Intense competition for physicians is prevalent across the country, and small to midsize medical groups face unique challenges in recruiting and retaining top talent. Evolving candidate expectations and rising competition from larger systems are forcing independent groups to rethink their strategies to stay competitive.
An April 29, 2025, MGMA Stat poll finds that 38% of medical groups saw time to fill physician vacancies increase in the past year, while 31% reported they were about the same, 9% managed to shorten time to fill vacancies, another 8% were unsure, and 14% responded “not applicable.” The poll had 248 responses.
What’s taking so long?
Among practices reporting longer times to fill vacancies, key barriers included an overall shortage of qualified physicians, rising compensation demands, geographic disadvantages, and increasing competition for top candidates. These respondents specifically cited endocrinology, gastroenterology, dermatology, cardiology, and pediatric subspecialties as among the most difficult areas to staff. Additional factors such as noncompete clauses, economic uncertainty, reimbursement issues, and changing physician preferences (e.g., location, schedule flexibility, housing needs) further complicate recruitment efforts:
- Geographic location issues, particularly in rural areas and states like Alaska and Michigan, are barriers to recruitment.
- Economic uncertainty and decreased reimbursement (e.g., Medicare/Medicaid) impact both candidate interest and organizational hiring capacity.
- Noncompete clauses and venture capital ownership can deter candidates or complicate hiring processes.
- Candidate preferences, including proximity to family, institutions, and favorable housing are increasingly influential.
- Political and social climates, as noted in Florida, are affecting recruitment success in some states.
Who’s holding steady and how?
For medical practices that reported no change in their physician time-to-fill metrics in 2025, the stability was largely driven by proactive and well-supported recruitment strategies. These organizations credited strong internal or external recruiter support, early pipeline development (such as hiring from residency or fellowship programs), competitive compensation and benefits, and leveraging personal and professional networks. However, several practices noted that the metric remained flat simply because it was already unacceptably long, with persistent challenges like lack of candidates or hard-to-fill roles still unresolved:
- Competitive compensation packages and sign-on bonuses were frequently credited in helping attract candidates.
- Marketing efforts and organizational reputation supported visibility and appeal.
- Physician-led recruitment, including peer referrals and networking with training programs, boosted results.
- In some cases, stability reflected continued difficulty, not improvement — time-to-fill remained long due to persistent candidate shortages.
What’s helping get physicians hired faster?
Combinations of strategic compensation and benefit enhancements, a stronger pool of candidates, and more robust recruitment support were cited by respondents whose practices reduced time to fill physician vacancies.
Some also pointed to broader market shifts — such as geographic appeal or improved practice culture — as factors attracting greater interest. In several cases, internal recruiting teams and streamlined hiring processes were key contributors to faster hiring outcomes:
- Loan repayment programs served as an additional draw for candidates.
- Enhanced marketing and positive practice culture helped generate candidate interest.
Why physician recruitment has grown more challenging
In recent years, the demand for outpatient and ambulatory care has surged. Simultaneously, the healthcare industry has experienced:
- A persistent shortage of primary care physicians (PCPs).
- Growing competition in specialties such as psychiatry, urgent care, and orthopedics.
- A strong physician preference for flexible work models and lifestyle balance.
- Geographic clustering around major metropolitan areas, leaving rural or suburban practices with greater difficulty attracting physicians.
In smaller groups and those without structured processes, time to fill physician vacancies has lengthened, costing these practices substantial revenue and operational stability.
Essential physician recruitment and onboarding elements
While the following steps are not exhaustive in what a medical group’s strategy might look like for optimizing physician recruitment and onboarding, it provides the foundational action steps that can yield successful hires:
1. Define the ideal candidate profile
- Clarify clinical skills, experience level, cultural fit, and personality traits.
- Use recent benchmarking data to align compensation expectations realistically.
- Identify "must-have" vs "nice-to-have" criteria.
2. Build a strong employer brand
- Update your website with engaging physician testimonials and "day in the life" stories.
- Promote work-life balance, flexible schedules, and community benefits.
- Showcase professional development opportunities like leadership training and CME support.
3. Streamline internal hiring processes
- Pre-approve a salary range, incentive structure, and signing bonus.
- Designate a recruitment task force with clear decision-making authority.
- Create templated offer letters, contracts, and onboarding materials to eliminate delays.
4. Broaden sourcing channels
- Use physician recruiters when sourcing hard-to-fill specialties.
- Post on niche healthcare job boards such as the MGMA Career Center, DocCafe, PracticeLink, PracticeMatch, or NEJM CareerCenter.
- Partner with residency and fellowship programs.
- Tap into physician social networks like Doximity, as well as recruitment channels on specialty society websites (e.g., AAFP CareerLink, Cardiology Careers, American Academy of Pediatrics).
5. Personalize the candidate experience
- Assign a "candidate concierge" to guide applicants through the process.
- Schedule interviews within one or two weeks of application receipt.
- Offer a "virtual site visit" tour option in addition to an in-person visit.
6. Create a competitive offer
- Offer loan repayment support if feasible.
- Include flexible scheduling (e.g., 4-day workweeks, telehealth options).
- Highlight community benefits — affordable housing, great schools, quality of life.
- The MGMA Physician Employment Contracting Toolkit is comprised of sample contract language as well as four common compensation methodologies that help organizations looking to contract with or employ a physician. Our Physician Contract Guidebook is another great resource.
7. Build a comprehensive onboarding program
- Start onboarding immediately after signing the contract.
- Provide a welcome packet with community guides, clinic workflow documentation, and EHR training schedules.
- Assign a "physician buddy" to support new hires socially and professionally during the first 6 months.
- Schedule regular check-ins during the first year to address any concerns early.
Additional tips for small to midsize practices
- Data is your ally: Use MGMA benchmarks to structure competitive offers.
- Flexibility wins: Younger physicians want work-life balance more than ever.
- Culture sells: A workplace-for-all environment can outweigh a slightly higher salary offer from a larger system.
- Retention starts on day one: A smooth, supportive onboarding experience is one of the strongest predictors of long-term physician retention.
Conclusion
Small to midsize medical groups can absolutely compete for top physician talent — but success requires proactive strategy, speed, and personalization. Clear, repeatable recruitment and onboarding processes help practices fill vacancies faster and build stronger, more committed clinical teams.
Additional resources
- Transform your strategy today with the member-exclusive Physician Recruitment Playbook, part of the larger Physician Hiring Playbooks, from Succession Planning to Onboarding.
- Learn about best practices in recruiting the next generation of doctors from the joint MGMA-Jackson Physician Search whitepaper, Early-Career Physician Recruiting & Retention Playbook.
- Read more about analyzing time to hire and physician recruitment metrics from MGMA Executive Partner Jackson Physician Search.
- If a physician — a new hire or an established physician — needs further training on the business of running a practice — including how to understand physician compensation, practices structures, etc. — see What Docs Don’t Taught in School: Physician Business Training.
