Permanent placement is the core of MedicalRecruiting.com's business — full-time, long-term employment across the entire healthcare workforce. We place physicians, nurse practitioners, physician assistants, registered nurses, certified registered nurse anesthetists (CRNAs), physical therapists, occupational therapists, speech-language pathologists, licensed professional counselors (LPCs) and licensed clinical social workers (LCSWs), pharmacists, healthcare administrators, C-suite executives (CEO, CMO, CNO, CFO, COO, CHRO, CIO), service-line directors, nurse leaders, practice managers, business development and provider-relations leaders, revenue cycle and coding specialists, and clinical research professionals — into hospital systems, multi-specialty groups, single-specialty practices, FQHCs, behavioral health platforms, ambulatory surgery centers, urgent care chains, post-acute and SNF operators, home health and hospice agencies, academic medical centers, and digital health and payer organizations. Permanent placement is a fundamentally different process from locum or contract coverage: candidate motivation is long-term career fit rather than short-term coverage flexibility, employer commitment includes benefits, partnership or equity participation where applicable, and full liability coverage; and the recruitment process involves structured interviewing, contract negotiation, credentialing, and onboarding that together span 30 to 180 days from search kickoff to first day of work, depending on role.
<strong>Physicians (MD/DO)</strong> across every primary-care, hospital-based, medical, and surgical subspecialty — from hospitalist, family medicine, internal medicine, EM, and pediatrics to interventional cardiology, neurosurgery, MFM, REI, and every fellowship-trained subspecialty. <strong>Nurse practitioners (NP)</strong> in family, adult-gerontology (AGNP, AGACNP), psychiatric-mental health (PMHNP), pediatric, neonatal (NNP), women's health (WHNP), and acute care across hospital, clinic, telehealth, and SNF settings. <strong>Physician assistants (PA)</strong> in primary care, surgical first-assist, EM, hospital medicine, orthopedics, dermatology, and procedural subspecialties. <strong>Certified registered nurse anesthetists (CRNAs)</strong> for hospitals, ASCs, and anesthesia groups under both employed and 1099 models.
<strong>Registered nurses (RN)</strong> across med-surg, telemetry, ICU, ER, OR, L&D, mother-baby, NICU, PICU, oncology, cath lab, dialysis, case management, ambulatory and clinic nursing, school health, and home health. <strong>Licensed practical nurses (LPN)</strong> and <strong>certified medical assistants (CMA/MA)</strong> for clinic, primary-care, and SNF settings. <strong>Pharmacists (PharmD)</strong> — retail, hospital, clinical, ambulatory, and specialty/infusion. <strong>Physical therapists (PT, DPT)</strong>, <strong>occupational therapists (OT)</strong>, and <strong>speech-language pathologists (SLP)</strong> across acute care, IRF, SNF, outpatient ortho, pediatrics, home health, and school-based settings. <strong>Behavioral and mental health clinicians</strong> — licensed professional counselors (LPC, LMHC, LPCC), licensed clinical social workers (LCSW), licensed marriage and family therapists (LMFT), behavior analysts (BCBA), and psychologists (PhD/PsyD).
<strong>Healthcare administration and leadership</strong> — practice administrators, clinic managers, hospital department directors, service-line directors (cardiology, oncology, women's health, surgery), nurse managers and directors, chief nursing officers (CNO), chief medical officers (CMO), chief executive officers (CEO), chief operating officers (COO), chief financial officers (CFO), chief information and digital officers (CIO/CDO), chief human resources officers (CHRO), chief quality and patient-safety officers, vice presidents of medical affairs, medical directors, and regional/divisional executives for multi-site operators. <strong>Business development, growth, and provider relations</strong> — VPs and directors of business development, payer-contracting and managed-care leaders, physician-liaison and provider-relations managers, network-development executives, M&A integration leaders, and partnership/strategic-alliance roles for digital health, payer, and platform organizations. <strong>Revenue cycle, coding, and informatics</strong> — RCM directors, coding managers (CPC/CCS), clinical-informatics leaders, EMR analysts and managers (Epic, Cerner/Oracle, Meditech), and population-health analytics leaders. <strong>Clinical research and quality</strong> — clinical research coordinators, principal investigators, quality and accreditation leaders, and infection-prevention/employee-health managers.
