What physicians want beyond a bigger paycheck

For much of the past decade, health systems have assumed that a bigger salary offer would be the most reliable way to win a physician search. New survey data suggests that strategy is reaching its limits, and that physicians are drawing a different line around what makes a job satisfying.

CHG Healthcare’s 2025 Physician Sentiment Survey, based on responses from more than 900 practicing physicians nationwide, shows a wide gap between what physicians say matters and what they actually have. Ninety-one percent of respondents said autonomy is very or extremely important to their satisfaction, but only 59% said they are satisfied with the autonomy they currently have. Compensation showed a similar gap: 87% said it is critical, while just 53% said they are satisfied with what they receive.

Taken together, those numbers suggest physicians are not evaluating job satisfaction in dollars alone. For hospitals and health systems, that means a compensation-first approach may overlook the real issues shaping whether a search closes or falls apart.

Data from Jordan Search Consultants indicates that this shift is already visible in recruitment. Across five major health systems profiled, none cited salary increases as their main recruitment lever. Instead, leaders pointed to flexible scheduling, less administrative burden and transparent communication from leadership as the factors that helped close searches.

That pattern is also reflected at Boston-based Tufts Medical Center, where the organization is rethinking its employment model around more than base pay. Erika Werner, MD, president of the hospital’s physician organization, said the goal is to give clinicians room to adjust both time and compensation rather than negotiate salary in isolation.

“We are evolving our employment model so that clinicians can titrate time and compensation to best fit their individual needs,” Dr. Werner told Becker’s. “Only with partnership, transparency and flexibility can we meet workforce and financial demands of 2026 and beyond.”

The move beyond salary is also showing up in how systems think about workload. A March survey of 360 independent practice leaders conducted by Veradigm found that 65% of physicians spend at least an hour a day on documentation outside scheduled patient visits, and more than a quarter spend two hours or more. That kind of burden can shape how physicians judge an employment offer. In many cases, reducing documentation time can feel like a raise even when the base salary does not change.

That does not mean compensation has stopped mattering, or that health systems have stopped competing on it. Pay escalation remains a real issue in specialties facing severe shortages. But as John Deledda, MD, chief medical officer of Henry Ford Medical Group, part of Detroit-based Henry Ford Health, described it, the problem is often that organizations are solving the wrong issue.

“What ends up happening is organizations in the same geography start competing against each other, offering higher and higher rates, and physicians jump from system to system chasing compensation,” Dr. Deledda said. “Competing organizations are not sitting down locally and saying, ‘The cost of healthcare in our geography is getting out of hand — we need to do something about this together.’”

His comments reflect a broader tension in the physician market. On one hand, salary remains a key part of any offer. On the other, systems that focus only on compensation may find themselves in a cycle of escalating costs without addressing the reasons physicians are dissatisfied in the first place.

A generational divide adds another layer to that challenge. Workforce data from SullivanCotter shows younger physicians increasingly prefer a stable base salary over the productivity-based upside that has shaped physician pay models for decades. Mark Ryberg, physician workforce practice leader at SullivanCotter, said many early-career physicians are less comfortable taking on risk tied to production or volume.

“Often younger physicians don’t want to be at risk relative to production or the amount of volume they can generate,” Ryberg said. “They’re prioritizing security in the form of base salaries.”

That preference matters because it suggests a changing view of what a good job looks like. For some physicians, the appeal of a role is no longer just the possibility of earning more through higher productivity. It is the predictability of income, the ability to manage workload and the amount of control they have over how they practice.

The survey data and recruitment examples together point to a common theme: physicians want more than a bigger paycheck. They want autonomy, flexibility, manageable documentation demands and a sense that leadership is communicating clearly. Those factors can influence whether physicians accept an offer, stay in a role or move elsewhere.

The findings also suggest that health systems may need to think more broadly about how they structure physician employment. Salary still matters, but it is only one part of a larger negotiation. Time, workload, transparency and control over practice conditions are becoming central to the conversation.

In that environment, a competitive offer may be less about simply raising the number on a contract and more about adjusting the overall employment model. Tufts Medical Center’s approach, for example, reflects an effort to align time and compensation with individual needs rather than treating compensation as the only lever available.

The broader message from the available data is straightforward: physicians are setting a higher bar for satisfaction than pay alone can meet. Health systems that want to recruit and retain them may need to look beyond salary increases and focus on the conditions that shape daily work.

For many physicians, that means the most valuable part of an offer may not be the biggest paycheck. It may be the opportunity to practice with more autonomy, less administrative strain and greater flexibility in how work is organized.