics/Gynecology $3,761,777 8. Rheumatology $3,410,281 9. Cardiology $3,406,027 10. Anesthesiology $3,329,020
Source: Physician Billing Report. AMN Healthcare. 2023
These amounts do not include billing to Medicare and other government payors, which could significantly increase the billing averages for some specialties. Given a collection rate of 50% or even less, most physicians generate millions of dollars in net revenue per year and continue to control how much of the healthcare dollar is spent
Workforce Volatility: Burnout and Turnover Today’s physician recruiting market is characterized not just by a dearth of candidates in many specialties, but by high turnover rates caused by physician burnout. According to the Association of Advancing Physician and Provider Recruitment’s (AAPPR) Physician and Provider Recruitment Benchmarking Study , 48% of all physician searches in 2021 were to replace departing physicians. This is up by 16% since 2018. One-third of physicians (33%) cited burnout as the reason for leaving their organizations. ( Report Finds Physician Shortage on the Rise as Burnout Continues to Drive Turnover. AAPPR Press Release. Oct. 18, 2022 ). The physician workforce is in a volatile state, as many physicians are reconsidering where, when and how they work. In response, employers need to be flexible and competitive in what they offer to physician and APP candidates, while also putting renewed focus on retention. Findings from the 2024 Review offer data that may be useful in creating competitive physician and APP recruiting programs that also support enhanced provider recruitment and retention.
of all physician searches in 2021 were 48%
to replace departing physicians
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