Physician compensation costs $400,740 at the median across all specialties and generates $2.13 in net revenue per wRVU-dollar spent, yet 46% of healthcare organizations report compensation misalignment as their top physician retention risk[1]. Talyx's intelligence infrastructure tracks compensation signals across 22,579 physicians and 7,177 facilities, identifying the exact moments when pay dissatisfaction converts into recruitment vulnerability -- delivering 40-60% faster candidate identification for PE-backed healthcare organizations competing in a market facing an 86,000-physician shortage by 2036.
Physician compensation is the single largest operating expense for most healthcare organizations, representing 8-12% of total revenue for hospital-employed physician groups and 45-65% of revenue for physician-owned practices[1]. But compensation data serves a far more consequential purpose than expense management. It is the most reliable leading indicator of physician movement.
Physicians who believe they are undercompensated relative to peers are 3.2 times more likely to actively explore new opportunities within 12 months[2]. Physicians whose compensation falls below the 25th percentile for their specialty and region generate resignation signals that are detectable 6-9 months before formal departure -- if the organization has the intelligence infrastructure to detect them.
For PE-backed healthcare organizations executing buy-and-build strategies, compensation intelligence serves three distinct functions: it informs recruitment offer calibration (what to pay), retention risk detection (who might leave), and acquisition due diligence (what compensation liabilities exist in target practices). Talyx's physician intelligence graph integrates compensation benchmarks with behavioral profiling, contract timing, and practice satisfaction signals to produce actionable intelligence that static salary surveys cannot provide.
The following table presents median total compensation and productivity metrics for high-demand specialties, sourced from MGMA 2024 data -- the most recent complete reporting cycle available as of January 2026.
| Specialty | Median Total Compensation | Median wRVUs | Compensation per wRVU | YoY Change |
|---|---|---|---|---|
| Orthopedic Surgery | $703,000 | 8,812 | $79.78 | +5.2% |
| Cardiology (Invasive) | $695,000 | 9,103 | $76.35 | +4.8% |
| Gastroenterology | $606,000 | 7,628 | $79.44 | +6.1% |
| Urology | $560,000 | 7,415 | $75.52 | +4.3% |
| Pulmonology/Critical Care | $510,000 | 6,221 | $82.00 | +5.7% |
| General Surgery | $480,000 | 6,483 | $74.04 | +3.9% |
| Emergency Medicine | $378,000 | 5,109 | $73.99 | -1.2% |
| Psychiatry | $335,000 | 4,412 | $75.93 | +8.4% |
| Family Medicine | $300,000 | 4,824 | $62.20 | +4.1% |
| Pediatrics | $272,000 | 4,389 | $61.97 | +3.2% |
| Internal Medicine | $305,000 | 4,736 | $64.39 | +3.8% |
| Hospitalist | $345,000 | 4,523 | $76.28 | +2.9% |
Source: MGMA DataDive 2024 Physician Compensation Survey; all figures reflect total compensation including salary, bonuses, and incentive pay.
Three patterns emerge from the current data that carry direct implications for recruitment and retention strategy.
Psychiatry posted an 8.4% year-over-year compensation increase -- nearly double the all-specialty average of 4.5%[1]. This acceleration reflects a supply-demand imbalance that the AAMC projects will worsen, with psychiatry facing a shortfall of 14,280 to 31,091 physicians by 2036[3]. For PE-backed behavioral health organizations, this trend means acquisition targets with psychiatrist-heavy staffing models carry escalating compensation liabilities that must be modeled into deal underwriting.
Emergency medicine is the only major specialty showing negative compensation growth (-1.2%), driven by a post-pandemic normalization of volumes and increasing competition from urgent care and telehealth alternatives[1]. This creates a distinctive recruitment dynamic: emergency physicians experiencing compensation compression are more receptive to outreach than physicians in appreciating specialties, but they are also more likely to exit clinical practice entirely -- making timing intelligence essential for engagement.
Orthopedic surgery, cardiology, and gastroenterology continue to post above-average compensation gains, fueled by procedure volume recovery and ASC (ambulatory surgery center) expansion under PE ownership. The median orthopedic surgeon now earns $703,000 -- but the 75th-90th percentile in high-volume ASC settings exceeds $900,000[1]. This gap between median and top-quartile compensation is a critical recruitment signal: surgeons at the median who learn about 90th-percentile opportunities become high-probability candidates.
Total compensation figures alone are insufficient for either recruitment or retention intelligence. The metric that matters is compensation per wRVU -- the effective rate an organization pays for each unit of physician productivity. This metric reveals whether a physician is being compensated fairly relative to their output, and whether an organization's compensation structure is sustainable.
When a physician generates 90th-percentile wRVUs but receives 50th-percentile compensation, the resulting compensation-productivity gap creates a measurable departure risk. Talyx's intelligence infrastructure monitors this gap across the physician population by cross-referencing publicly available productivity indicators (billing patterns, panel sizes, procedure volumes reported in facility data) against compensation benchmarks.
