Coffee & Contracts - Advertised signing bonuses

Physician signing bonuses currently average $47,993 across 430,000 healthcare jobs, though this figure may be inflated by the inclusion of broader "signing incentives" like relocation and student loan repayment. While approximately 70% of physician contracts include such bonuses, significant discrepancies exist between advertised averages and the reality of private practice or small-group budgets, where offers can range from $1,500 to $250,000. Critical contractual distinctions between "signing" and "commencement" bonuses dictate whether funds are issued upon execution or after starting work, impacting tax withholding and 401k deductions. Furthermore, repayment "clawback" provisions often require physicians to remain employed for one to three years to avoid returning the bonus. Given the current supply-demand mismatch in healthcare, physicians possess significant negotiating capital to secure these upfront payments, provided they account for amortization schedules and forgiveness clauses related to disability or termination.