Physician base salaries grew just 2.0% in 2026, while signing bonuses climbed 12.0% to a median of $25,000, according to Resolve's analysis of 4,417 signed physician employment contracts, published in July 2026. For a practice trying to fill an open seat, the real negotiation has moved from the base salary line to the bonus line.
Resolve built the report from actual signed contracts rather than a survey, drawing on data from 116 specialties across all 50 states. The national average base salary across every specialty in the data set reached $387,000. That base pay grew 2.9% to 3.7% year over year nationally, a sharp slowdown from the 5.0% to 6.0% annual growth practices paid during the post-pandemic hiring surge.
What Base Pay Did by Specialty
Base pay growth was not even across specialties. Resolve's contract data shows a wide spread between primary care and high-demand procedural fields, and the range within each specialty is often as wide as the gap between specialties.
| Specialty | Median base salary | Typical range |
|---|---|---|
| Family medicine (without OB) | $270,000 | $160,000 to $320,000 |
| Emergency medicine | $307,000 | $264,000 to $345,000 |
| General surgery | $424,000 | $375,000 to $462,000 |
| Anesthesiology | $500,000 | $420,000 to $525,000 |
| Diagnostic radiology | $500,000 | $425,000 to $536,000 |
Source: Resolve, 2026 Physician Salary & Employment Report.
The gap between family medicine's $270,000 median and the $500,000 medians in anesthesiology and diagnostic radiology is nearly $230,000 in base pay alone, before any bonus or productivity incentive is added. For a practice budgeting a new hire, the specialty line matters more than the year-over-year growth number.
Bonuses Did the Work Base Pay Didn't
While base pay grew 2.0% at the median, bonus opportunity grew 12.0%, a six-fold difference in growth rate on the two main pieces of a physician compensation offer. The median signing bonus in the Resolve data set is $25,000, and the range runs from $6,500 up to $57,500 or more depending on specialty and market.
That split shows up as a deliberate structural choice, not a rounding difference. Employers facing a tight labor market and margin pressure are choosing to add money through a bonus that only pays out once, or that is tied to relative value unit production, rather than raising the guaranteed base salary that carries forward into every future year of the contract. A base salary increase compounds every year the physician stays on staff. A signing bonus is a single line item that never repeats, which makes it a cheaper way for an employer to close a gap in a competitive offer.
The practical effect for a hiring administrator is that last year's base salary range understates what candidates are being offered elsewhere in 2026. A candidate comparing two offers with matching base pay will weigh the signing bonus, the relocation allowance, and the productivity threshold in the contract as heavily as the number on the salary line.
Staff Raises Are Not Moving at the Same Pace
Physician bonus growth of 12.0% stands next to a much smaller number for support staff. MGMA polled 349 medical groups on September 9, 2025, about their 2026 staff pay budgets. Nearly two-thirds, 64.0% of respondents, are targeting a 1.0% to 3.0% base pay increase for staff. Another 23.0% built in a 4.0% to 6.0% increase, just 1.0% budgeted 7.0% or higher, and 10.0% reported no staff base pay increase planned at all.
Put the two data sets side by side and a practice's 2026 compensation budget carries two different stories at once: a physician bonus pool growing in the double digits, and a staff pay budget where nearly three in four practices are holding increases to 6.0% or under.
Two Reports, Two Similar Numbers That Mean Different Things
Resolve's $387,000 average base salary sits close to another widely cited figure: Medscape's 2026 Physician Compensation Report put average total physician compensation at $386,000, up 3.0% from the prior year. The survey, fielded from September 5, 2025 to December 17, 2025 among 5,916 full-time U.S. physicians, also found that 53.0% of respondents feel fairly compensated, up from 48.0% a year earlier and the highest share Medscape has recorded in three years.
The two numbers land within $1,000 of each other, and that is close to a coincidence. Resolve measures base salary written into signed contracts. Medscape asks physicians to self-report total compensation, which folds in bonuses, productivity pay, and other incentive income on top of base. A practice that quotes one figure against the other in a recruiting conversation, or in a board presentation on compensation trends, is comparing a floor to a total.
What It Means for a Recruiting Budget
For a practice administrator building next year's compensation budget, three numbers from this year's data are worth writing down together: 2.0% base pay growth, 12.0% bonus growth, and a $25,000 median signing bonus. A recruiting offer built only around the base salary line will look flat against last year's market. The competitive move, based on where the Resolve data shows the money actually going, is in the bonus and incentive structure.
The same logic applies in reverse when budgeting for existing staff. MGMA's 349-practice poll shows 64.0% of groups holding staff increases to 1.0% to 3.0%, a pace that looks conservative next to a physician bonus pool growing 12.0%. Practices that want to close that gap without inflating base pay have the same tool physicians' employers are already using: a one-time or performance-linked bonus rather than a permanent raise to the pay line.
None of these figures set the number for a single hire. Specialty, region, call schedule, and payer mix still decide that. What the 2026 data shows is where this year's growth actually sits: not in the guaranteed base salary line, but in the bonus and incentive lines underneath it.
Sources
- Resolve, "2026 Physician Salary & Employment Report," July 2026
- MGMA, "Budgeting competitive, sustainable 2026 staff pay for your medical practice," September 9, 2025
- Medscape, "Physician Compensation Report 2026," 2026
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