Physician and provider recruitment remains one of the most pressing challenges facing medical practices and health systems in 2026. On a recent episode of the MGMA Insights Podcast, Sr. Editor and host Daniel Williams, sat down with Doug Lewis, Vice President of Talent Acquisition at Sentara Health and a board member of the Association for Advancing Physician and Provider Recruitment (AAPPR), to examine how recruitment strategies are evolving — and what medical practice leaders must do differently to attract and retain talent.

Drawing on decades of frontline recruiting experience and national insights from AAPPR’s membership, Lewis addressed some of the most urgent workforce issues facing healthcare today: shifting candidate expectations, family-centered recruitment, longer hiring timelines, compensation strategy, reliance on locum tenens, and the growing need for collaboration between recruiters and executive leadership.

Recruitment Is No Longer Just About the Physician

One of the clearest messages from Lewis was that recruitment decisions today are rarely made by physicians alone. Practices that fail to account for family considerations risk losing candidates late in the process.

“It’s incredibly important for health systems and recruiters to really think about the family and the impact that a potential relocation has on them,” Lewis said. “So absolutely, we include the spouse or the significant other [and] their children in the interview process.”

Lewis emphasized that these conversations must start early, with recruiters asking what matters most to both the physician and their family. Community fit, school systems, churches, outdoor activities, commute times, and cost of living all play a role. At Sentara Health, that often includes structured community tours and deliberate conversations about lifestyle.

Recruitment strategies must extend beyond clinical roles and compensation packages to include a holistic view of life outside the exam room.

Candidate Expectations Have Shifted Dramatically

Lewis noted that while compensation remains important, it is no longer the primary driver for many physicians — especially those completing training.

“Candidate expectations have sharply shifted from focusing on compensation to now they’re really focusing on lifestyle, work-life balance, flexibility, looking for an untraditional [model] in their next opportunity,” he said.

The COVID-19 pandemic accelerated this shift. According to Lewis, it forced health systems to rapidly adopt telehealth and flexible care models, which in turn reshaped how physicians think about where and how they want to practice.

“COVID really opened up a lot of different opportunities,” Lewis said. The traditional model in which physicians work full‑time, on‑site, in a physical clinic or hospital — often with rigid schedules and limited flexibility — is no longer the standard.

For practice leaders, this shift requires rethinking traditional staffing models and considering whether existing care delivery structures align with what today’s workforce expects.

Job Sharing and Flexible Models Offer Opportunity — and Complexity

Among the emerging workforce models Lewis discussed was job sharing, particularly in primary care. While attractive to physicians seeking flexibility, job sharing introduces operational challenges that practices must be prepared to manage.

Lewis explained that when thinking in terms of job sharing, he and other recruiters are focused on those physicians working part time. “So in primary care, I have to have a complement, right?" he said. "If I’m committed to working two days a week and the other provider’s committed to working three days a week, that practice administrator now has to figure out how [to] fill that void.”

Not all physicians are comfortable co-managing patient panels, Lewis noted, but for others, the flexibility is a significant draw. The challenge for leaders is ensuring continuity of care, operational clarity, and alignment among providers.

For practices willing to invest in the infrastructure and planning required, flexible models can be a powerful recruitment tool.

Hiring Timelines Are Slowing — and That Requires a New Approach

Another key trend Lewis highlighted was that hiring decision timelines are getting longer. Increased financial scrutiny, governance layers, and risk management considerations are slowing decisions across many organizations.

“What we’re hearing from our members … speaks to a decision timeline,” Lewis said. “Making sure that every hire is adding to that bottom line and that they’re looking at the risk management lens as well.”

This “hurry up and wait” dynamic places new demands on recruiters, who must keep candidates engaged throughout extended decision periods. Lewis emphasized the importance of frequent communication and transparency.

“The recruiter has to really make sure that they’re checking in with that provider, making sure they understand the timeline,” he said.

Credentialing delays further extend onboarding, with timelines often ranging from 90 to 120 days. Practice leaders should prioritize aligning recruitment, credentialing, and onboarding teams to maintain a positive candidate experience.

Compensation Strategy Requires Balance and Transparency

Compensation remains one of the most complex aspects of recruitment — and one where missteps can undermine long-term sustainability.

“I was told compensation is science, and then I was told compensation is an art,” Lewis said. “I think it’s both.”

Lewis cautioned against bidding wars for talent, emphasizing the need for compensation models that feel fair to providers while protecting the financial health of the organization.

“It has to be a sustainable model where the provider feels they have been taken care of,” he said, “and the health system doesn’t feel like they're being taken advantage of.”

Clear communication is critical. Whether compensation includes base salary, RVUs, or outcome-based incentives, physicians must understand exactly how they are paid and why.

Locum Tenens Use Signals Deeper Workforce Challenges

Lewis also addressed the continued reliance on locum tenens providers, particularly in hard-to-recruit specialties where locums rates often exceed permanent compensation.

“When we see locums as a reliance, it often reflects a deeper structural workforce challenge,” Lewis said.

While locums play an important role in maintaining patient access, Lewis stressed they should be viewed as a short-term bridge rather than a long-term solution.

“Organizations really have to look at locums as a short-term strategy,” he said, emphasizing the need for better workforce forecasting and pipeline development.

Recruiter–Leader Partnerships Are Essential for Success

As recruitment pressures intensify, Lewis emphasized the importance of strong collaboration between recruiters and leadership, along with greater attention to recruiter satisfaction and well‑being. “Recruiters still have ... burnout just like physicians do,” he said.

Looking ahead, Lewis believes success in 2026 and beyond will depend on shared data, shared strategy, and shared accountability.

“How do we build that relationship with leaders?” he asked. “How do we make sure that the recruiters are sharing industry trends with their hiring leaders?”

By treating recruitment as a strategic partnership rather than a transactional function, organizations can make better workforce decisions and improve long-term outcomes for patients and providers alike.

Resources 

• Contact Doug on LinkedIn
• Sentara Health
• Association for Advancing Physician and Provider Recruitment (AAPPR)
• MGMA Physician Hiring Playbooks - Member-exclusive, downloadable playbooks provide actionable insights, proven strategies, and step-by-step guidance for practice leaders.