Permanent placement, across clinician and non-clinician roles alike, refers to a full-time long-term employment relationship — typically W-2 employee status with the hiring entity, with full benefits (health, dental, vision, disability, life), retirement plan participation (typically 401(k) or 403(b) with employer match, plus access to a defined contribution plan or cash balance plan in larger groups), CME or continuing-education allowance, paid time off, and — for clinical roles — full malpractice coverage. Physicians and senior APPs may also be offered a partnership track (in physician-owned and small-group settings) or a defined leadership pathway (in hospital-employed settings). Executive roles routinely include performance bonus, long-term incentive plans, supplemental retirement (SERP), severance protection, and relocation packages.
The contract structure for permanent placement is typically a 1- to 3-year initial term with automatic renewal, an evergreen renewal, or a multi-year initial term followed by partnership or executive review. Compensation is structured as base salary plus productivity (wRVU-based for physicians, visit- or productivity-based for APPs, or KPI/MBO-based for executives) plus signing bonus, retention bonus, and — in many cases — student loan repayment for clinicians or equity/long-term incentive participation for executives. Non-compete and non-solicitation clauses are nearly universal in clinical and executive contracts, with scope and duration varying significantly by state. Several states have restricted clinician non-compete enforceability, which is a material consideration in geographic flexibility.
Permanent placement is the right model for the substantial majority of healthcare careers. It provides income stability, full benefits, partnership or equity opportunity where available, continuity of patient and team relationships, and the operational simplicity of a single employer relationship. Locum tenens, travel nursing, allied-health travel contracts, and interim-leadership engagements (see /locum-tenens) are the right models for clinicians and executives who specifically value schedule flexibility, geographic exploration, or income optimization over the structural advantages of permanent employment.
MedicalRecruiting.com runs permanent searches under three engagement models — open contingency, exclusive contingency, and retained — and the right model depends on the seniority of the role, the depth of the candidate pool, the geographic difficulty, and the timeline. Open contingency is the dominant model for the substantial majority of permanent physician searches: no upfront fee, multiple firms may run the search in parallel, the recruiting firm earns its fee only when a placed physician accepts and starts. This is the right model for high-volume specialties (hospitalist, primary care, EM, urgent care) and metro-market searches where the candidate pool is well-developed.
Exclusive contingency — sometimes called engaged search — combines single-firm exclusivity for a defined window (typically 60-90 days) with a contingency fee structure (no upfront cost, fee at start, often at a reduced percentage in exchange for the exclusivity). This is the right model for difficult-to-fill roles, structurally complex partnership-track openings, and markets where open contingency has produced fragmentary candidate flow. Retained search carries an upfront engagement fee paid in installments regardless of search outcome and is appropriate for executive-level searches (CMO, Chair, Service Line Director) and severely thin subspecialty markets where structured off-market sourcing is required. For a complete decision framework, see our Retained vs. Contingency Physician Recruiting guide — and request a quote for the specific proposal scoped to your search.
Every permanent placement at MedicalRecruiting.com — regardless of engagement model — carries a 90-day replacement guarantee at no additional cost. If a placed physician departs within 90 days for any reason, the search is re-run at no additional fee. Combined with the zero-upfront-cost structure of contingency engagements, this means employers can engage MedicalRecruiting.com with effectively zero financial risk and evaluate our pipeline head-to-head against any incumbent firm or in-house talent team.
