Registered nurses in US physician offices earned a mean of $83,110 in May 2023, about 14% less than the $96,830 paid in general hospitals, according to the Bureau of Labor Statistics (BLS).¹ Hospitals still struggle to keep their nurses. A national HRSA nursing survey put the share of hospital RNs who had considered leaving their position at 65.4%, compared with 52.7% in outpatient and ambulatory settings.²
For a private practice, the retention numbers carry more weight than the pay gap. Few practices can match a hospital salary dollar for dollar. What a small office does control is workload, scheduling and the quality of supervision, which are the same conditions researchers tie to burnout.³ A practice that builds its hiring process around those strengths, from the wording of the job ad to the questions in the final interview, stops competing on the hospital’s terms.
One Practice Hire Often Covers Two Jobs
Practices and hospitals draw on different workforces. In BLS data, medical assistants made up 15.15% of employees in US physician offices in May 2023 and just 2.03% in general hospitals,⁴ while registered nurses accounted for 7.74% and 30.61%, respectively.¹
The official medical assistant task list on O*NET OnLine shows how far one practice role can stretch:
- Taking vital signs and medical histories
- Sterilizing instruments
- Collecting specimens
- Greeting and logging in patients
A hospital would normally divide that work between clinical and registration staff. Before lunch, a single practice employee may cover the whole list. Screening therefore needs to test clinical competence and front desk skills together, since a strong candidate for one half of the job can be a poor fit for the other.
The Practice Manager Usually Runs Recruiting
US general hospitals employed 21,400 human resources specialists, 5,150 HR managers and 13,360 training and development specialists in May 2023, BLS industry estimates show.
Practices rarely have that bench. The American Medical Association reports that 47.4% of US physicians worked in practices with 10 or fewer physicians in 2024, and 28.8% were in practices with fewer than five.⁵ Hiring in offices that size usually lands on the practice manager, a role whose BLS job description covers recruiting, training and supervising staff, plus ordering supplies in smaller settings.⁶
Some owners bring in medical practice recruitment services for the early stages, so the manager spends interview time only on candidates who already meet the criteria.
Hospitals Can Outbid Practices on Pay and Benefits
Wage data from BLS shows hospitals paying more than physician offices in every role below, and the nursing gap mentioned earlier is not the widest.
| Role (Measure, Year) | Hospitals | Physician Offices | Practice Pay Gap |
|---|---|---|---|
| Medical and health services managers (median, 2025)⁶ | $133,580 | $105,770 | 20.8% lower |
| Medical secretaries and administrative assistants (mean, 2023) | $44,840 | $41,440 | 7.6% lower |
| Medical assistants (median, 2025) | $46,910 | $45,520 | 3.0% lower |
| Licensed practical nurses (median, 2025) | $61,160 | $59,520 | 2.7% lower |
Benefits widen the distance. In March 2026, 55% of employees at US establishments with 1 to 49 workers had access to medical care benefits, versus 90% at establishments with 500 or more.⁷ Life insurance shows an even bigger split, with access at 40% for small establishments and 86% for large ones.
When a practice cannot close that difference with money, its offer has to win on something else.
Where Practices Have the Upper Hand
Outpatient nurses are the more satisfied group. The same HRSA survey found 88.6% of outpatient and ambulatory RNs were satisfied with their jobs in 2021, against 77.2% of hospital RNs.² Hospital nurses were also far more likely to name burnout as a reason for leaving a position, by 54.2% to 31.4%.²
Several factors behind burnout sit within a practice owner’s direct control. A CDC study of US health workers linked lower odds of burnout to helpful supervisors (odds ratio 0.26), trust in management (0.40) and having enough time to finish the work (0.33).³
Job ads and interviews should spell out those factors: patients seen per day, the time the office closes, and who covers when someone calls in sick. Vague promises about a supportive culture will not persuade a nurse who earns more at the hospital.
Compliance Checks Without a Credentialing Team
Most hiring checks apply in both settings, though hospitals have credentialing staff to manage them. The person who wrote the job ad at a practice often tracks these requirements too:
- Exclusion screening (US): physicians are responsible for not employing anyone on the HHS Office of Inspector General exclusion list, and federal rules set the 2025 maximum penalty at $25,595 per item or service.
- Bloodborne pathogens training (US): OSHA requires it at assignment and at least once a year for staff with exposure risk.
- Nurse registration (Ontario): the College of Nurses of Ontario keeps a Find a Nurse profile for every nurse in the province, so employers can confirm status before an offer.
One federal mandate applies to hospitals alone. They must query the National Practitioner Data Bank when appointing practitioners and every two years after,⁸ while group practices may use it only if they run a formal peer review process.
Final Thoughts
Private practices hire for broader roles, with fewer people running the process and less money to offer. Salary and benefits favour hospitals. Practices hold the advantage on workload and supervision, which is where hospital nurses report the most strain. A process that leads with those strengths, tests for clinical and front desk skills at once, and keeps compliance checks on a calendar gives a small office a fair fight.
How We Can Help
We work with private practices that need to hire without pulling the practice manager away from patients. Our recruitment services include job ads written like marketing copy, AI screening of every applicant against strict criteria, automatic text and email invitations to screening interviews, and screening calls run by human recruiters or AI avatar recruiters, depending on your budget.
To fill your next practice role with screened, qualified candidates, visit us and request a quote today.
References
- “Registered Nurses, May 2023.” Occupational Employment and Wage Statistics, U.S. Bureau of Labor Statistics, www.bls.gov/oes/2023/may/oes291141.htm. Accessed 13 Oct. 2026.
- Job Satisfaction Among Registered Nurses. Health Resources and Services Administration, Mar. 2024, bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nssrn-job-satisfaction-report.pdf. Accessed 13 Oct. 2026.
- Nigam, Jeannie A. S., et al. “Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health: Quality of Worklife Survey, United States, 2018-2022.” Morbidity and Mortality Weekly Report, vol. 72, no. 44, 3 Nov. 2023, pp. 1197-205, www.cdc.gov/mmwr/volumes/72/wr/mm7244e1.htm. Accessed 13 Oct. 2026.
- “Medical Assistants, May 2023.” Occupational Employment and Wage Statistics, U.S. Bureau of Labor Statistics, www.bls.gov/oes/2023/may/oes319092.htm. Accessed 13 Oct. 2026.
- Kane, Carol K. Physician Practice Characteristics in 2024: Private Practices Account for Less Than Half of Physicians in Most Specialties. American Medical Association, May 2025, www.ama-assn.org/system/files/2024-prp-pp-characteristics.pdf. Accessed 13 Oct. 2026.
- “Medical and Health Services Managers.” Occupational Outlook Handbook, U.S. Bureau of Labor Statistics, 2026, www.bls.gov/ooh/management/medical-and-health-services-managers.htm. Accessed 13 Oct. 2026.
- “Employee Benefits in the United States, March 2026: Table 2.” Economic News Release, U.S. Bureau of Labor Statistics, Sept. 2026, www.bls.gov/news.release/ebs2.t02.htm. Accessed 13 Oct. 2026.
- “Hospitals.” National Practitioner Data Bank, Health Resources and Services Administration, www.npdb.hrsa.gov/orgs/hospitals.jsp. Accessed 13 Oct. 2026.
