As medical practices head into 2026 facing sustained physician shortages, rising patient demand, and ongoing burnout pressures, recruitment and retention have become inseparable from organizational culture and compensation strategy. In the first MGMA Insights Podcast episode of the new year, host Daniel Williams, senior editor at MGMA, welcomed back Jessica Minesinger, FACMPE, CMOM, founder and CEO of Surgical Compensation and Consulting, to explore how practice leaders can rethink hiring, onboarding, and long-term engagement in a challenging labor market.
Drawing on nearly 15 years of experience working with physicians, hospitals, and health systems nationwide, Minesinger addressed the most common recruitment pitfalls she sees today, why compensation transitions are a critical vulnerability point, and how communication and transparency directly shape physician trust and retention. The conversation also highlighted new MGMA data trends showing increased patient encounters without corresponding RVU growth — a signal that compensation models must evolve alongside clinical realities.
Addressing the Physician Supply-Demand Imbalance
Minesinger framed the discussion around a fundamental workforce challenge: Demand for care continues to rise while the physician pipeline struggles to keep pace.
“We really have a supply and demand issue with physicians,” she said. “We have a growing demand of patients, of population, and just not enough physicians to meet that demand.”
Her work, she explained, is focused on helping practices keep physicians engaged in medicine for the long term. “My goal is to really bridge the gap between physicians and employers… with the end goal really being to keep as many physicians practicing in medicine for as long as possible.”
For practice leaders, this means recruitment cannot be treated as a transactional process. It must be part of a broader strategy that supports physician sustainability, engagement, and fairness over time.
Recruitment Urgency Can Create Long-Term Risk
One of the biggest challenges Minesinger sees in today’s recruitment market is urgency driving short-term decisions.
“I think at times what I find is that desperation is high,” she said. “We need to get this position replaced or we need to add to this specialty.”
As a result, organizations often rely on high guaranteed compensation periods to attract candidates quickly, followed by a shift to productivity-based models.
“We see that often… a high guaranteed compensation from the outset… and then it flips to a productivity model or it flips to somewhat of a hybrid model with a productivity emphasis.”
The danger comes when those transitions are poorly designed. Minesinger cautioned that practices must ensure productivity expectations are realistic. “You’ve got an offer in place where the physician has realistic productivity thresholds so that that person isn’t sliding backwards from a compensation standpoint.”
Without that foresight, practices risk losing physicians just as their recruitment investment should begin paying off.
Fit Matters as Much as Financial Incentives
Beyond compensation, Minesinger emphasized the importance of assessing fit early in the recruitment process — particularly as physician priorities evolve.
“Work-life balance is a big priority, especially for the younger generation of physicians coming in,” she said. “That isn’t right or wrong. That just is.”
She encouraged leaders to have direct, upfront conversations about call coverage, site rotations, commute expectations and workload distribution. “Have those conversations up front,” she said, noting that unclear expectations often surface later as dissatisfaction or disengagement.
Leadership opportunities, research interests and volunteer commitments are also increasingly important to candidates. Minesinger shared an example of a physician whose primary contract priority had nothing to do with pay. “Her red line was that she needed two consecutive weeks for a volunteer opportunity that she was really passionate about in Africa.”
These discussions are foundational to physician retention.
Compensation Transitions Are a Critical Retention Moment
Minesinger identified the end of guaranteed compensation periods as one of the most vulnerable moments in a physician’s tenure.
“When somebody feels that they’re taking a pay cut and they don’t understand why… that is a really vulnerable time for physicians,” she said.
Complex formulas, unclear RVU mechanics and misaligned incentives can quickly erode trust. “If an incentive for productivity is sitting out there and you can’t reach it, it’s not an incentive at all. It actually discourages the physician.”
She stressed that transparency is not optional. “Compensation, the way that you are transparent about it, the way you communicate it… that goes to the culture of the organization.”
Communication Is the Cultural Multiplier
Throughout the conversation, Minesinger repeatedly returned to the central role of communication.
“In provider compensation, it’s so important to have conversation, conversation, conversation,” she said. “You can’t talk with your physicians too much about this.”
Regular check-ins around compensation, career progression, and leadership opportunities help physicians feel seen and supported. Minesinger encouraged leaders to create open doors where physicians feel comfortable raising concerns. “I want that door open for sure,” she said.
This level of engagement, she noted, directly counters an “us versus them” mentality that undermines culture and collaboration.
Data Signals the Need for Smarter Models
Minesinger also referenced recent MGMA data trends that highlight growing strain on productivity-based models.
“What we found was a trend where patient encounters are up,” she said, “and in many specialties, RVUs are stagnant or decreasing.”
Physicians are seeing more patients, she explained, but that effort is not always reflected in traditional productivity metrics. “So we know physicians are working harder… that’s not necessarily translating into productivity.”
As a result, Minesinger advised practice leaders to rethink how compensation is structured in 2026.
Returning to Common Sense and Fairness
Ultimately, Minesinger urged leaders to simplify and humanize compensation design.
“What we really need is more common sense,” she said. “It really comes down to this… The Golden Rule.”
She encouraged leaders to ask whether compensation plans are understandable, achievable and fair. “Would I understand this formula? Would I be able to meet this target?”
Her recommendation for 2026: “I’d really focus on base salary… guaranteed base salary and then productivity, admin time, quality incentives that are really meaningful, attainable, and driving the mission of your organization.”
At its core, she concluded, success depends on partnership. “We’re all in this together to lift our patients up, to provide the best care.”
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