Search timelines vary materially by role family. <strong>Registered nurses, LPNs, allied health (PT/OT/SLP), and behavioral health clinicians (LPC, LCSW, LMFT)</strong> typically close in 30 to 60 days from intake to first day of work, driven by faster credentialing and a deeper national candidate pool. <strong>Nurse practitioners and physician assistants</strong> typically close in 60 to 120 days. <strong>Pharmacists, CRNAs, and high-demand RN subspecialties (cath lab, OR, L&D)</strong> typically close in 60 to 90 days. <strong>Physicians</strong> close in 90 to 180 days, with thin-market subspecialties (interventional cardiology, MFM, REI, child & adolescent psychiatry, neurosurgery) extending to 180 to 300 days. <strong>Healthcare executives (CEO, CMO, CNO, CFO, COO) and service-line directors</strong> typically close in 90 to 180 days under retained search, with confidential sourcing, structured interview committees, and formal succession planning. <strong>Business development, payer-contracting, and provider-relations leaders</strong> typically close in 60 to 120 days.
Every permanent search begins with a structured intake call — typically 60 to 90 minutes with the hiring leader (chief, department director, practice administrator, or board representative for executive searches) and any additional decision-makers involved in the final offer. The intake captures the specific must-haves and nice-to-haves of the role: practice or operating model, productivity or KPI expectations, base and bonus structure, partnership/equity track and timeline, sign-on, relocation, loan assistance, CME or continuing-education budget, liability coverage type (occurrence vs. claims-made and tail responsibility for clinicians; D&O for executives), EMR or technology environment, call coverage or on-call leadership rotation, scope of clinical or operational responsibility, and any visa, J-1 waiver, or relocation considerations. We translate the intake into a written search profile that the principal recruiter works against for the duration of the search.
Within 7 to 21 days of intake, we deliver a curated slate of pre-qualified candidates whose practice interests, geography, family considerations, and compensation expectations match the role. Every candidate has been pre-briefed on the position, has a current CV in hand, and has confirmed availability for an interview. Employer interview slots are never wasted on misaligned introductions — the slate has been screened down to candidates who are mutually interested and credentialing- or onboarding-ready. From slate delivery to first interview is typically 7 to 14 days; from first interview to second-round site visit or panel is typically 14 to 28 days.
Offer negotiation, contract review, credentialing, and onboarding are the longest phases of the cycle. From verbal offer acceptance to first day of work is typically 30 to 120 days, driven primarily by hospital credentialing and state licensing timelines for clinicians, and by reference-check, board-approval, and notice-period timelines for executives. We coordinate with the employer's credentialing or HR department, the candidate's state licensing applications, and the candidate's healthcare or executive-employment attorney during contract review.
From the candidate side, permanent placement through MedicalRecruiting.com is free — there is no fee charged to the clinician, allied-health professional, executive, or other healthcare candidate at any point in the process. The recruiter handling your search is paid by the employer on contingency or retainer, and that fee is not reduced from your compensation. Working with a recruiter does not affect your offer terms; in fact, recruiter-represented candidates routinely receive higher offers than candidates who apply directly, because the recruiter is actively negotiating on your behalf with comparable market data in hand.
What you should expect from a recruiter: a thorough intake conversation about your career goals, geographic preferences, family considerations, and compensation expectations. Targeted presentation of opportunities that fit your priorities — not blast distribution of every open job. Pre-interview briefing on the organization, the search committee members, the known priorities and concerns. Post-interview debriefing and coaching. Active negotiation of the offer terms in collaboration with you. Coordination of credentialing and onboarding logistics. Honest assessment of opportunities, including direct counsel on opportunities that are not the right fit.
What you should not expect from any recruiter: pressure to accept an offer that does not fit, blast distribution of your CV without your explicit permission, opaqueness about the employer or the search committee, or pressure to sign a contract without time for healthcare attorney review. If you experience any of these from a recruiter, switch recruiters. The candidate-recruiter relationship is the foundation of the entire process, and there is no obligation to continue working with a recruiter who is not representing your interests well.
