Why Clinicians are Choosing Sustainability over Salary in 2026

And What This Means for Healthcare Recruiting Leaders

For much of the last decade, healthcare recruiting math has been simple: increase salary, fill the role.

In 2026, that math is breaking down.

Healthcare leaders are discovering that even competitive offers are being rejected. It’s not because the money isn’t enough, it’s because salary is no longer the deciding factor for many clinicians.

This shift is reshaping how recruiting works, how offers are evaluated, and how organizations retain talent once they arrive.

Compensation Still Matters, but It’s No Longer the Differentiator

Clinicians are not walking away from fair pay. But they are increasingly unwilling to trade sustainability for incremental increases.

Across markets and specialties, providers are prioritizing predicable schedules, manageable patient loads, autonomy and transparency.

In many cases, candidates are choosing the role they can stay in, not the one that pays the most.

Burnout Is Still Driving Decisions

Burnout has evolved. Clinicians are recognizing how important a work/life balance is. Many clinicians, especially younger ones, are more protective of their personal time, less willing to “pitch in” when an organization is chronically understaffed, and more skeptical of systems that rely on constant overextension.

This has changed how providers evaluate open opportunities. During interviews, candidates want to know:

• How often does coverage fall short?
• What happens when a colleague leaves unexpectedly?
• How is after-hours work actually handled?

Recruiting teams need to be able to answer these questions, or lose credibility.

The Experience Has Become the Offer

In this environment, recruiting success depends on whether organizations can clearly articulate the lived experience of the role.

It’s important that a recruiter can answer how provider schedules are built and protected, how patient volume is managed, and how leadership responds when there are gaps in coverage.

Many offers can fall apart if the experience can’t be articulated clearly. Or worse, if it sounds like the experience isn’t thoughtful.

For permanent hiring, this alignment is especially critical. Many organizations are rethinking how to place greater emphasis on fit, transparency, and long-term retention, not just putting someone in a seat.

Why Misalignment Is Costlier Than Ever

When clinicians leave roles that didn’t match expectations, the cost is no longer limited to simply backfilling the position. Misalignment can create ripple effects of increased burden on remaining staff, declining morale and trust, and higher recruiting and onboarding costs.

In contrast, organizations that design roles with sustainability in mind are seeing longer staff tenure, higher engagement, stronger referral pipelines and more stable teams.

Sustainability, it turns out, is a retention strategy.

What This Means for Recruiting Strategy in 2026

To compete in today’s market, healthcare leaders are shifting their recruiting approach in three key ways:

1. Designing Roles Before Marketing Them: instead of selling flexibility, organizations are building it into schedules, coverage models, and expectations first.
2. Aligning Recruiting and Operations: recruiting teams are working more closely with clinical leadership to ensure what’s promised matches what’s possible.
3. Creating Optionality Through Workforce Design: many organizations are pairing permanent hiring with scalable support, using models like
Recruitment Process Outsourcing (RPO) to maintain consistency and capacity without overwhelming internal teams.

At Optigy, we see this shift clearly: the organizations that win clinical talent aren’t offering more, they’re offering clarity and sustainability.

Sustainability Is the Signal Clinicians Trust

In 2026, clinicians are no longer betting on promises. They’re choosing environments that demonstrate respect for their time, realistic expectations and leadership accountability.

Recruiting strategies that fail to account for this shift will continue to struggle, regardless of compensation levels.

Those that embrace it will build teams that don’t just accept offers, but stay for the long run.

What’s Next in the Series

In our next post, we’ll examine how organizations are responding to this shift operationally: by reframing locum tenens from a stopgap into a strategic workforce tool.

Check out the first blog in this series that frames out The Top Clinical Recruiting Trends Shaping 2026.