Signing bonuses become usual part of physician recruitment packages

Signing bonuses for new physicians have become a common hiring incentive, part of what can be lucrative packages for doctors who have just completed their residencies or fellowship training. Newly trained physicians in some highly sought-after specialties can command incentives worth six figures in exchange for their first years of work.

Surveys by the Medical Group Management Assn. and Irving, Texas-based physician placement firm Merritt Hawkins that examined recruiting packages from 2010 show that signing bonuses -- once an incentive offered on occasion for hard-to-fill jobs -- have become the norm.
"Signing bonuses have gone from carrot at the end of the stick to an expected part of the package," said Travis Singleton, senior vice president for Merritt Hawkins. "It's an extreme negative these days if you don't have a signing bonus."
Medical liability insurance, relocation expenses and paid time off for continuing medical education also are common, if not standard, according to the MGMA and Merritt Hawkins reports.
Other types of one-time incentives beyond cash bonuses are emerging, allowing hospitals and physician groups to stand out in a crowded field of potential employers. But bonuses remain a core part of employment offers.
The MGMA report, released in May, was based on responses to a voluntary online survey during 2010 and looked at information on about 4,300 physician placements. Of the 2,971 answers about recruitment packages, 56% reported that signing bonuses were part of the deal.
According to Merritt Hawkins' most recent report, released to American Medical News before its publication this summer, 76% of the jobs for which the firm recruited between April 1, 2010, and March 31, 2011, included a signing bonus. That was stable from the prior year's level but down from the 2008-09 survey year, when 85% of searches included a signing bonus.
Even though the percentage of packages with bonuses was down slightly from a few years ago, the average bonus for the 2010-11 survey year was $23,790, up from $22,915 the prior year.
Singleton said the only time a signing bonus typically is not offered is when a physician is going to a different practice in the same community. In those cases, a doctor often is motivated to move away from one practice and jump to another, and a signing bonus isn't necessary.
Both reports also show continued reliance on other one-time incentives, including loan forgiveness -- the practice of paying off part or all of a new physician's student loans.
Among physicians who responded to the MGMA survey, 12% said their recruitment package included loan forgiveness. Among the last year's searches in the Merritt Hawkins report, 29% had educational loan forgiveness.
New recruiting tools are emerging, as well, Singleton said. Amid a poor housing market, 6% of searches in the last survey year featured a housing allowance for relocating physicians to offset the loss of selling a home for less than the purchase price.
Hospitals and medical groups are searching for new ways to attract young, talented physicians beyond salary, offering perks such as extra pay for weekends spent on-call, said Barry Biagini, founder of physician recruiting firm BJB Medical Associates. The Scottsdale-Ariz.-based agency specializes in ophthalmology placements.
"What we're seeing now is younger physicians, many second-generation physicians, people who come from successful families, who are not necessarily as money-motivated as they are by lifestyle and location," he said. "Everybody is trying to find the right mix of lifestyle and the ability to do the art and craft and science of medicine."