The intelligence value is bidirectional:
For recruiting organizations: Identifying physicians with high productivity and below-market compensation reveals candidates most likely to respond to outreach. A gastroenterologist generating 9,000 wRVUs (75th percentile) at $79/wRVU ($711,000 total) is less likely to move than one generating the same wRVUs at $65/wRVU ($585,000 total) -- $126,000 below market rate.
For retaining organizations: Monitoring internal compensation-per-wRVU ratios against market benchmarks identifies retention risks before they become resignations. Organizations that adjust compensation proactively -- before the physician begins interviewing -- retain physicians at 2.4 times the rate of organizations that counter-offer after a competing offer arrives[2].
PE-backed practices consistently report higher wRVU expectations than independent practices. The median PE-backed multispecialty group targets 5,200-5,800 wRVUs for primary care physicians versus 4,600-5,000 wRVUs in independent groups -- a 10-16% productivity differential[1]. This productivity premium is enabled by operational efficiencies (reduced administrative burden, optimized scheduling, ancillary support staff) that PE operating teams implement post-acquisition.
However, the productivity premium creates a recruitment intelligence consideration: physicians accustomed to independent practice productivity norms may underperform against PE-backed targets during their first 12-18 months. Recruitment intelligence that includes productivity trajectory analysis -- not just current output -- identifies candidates whose productivity arc is compatible with PE operating expectations.
The compensation gap between PE-backed and independent practices has widened from 6-8% in 2020 to 12-18% in 2025 across most specialties[1]. This divergence is driven by three structural factors.
Scale economics. PE-backed organizations negotiate payer contracts across larger patient volumes, achieving reimbursement rates 5-12% higher than independent practices for identical CPT codes[4]. Higher per-procedure revenue funds higher physician compensation while maintaining or improving margins.
Ancillary revenue capture. PE-backed practices systematically develop ancillary revenue streams (imaging, lab, pharmacy, physical therapy) that independent practices often lack. This ancillary revenue increases total practice revenue without requiring additional physician productivity, creating headroom for above-market compensation.
Signing bonus escalation. The median signing bonus for PE-backed practice hires reached $55,000 in 2024, compared to $32,000 for independent practices[1]. For surgical subspecialties, PE-backed signing bonuses frequently exceed $100,000 -- a figure that independent practices cannot match without external financing.
The implication for workforce intelligence is clear: PE-backed organizations are structurally advantaged in compensation-driven recruitment. The intelligence question is not whether PE organizations can outpay independents -- they can -- but which physicians are most motivated by compensation versus practice autonomy, lifestyle, or mission alignment. Talyx's behavioral profiling identifies these motivational dimensions for individual physician targets, enabling engagement messaging that addresses the specific factors driving each candidate's career decisions.
Is your organization making compensation offers based on market data -- or market intelligence? Talyx's physician intelligence infrastructure identifies the exact compensation, timing, and messaging combination that converts passive candidates into signed contracts. Schedule a physician intelligence briefing →
Static compensation surveys tell organizations what the market pays. Intelligence infrastructure tells organizations what to do about it. Talyx's physician intelligence graph integrates compensation benchmarks with five additional data streams to produce recruitment and retention intelligence that compensation data alone cannot generate.
Compensation benchmark + contract expiration timing. A physician earning below the 25th percentile with a contract expiring in 6-12 months is a high-probability recruitment target. The intelligence graph flags these convergences automatically.
Compensation trajectory + practice ownership changes. When a practice is acquired by a PE firm, compensation structures change within 6-12 months. Physicians whose compensation drops relative to new benchmarks become flight risks; physicians whose compensation increases become harder to recruit. Monitoring ownership change announcements generates forward-looking intelligence about which physicians will become more or less recruitable.
Compensation + geographic cost-of-living adjustment. A physician earning $350,000 in San Francisco has less purchasing power than one earning $280,000 in Nashville. Geographic normalization reveals compensation dissatisfaction that raw salary figures obscure.
Compensation + burnout indicators. Physicians experiencing burnout combined with below-market compensation exhibit the highest departure probability. Burnout signals (reduced publication activity, decreased conference participation, social media sentiment shifts) combined with compensation data produce the most accurate retention risk scores.
Compensation + fellowship pipeline. Graduating fellows entering the market with $250,000+ in educational debt are disproportionately influenced by starting compensation. Fellowship pipeline intelligence combined with compensation benchmarking identifies which graduating fellows are most recruitable based on their debt-to-income sensitivity.
Physician compensation varies by 30-45% across geographic regions for identical specialties and productivity levels[1]. This variation creates arbitrage opportunities for organizations with the intelligence infrastructure to identify them.
