More than 80% of physicians are now employed by a hospital, health system or other corporate entity, up from just 26% in 2012, a shift that has reshaped what physician contracts look like, according to a Sept. 16 white paper from AMN Healthcare.
The “2026 Review of Physician and Advanced Practitioner Recruiting Incentives” report includes data from a representative sample of the 1,293 permanent physician and advanced practitioner search engagements from AMN Healthcare’s Physician Solutions division, which were ongoing or conducted between April 1, 2025, and March 31, 2026.
Here are 10 numbers that define the current state of physician contracts:
- 68%: The share of physician contracts built around a base salary plus a production bonus, the dominant contract structure in the 2026 report, up from 61% five years ago.
- 65%: Among contracts with a production bonus, the share basing that bonus on relative value units (RVUs), the most commonly used productivity metric, far ahead of net collections (15%) or gross billings.
- 8%: The average share of total physician compensation determined by quality-of-care metrics when quality factors are included in a bonus structure — down from 16% last year.
- 87%: The share of search engagements that offered a signing bonus this year, up from 74% last year.
- $49,306: The average signing bonus offered to physicians, up from $38,215 last year — a jump of more than $11,000.
- $13,594: The average relocation allowance being offered to physicians.
- 58%: The share of contracts offering a continuing medical education allowance this year, a decline from 90% last year.
- 12%: The share of contracts offering educational loan repayment, down from 16% last year. However, the average amount offered to nurse practitioners and physician assistants rose to $60,000 from $50,000.
- 26%: The share of physician contracts built on a straight salary with no production bonus, the second most common structure behind salary-plus-bonus. This structure is most typically used at urgent care centers, federally qualified health centers and academic settings.
- $90,000: The gap between the average starting salary for academic physicians ($362,000) and non-academic physicians ($452,000) across all specialties tracked in the report.
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