Resolve’s 2026 Physician Salary & Employment Report, compiled from 4,417 actual signed physician employment contracts, shows a notable shift in how employers are structuring physician compensation. On a national level, base salary growth cooled to an estimated 2.9%–3.7%, a slowdown from the 5%–6% growth that characterized the post-pandemic years. At the same time, employers maintained or increased overall pay opportunities by reallocating more of compensation into bonuses and signing incentives.
Although base pay increases decelerated, the report finds median bonus opportunity rose 12% year-over-year while base pay rose roughly 2% in the same period. Signing bonuses have also become a more prominent part of offers: the median signing bonus reported was $25,000, with top values reaching $57,500 depending on specialty. This shift indicates employers are relying more on variable pay to attract and retain physicians rather than raising guaranteed base salaries.
The authors stress that the way a contract is constructed can have a larger impact on long-term financial outcomes than the base salary line alone. Important elements highlighted in the report include wRVU conversion rates, definitions and measurement of quality metrics, termination clauses, and call pay. Because bonuses and incentives now make up a larger share of total compensation, understanding the performance metrics, thresholds, and pay formulas is critical for physicians evaluating offers.
Despite regulatory activity around non-compete agreements, the report notes these clauses remain widespread in physician contracts. A proposed nationwide ban by the Federal Trade Commission was formally abandoned in September 2025, leaving a state-by-state regulatory landscape. The authors advise physicians to understand how non-compete provisions could affect career mobility before signing an employment agreement.
The report identifies widening regional differences. On a raw pay basis, markets in the Midwest and South led the country, while coastal markets lagged once cost-of-living adjustments were applied. The data suggest that headline salary comparisons can be misleading unless adjusted for local economic conditions and living costs.
With lower guaranteed base salary growth but larger bonus pools and signing incentives, the practical implication is that physicians must look beyond the base salary figure. The report’s emphasis on contract structure implies a few practical steps:
Unlike many compensation reports that rely on self-reported survey responses, Resolve’s 2026 report used a dataset of 4,417 signed employment contracts. That approach provides direct insight into the actual terms employers were willing to execute in signed agreements, rather than intentions or expectations reported by respondents.
The source material reports the key findings summarized above but does not provide a full breakdown by specialty, exact regional salary figures, or detailed examples of contract language beyond the general areas highlighted (wRVU conversion, quality metrics, termination clauses, and call pay). Specific specialty-level median signing bonuses or a comprehensive list of the highest reported signing bonuses by specialty were not included in the summary available.
Employers appear to be managing compensation budgets by shifting pay into variable components and one-time incentives rather than maintaining the higher base salary growth seen in earlier post-pandemic years. For physicians, especially those negotiating initial employment contracts or contemplating moves, the report suggests increased importance of contract negotiation skills and careful review of incentive design.
Physicians reviewing job offers should prioritize clarity on how bonus opportunities are measured and paid, request written examples or historical attainment when available, and assess how non-compete terms could limit future options. Because the dataset reflects signed contracts, the trends captured show what employers are currently willing to put into executed agreements — making the findings relevant for physicians actively negotiating employment terms.
Resolve’s 2026 analysis of 4,417 signed contracts shows physician pay is not simply plateauing: the composition of compensation is changing. Base salary growth has slowed to the mid-single-digit range, but employers have increased bonus opportunities and signing incentives. Given the prominence of variable pay and the persistence of non-compete clauses in a fragmented regulatory environment, careful contract review and negotiation remain central to maximizing long-term financial outcomes for physicians.
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