From the employer side, engaging MedicalRecruiting.com begins with a no-cost diagnostic conversation about the search — the role specifics, the geography, the historical recruitment difficulty, and the right engagement model. We do not charge for the intake conversation, and many of the conversations we have with healthcare employers each week are diagnostic-only and result in no engagement. If we agree to engage, we issue a written search agreement covering the engagement model (open contingency, exclusive contingency, or retained), the fee, the replacement guarantee, and the search timeline.
Geography is one of the most consequential variables in permanent search. Coastal and major-metro searches in well-developed candidate markets (Boston, NY metro, DC metro, Atlanta, Chicago, Dallas, Houston, Denver, Seattle, SF Bay Area, LA metro) typically run on open contingency with strong candidate flow. Mid-market and rural searches require deliberate market work — signing bonus, loan repayment, partnership-track structuring, and often spousal employment support to bring candidates to the geography. Frontier and severely-rural searches (frontier counties in MT, WY, ND, SD, AK, rural NM, rural NV) typically require retained or exclusive contingency engagement and 6-9 month search timelines, even in primary care.
We work in all 50 states with no geographic exclusion. Our recruiters maintain candidate pipelines that include physicians actively seeking relocation across regional boundaries — Northeast physicians considering the Mountain West, California physicians considering the South, Midwest physicians considering coastal markets — which dramatically improves the candidate pool for non-coastal employers. For employers in difficult-recruitment geographies, the right strategic question is not just "who is in our local market" but "who in the national candidate pool would consider relocating here, and what would it take?" — and that is the analysis our recruiters run on every search.
MedicalRecruiting.com runs the substantial majority of permanent physician searches on open contingency, billed only when the physician starts in the role. There is no upfront fee, no monthly retainer, no per-search charge, and no fee for candidates presented but not hired. Subspecialty and difficult-market searches sit at the upper end of our range. Volume employers running multiple concurrent searches receive volume pricing. Exclusive contingency is offered at a reduced percentage in exchange for single-firm exclusivity for 60-90 days. Retained search in three installments is reserved for executive-level and severely thin subspecialty searches. Request a quote at /contact for a tailored proposal within one business day.
Every permanent placement carries a 90-day replacement guarantee at no additional cost. If a placed physician departs within 90 days of start for any reason, the search is re-run at no additional fee. Combined with the zero-upfront-cost structure of contingency engagements, this means employers can engage MedicalRecruiting.com with effectively zero financial risk on the initial search and evaluate our pipeline head-to-head against any incumbent firm or in-house talent team.
Typical permanent physician searches close in 90 to 180 days from search kickoff to the placed physician's first day of work. The intake-to-slate-delivery phase is 7 to 21 days; slate-to-first-interview is 7 to 14 days; first-interview-to-second-visit is 14 to 28 days; verbal offer to start is typically 60 to 120 days driven by hospital credentialing and state licensing. High-volume specialties (hospitalist, primary care, EM) close faster; thin-market subspecialties (interventional cardiology in tertiary markets, MFM, REI, child & adolescent psychiatry in rural geographies) routinely take 6 to 9 months.
Yes — under the open contingency model, the employer can engage multiple firms in parallel and pay only the firm whose candidate ultimately starts. This is standard practice and we have no objection to running open contingency searches alongside other firms. Under exclusive contingency, the employer commits to a single firm for a defined window (typically 60-90 days) in exchange for a reduced fee percentage and the firm's full prioritization of the search. Under retained, the employer commits to a single firm for the full search regardless of timeline.
We coordinate closely with the employer's credentialing department and with the candidate's state licensing applications, but we do not perform credentialing ourselves — credentialing is a statutory function of the hospital's medical staff office. We do, however, actively manage the candidate through the credentialing and onboarding process to compress the typical 90- to 120-day timeline where possible. For locum coverage, where credentialing is more time-pressed, we maintain credentialing-ready document files for active locum candidates so deployment is a matter of weeks rather than months — see /locum-tenens for more on locum credentialing operations.