Doc Comp Inches Up in 2025, Varies Widely by Specialty

Orthos top all salaries; PCPs comp at the bottom; NPs in high demand.

Hospitals, physician groups and other providers recruiting physicians should prepare to offer starting compensation packages averaging a half-million dollars or more across several specialties, according to AMN Healthcare's 2025 Review of Physician Recruiting Incentives.

The average starting salary for all physicians tracked in the clinician recruiter's 32^th annual review was $403,000, slightly down from the $406,000 reported last year. However, average signing bonuses ($38,215), CME ($4,073) and relocation ($12,619) allowances and other financial incentives account for nearly $59,000 above salary. 

The findings in the 2025 Review are based on 1,420 physician and advanced practitioner searches AMN conducted in the 12 months between April 2024 and March 2025.

Jeff Decker, president of AMN Healthcare's Physician and Leadership Solutions division, says the review "underscores the continued competition for physicians and the need to offer not only competitive starting salaries but other incentives such as signing bonuses, relocation allowances, CME allowances, production bonuses, and in some cases educational loan forgiveness."

"What is not indicated in the review, but which is just as important, is that healthcare organizations also need offer physicians an attractive practice environment, with flexible schedules, reduced bureaucracy, clinical autonomy and the other hallmarks of a physician-friendly practice," he says. "That is a separate issue, but an important one."  

Of course, compensation varies greatly depending upon variables such as the specialty, the care venue, and geography, all of which is detailed in the survey.

As has been the case since forever, orthopedic surgeons in the AMN 2025 review garner the highest average starting salaries ($576,000) while pediatricians and other primary care docs remain stuck at the bottom, where they've always been, averaging $258,000.

Decker says the compensation differences reflect the long-standing trend in U.S. healthcare to reward specialties that generate money.

"Knee replacements or heart surgery are awarded a relatively high number of RVUs (relative value units), while managing a chronic disease such as diabetes is awarded fewer RVUs," he says. "A PCP may diagnose an incipient heart attack in a patient and thereby save his or her life. But that does not pay as well as performing bypass surgery. It's simply a function of our current physician payment model."

APPs v. PCPs

For the fifth straight year, nurse practitioners continue to be the most-heavily recruited specialists in the survey. Their average starting salary is $180,000, up from $164,000 last year, a 9.6% increase.

Several factors are generating the demand, Decker says, particularly the NP's ability to mesh with team-based care and "the rapidly proliferating number of convenient care venues such as urgent care centers, retail clinics and telehealth platforms."

"These venues were built on the advanced practice professional staffing model, and while they have moved into physician provided primary and specialty care, they continue to employ many NPs and PAs," Decker says.

"In addition, NPs are no longer concentrated in just primary care practices," Decker says. "A growing number of physician specialty practices now are employing NPs and PAs to expand patient access and to provide patient education and follow-up. This allows specialists to see more patients and generate more revenue. NPs also are expanding rapidly into mental health care, alleviating the shortage of psychiatrists, particularly in rural areas."

Overall, Decker says the review illustrates how NPs and other APPs have changed the primary care delivery model.

"Traditionally, primary care physicians were gatekeepers to the healthcare system," he says. "They still are, but a significant percentage of that role has shifted to NPs and other APPs practicing in urgent care centers, retail clinics and telehealth platforms.  Increasingly, they are the new front door to the system. 

Family medicine physician recruiting remains AMN's most-requested physician search, Decker says, but those requests are waning. "Fifteen years ago, about one half of our physician search engagements were for primary care physicians," Decker says. "This year, that is down to 22%."

"Interestingly, this has not affected comp for primary care physicians," Decker says. "They remain in significant demand and starting salaries for family and internal medicine were both up this year."

To some extent, Decker says, some hospitals and physician groups view NPs as lower-cost alternatives to PCPs. However, the demand for these APPs more accurately reflects the ongoing PCP shortage, especially in rural America.

"We have a rapidly aging population, and the majority of adults in the U.S. suffer from at least one chronic condition," he says. "PCPs are increasingly needed to manage the complex care of older, sicker patients with multiple morbidities.  They must practice to the top of their training to care for these patients, while APPs play a key role in expanding patient access, education and care follow-up.  

Highlights

Here's a rundown of some of the comp trends AMN identified for physicians and APPs.

• Average starting salaries for physicians across all specialties in academia ($338,000) were 26% lower than for physicians in non-academic settings ($425,000).
• The average signing bonus for physicians is $38,215, up from $31,103 last year.
• The average signing bonus for NPs and PAs is $12,869, up from $11,758 last year.
• The average relocation allowance for physicians is $12,619, up from $11,284 last year.
• The average relocation allowance for NPs and PAs is $9,016, up from $7,910 last year.
• The average CME allowance for physicians is $4,073, up from $3,969 last year.
• 16% of physicians and APP contracts feature student loan repayments. The average repayment offered to physicians is $104,200, down from $117,217 last year.
• The average educational loan repayment offered to NPs and PAs is $50,000, down from $78,337 last year.
• Of the physician searches AMN conducted in its 2025 review, 22% were for primary care physicians, and 78% were for specialists.