The highest-compensation regions -- the Upper Midwest, Northern Plains, and parts of the Southeast -- typically face the most acute physician shortages. Rural Wisconsin pays family medicine physicians a median of $315,000 versus $258,000 in urban Boston -- a 22% premium driven entirely by supply scarcity[1]. But many physicians in lower-compensation urban markets are unaware of these differentials, making targeted outreach with specific compensation data a highly effective recruitment strategy.
Talyx's intelligence infrastructure maps these regional differentials and identifies physicians in over-saturated, lower-compensation markets whose professional profiles suggest receptivity to relocation. A cardiologist earning $580,000 in a saturated urban market who demonstrates geographic mobility indicators (spouse career portability, no school-age children, prior relocation history) and compensation sensitivity signals is a high-probability candidate for a $695,000 opportunity in an underserved region.
Healthcare organizations collectively spent an estimated $11.2 billion on physician recruitment in 2024[5]. A significant portion of that spend goes toward compensation escalation -- signing bonuses, loan forgiveness, and salary guarantees that inflate costs without improving recruitment precision.
Intelligence infrastructure offers an alternative to the compensation arms race. Instead of outspending competitors on every candidate, organizations with compensation intelligence can:
Target efficiently. Identify the 5-10% of physicians in any specialty whose compensation-productivity gap makes them most recruitable -- rather than broadcasting offers to the entire market.
Offer accurately. Calibrate compensation packages to the specific figure that converts a particular candidate, rather than defaulting to 75th-percentile packages for all candidates regardless of their current compensation or motivational profile.
Time precisely. Engage candidates during contract renewal windows, post-acquisition compensation adjustments, or other inflection points when compensation receptivity peaks.
Retain proactively. Adjust internal compensation before departure signals escalate, at a fraction of the cost of recruiting a replacement ($750,000 to $1.8 million per physician departure)[6].
MGMA publishes its physician compensation survey annually, with data collected from over 6,000 organizations representing more than 200,000 providers[1]. The survey reflects compensation for the prior calendar year, meaning 2024 data published in mid-2025 represents the most current benchmarks available in January 2026. Organizations should use MGMA benchmarks as the foundation for compensation analysis but should not rely on them exclusively. MGMA data represents reported compensation -- it does not capture informal benefits, productivity bonuses not yet paid, or signing bonuses that influence total effective compensation. Intelligence-driven organizations supplement MGMA benchmarks with real-time signals including job posting compensation ranges, contract negotiation intelligence, and competitive offer data gathered through structured collection.
Compensation misalignment -- paying significantly above or below market -- generates measurable financial consequences in both directions. Below-market compensation increases turnover risk: each physician departure costs $750,000 to $1.8 million in recruitment, onboarding, lost revenue during vacancy (at $7,000-$9,000 per day), and productivity ramp-up[6]. Above-market compensation erodes margins without proportional productivity gains. The optimal compensation position -- which varies by specialty, geography, and organizational strategy -- typically falls between the 50th and 75th percentile for the relevant market, adjusted for wRVU expectations. Organizations using intelligence infrastructure to monitor compensation alignment across their physician population identify and correct misalignment before it generates either departures or margin erosion.
PE-backed healthcare organizations typically increase physician compensation by 8-15% within the first 18 months of acquisition, funded by operational efficiencies, payer contract renegotiation, and ancillary revenue development[7]. However, this increase is accompanied by productivity expectations that rise by 10-16% as PE operating teams implement scheduling optimization, support staff augmentation, and administrative burden reduction[1]. The net effect on physician satisfaction depends on whether individual physicians value higher absolute compensation or stable productivity expectations. Intelligence infrastructure monitors this satisfaction dynamic at the individual physician level, identifying which physicians within acquired practices are adapting positively to PE ownership compensation structures and which are generating departure signals. This intelligence is critical for PE operating teams managing retention through the post-acquisition integration period.
Compensation data alone is an incomplete predictor, but it is the strongest single variable in physician movement models. Research indicates that physicians earning below the 25th percentile for their specialty and region are 3.2 times more likely to explore opportunities within 12 months compared to physicians at or above the median[2]. However, compensation interacts with non-financial factors -- practice autonomy, call burden, leadership quality, geographic preference, and family considerations -- that modify its predictive power. The most accurate movement prediction models integrate compensation data with contract timing, burnout indicators, practice ownership changes, and behavioral signals. Talyx's intelligence infrastructure combines all five data streams to generate physician movement probability scores that exceed the accuracy of any single-variable model, enabling organizations to focus recruitment resources on physicians with the highest actual probability of movement rather than the highest theoretical compensation dissatisfaction.
[1] MGMA, 2024 [2] Merritt Hawkins, 2024 [3] AAMC, 2024 [4] McKinsey, 2024 [5] Becker's Hospital Review, 2024 [6] CompHealth, 2024 [7] Bain, 2026
The Talyx Intelligence Team publishes research and analysis on intelligence-driven methodologies for PE healthcare organizations, wealth advisory firms, and mid-market enterprises. Talyx specializes in AI-augmented intelligence systems that build permanent organizational capability rather than consulting dependency.
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