Recruiting a physician into private practice is about much more than compensation. It requires the practice to explain its ownership model clearly and honestly enough for a candidate to believe in building the business. 

With a projected national physician shortage of up to 86,000 by 2036 and MGMA polling showing that 38% of medical groups said time to fill physician vacancies increased, there is less margin for a fumbled recruitment conversation than there once was — especially as independent groups compete with hospitals, health systems, and private-equity-backed platforms that can offer income certainty and a simpler narrative. 

“You’re not just competing with the practice down the street anymore,” said Tara Osseck, MHA, senior vice president, recruiting, of Jackson Physician Search. “Recruitment and retention has become one of the single biggest challenges facing independent practices today.” 

• Learn more: Osseck will be co-presenting on the topic with Matthew A. Phillips, JD, MBA, managing director, City Capital Advisors LLC, at the 2026 MGMA Private Practice Conference in St. Louis and the 2026 MGMA Summit.  

What physician candidates are weighing 

Today’s candidates — particularly early-career physicians carrying significant education debt — often prioritize income certainty and schedule predictability. The MGMA and Jackson Physician Search early-career physician study found that compensation was the top need in a first job, but practice ownership and governance became the top reason for leaving the first job later on. Early-career physicians spent less than two years on average in their first jobs, compared with six years for physicians overall — making recruitment and retention inseparable. 

“When a young physician is looking at all of this, they’re not just evaluating a job — they’re evaluating an entire business,” Osseck said. “And they’re asking, ‘is this something I actually want to step into?’ If that answer is not clearly ‘yes,’ they have plenty of other options.” 

That means independent groups have to meet candidates where they are while making the case for ownership over time. Work-life balance is a baseline expectation. When younger physicians compare employed roles against independent practice, what they often see is call coverage challenges, staffing pressure, heavier operational responsibility, and a traditional buy-in model that no longer lands the way it once did.  

None of that is disqualifying — physician-owned practices can still outperform system-owned peers on collections and patient throughput when operations are disciplined — but candidates are looking for signs that the practice understands its own business, not just that it values its own history. 

Where recruitment breaks down 

Every serious candidate is running the same mental checklist, whether they say it out loud or not, Osseck said. The five questions practices should be prepared to answer: 

1. Will I have real autonomy here? 
2. What does professional development look like? 
3. What does ownership actually cost — financially and in time? 
4. When is partnership real, and what could take it away? 
5. What happens if this doesn’t work out? 

And the most common missteps, she said, are remarkably consistent. 

The first is vague language. “‘We have a great partnership track’ is not a value proposition — it’s a placeholder,” Osseck said. “If candidates don’t hear specifics, they tend to assume there aren’t any.” 

The second is deferring the conversation — telling a candidate the details will come later. That does not create intrigue; it signals that the details either aren’t fleshed out or that the practice isn’t comfortable discussing them. 

The third is conflating culture with structure. “Culture absolutely matters, but it doesn’t answer the real questions around governance or economics or decision-making,” Osseck said. “Warmth builds connection. Clarity builds trust. You need both.” 

And the fourth — the most damaging — is overselling. “When what is said in the interview does not match what shows up in the contract, the issue isn’t confusion,” Osseck said. “It’s credibility. And once that’s gone, it is incredibly difficult to recover.” 

Misalignment does not surface in year three when partnership becomes real, Osseck added. It starts with the very first recruitment conversation — what you say, what you don’t say, and how clearly you say it. 

Make ownership investable 

A practice cannot communicate its ownership value proposition until it has defined it — and that means confronting a structural tension most groups have not made explicit. Only 35.4% of physicians held an ownership stake in their practice in 2024. If ownership is now rarer, the case for it has to be sharper. 

No practice can simultaneously maximize exit proceeds for senior physicians, keep buy-ins highly affordable for newer physicians, and preserve enough capital for reinvestment and long-term sustainability. Every group is making a choice among those three, whether it says so out loud or not. 

“Inevitably, one of these things has to give,” Phillips said. “If the goal of the practice is to remain independent for the foreseeable future, the ownership model you choose is going to be your capital strategy. It ultimately determines whether or not your independence is sustainable.” 

If the practice wants younger physicians to commit, the offer has to feel investable. In practical terms, that means spelling out the associate period, explaining whether buy-in is fixed, formula-based, or market-based, showing how financing works, and putting reserve policies and profit-distribution logic in writing.  

Phased buy-ins, earn-ins, and staggered buyouts can all soften entry risk without pretending the risk disappears. Groups also have more structural flexibility than many assume — LLC and MSO structures can accommodate different physician risk and reward profiles, different entry points, and even separate investment vehicles for core medical operations versus ancillary businesses. 

The point is not to make ownership look risk-free. The point is to show that the practice has thought carefully about when risk is taken, how returns are earned, and why the model is fair to both current and future partners. 

Phillips also stressed the importance of separating fair-market-value compensation for clinical work from the return on ownership itself, so candidates can see what they are earning as physicians and what they are earning as investors in the enterprise. A group that overpays physicians as compensation may be quietly eliminating its equity returns; a group that underpays may be distributing returns that do not actually exist. 

Read the signals 

Osseck said the most effective interview questions are the ones that test how a candidate is thinking — not just what they say they want. 

“If someone is exclusively focused on base salary with no curiosity about ownership, that’s a signal,” she said. “If a physician resists the idea of an associate period — not the timeline, but the concept itself — that’s worth exploring further. If every question is framed against employed medicine, but they can’t articulate why ownership appeals to them, that’s a signal too.” 

She cautioned against treating those signals as automatic disqualifiers. “None of these should end the conversation — they should start it,” Osseck said. “The best interviews don’t just evaluate. You’re not just assessing fit — you’re helping the candidate understand what this really is and whether it aligns with what they want.” 

Build a written candidate FAQ that answers the five core questions directly — Osseck recommended approaching this as an exercise with the practice’s most recent partner to recall what they wish they had more clarity on during their own recruitment. And pay attention to the handoff from recruiting to onboarding — MGMA’s physician onboarding guidance underscores that retention starts before the physician sees the first clinic schedule. If the promises made during recruitment are not reflected in the first 90 days, even a strong hire can begin to question whether any of it was real. 

The real question candidates are asking 

A signing bonus may get attention, and a repayment clause may protect against a quick exit, but neither one answers the harder question a serious candidate is asking: Why should I build here instead of somewhere else? 

The practices recruiting well right now are not necessarily the ones offering the richest headline number. They are the ones presenting a credible future — explaining autonomy without romanticizing chaos and explaining partnership without hiding the math. They can show that the practice is built not only to survive current pressures, but to give the next physician a real stake in what comes next. 

“Independent practice is a choice — a strategic choice,” Phillips said. “It’s not a default. It’s not a fallback. It’s a choice to build something, to own your decisions, to practice medicine on your own terms.” 

“The practices winning right now are not winning on compensation alone,” Osseck said. “Compensation is table stakes. They’re winning on clarity, culture, and a credible future. Your partnership model, if it’s well designed and well communicated, is how you tell that story.”