Wednesday, June 22, 2011
Internists getting paid more; hospitalists in demand
Primary care physicians are getting paid more, two surveys agree, while hospital employment is rising.
Internists earned $205,379 in median compensation in 2010, an increase of 4.21% over the previous year, reported the Medical Group Management Association's (MGMA's) Physician Compensation and Production Survey: 2011 Report Based on 2010 Data. Family practitioners (without obstetrics) reported median compensation of $189,402. Pediatric/adolescent medicine physicians earned $192,148 in median compensation, an increase of 0.39% since 2009.
Among specialists, anesthesiologists reported decreased compensation, as did gastroenterologists and radiologists. Psychiatrists, dermatologists, neurologists and general surgeons reported an increase in median compensation since 2009.
(Click "more" below to continue reading.)
Regional data reveals primary and specialty physicians in the South reported the highest earnings at $216,170 and $404,000 respectively. Primary and specialty-care physicians in the Eastern section reported the lowest median compensation at $194,409 and $305,575. This year's report provides data on nearly 60,000 providers.
Recruiting firm Merritt Hawkins reported that general internal medicine was one of its top two most requested searches for the sixth consecutive year. Family physicians were the firm's most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons.
Average compensation for internists rose again this year, from an average of $191,000 in 2009-2010 to $205,000 in 2010-2011, the firm reported.
Primary care physicians have become a particular focus of recruiting efforts because medical students have been avoiding primary care. So, residency programs, particularly in family medicine, fell short of filling their available positions.
The trend toward physician hospital employment continues, though. 56% of Merritt Hawkins' physician search assignments were for hospital jobs, up from 51% the previous year and 23% five years ago. Average compensation for hospitalists rose from an average of $208,000 in 2009-2010 to $217,000 in 2010-2011.
Physicians seek the stability of employment, noted the report, while hospitals are seeking to align with accountable care organizations, bundled payments and other physician-aligned and integrated delivery mechanisms demanded by health care reform legislation. Internist Jonathan Plotsky, MD, a Member of the American College of Physicians, told The Washington Post that he's contemplating such a switch because, "All the rules are changing." Still, he added, he worries about the impact of turning over his patients to others.
Only 2% of recruitment searches by the private firm were for independent, solo practitioners, down from 17% five years ago, the firm noted.
Physician productivity and compensation is still based on volume, despite calls for paying for quality measures or cognitive services. While health care reform promotes reimbursement based on quality of care and cost efficiency metrics, physicians are still compensated on the number of patients they see, the amount of revenue they generate, or the number of Relative Value Units (RVUs) they accrue. More than 90% of recruitment searches in the 2011 Review that featured physician production bonuses reward physicians for fee-for-service volume, while less than 7% reward physicians for meeting quality of cost objectives.
Other findings include:
--Salaries have almost entirely replaced income guarantees. Only 9% of physician search assignments Merritt Hawkins conducted in 2010-2011 featured income guarantees, down from 21% in 2006-2007 and down from 41% in 2003-2004.
--74% of searches in 2010-2011 featured production bonus. 52% were based on RVUs.
--Psychiatry was Merritt Hawkins' fourth most requested search assignment in 2010-2011, up from 10th four years ago, likely due to patient aging, a stagnant economy, two wars, and a limited supply of practitioners.
--Reimbursement cuts and declines in elective procedures have significantly reduced volume of search assignments for certain specialists. Radiologists, cardiologists and anesthesiologists, all among Merritt Hawkins' most requested search assignments four to five years ago, were the firm's 17th, 18th, and 19th most requested assignments in 2010-2011.
--Signing bonuses, relocation and continuing medical education allowances remain standard in most physician recruitment incentives packages, rather than the occasional carrot they were in years past.
--Housing allowances rose to 6% of job offers in 2010-2011, up from less than 1% in previous years, because some physician candidates cannot relocate without them.
The firm's 2011 Review of Physician Recruiting Incentives tracks over 2,660 physician recruiting assignments Merritt Hawkins conducted nationwide from April 1, 2010 to March 31, 2011.
Labels: career choices, health care reform, Patient Protection and Affordable Care Act
posted by Ryan DuBosar at
7:00 AM
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Blog log
Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:
Albert
Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the
University of California, Los Angeles School of Medicine, where he
also did his internal medicine training. Certified by the American
Board of Internal Medicine, Dr. Fuchs spent three years as a
full-time faculty member at UCLA School of Medicine before opening
his private practice in Beverly Hills in 2000.
Zackary
Berger
Zackary Berger, MD, ACP Member, is a primary care
doctor and general internist in the Division of General Internal
Medicine at Johns Hopkins. His research interests include
doctor-patient communication, bioethics, and systematic reviews.
CasesBlog
Ves
Dimov, MD, ACP Member, is an allergist/immunologist and Assistant
Professor of Medicine and Pediatrics at the University of Chicago,
where he evaluates and treats both pediatric and adult patients.
David
Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally
renowned authority on nutrition, weight management, and the
prevention of chronic disease, and an internationally recognized
leader in integrative medicine and patient-centered care.
db's
Medical Rants
Robert M. Centor, MD, FACP,
contributes short essays contemplating medicine and the health care
system.
DrDialogue
Juliet
K. Mavromatis, MD, FACP, provides a conversation about health topics
for patients and health professionals.
Dr.
Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal
medicine for more than a decade and is an Associate Professor of
Medicine at an academic medical center on the East Coast. His time is
split between teaching medical students and residents, and caring for
patients.
Everything
Health
Toni Brayer, MD, FACP, blogs about the rapid
changes in science, medicine, health and healing in the 21st century.
FutureDocs
Vineet
Arora, MD, FACP, is Associate Program Director for the Internal
Medicine Residency and Assistant Dean of Scholarship & Discovery
at the Pritzker School of Medicine for the University of Chicago. Her
education and research focus is on resident duty hours, patient
handoffs, medical professionalism, and quality of hospital care. She
is also an academic hospitalist.
Glass
Hospital
John H. Schumann, MD, FACP, provides
transparency on the workings of medical practice and the complexities
of hospital care, illuminates the emotional and cognitive aspects of
caregiving and decision-making from the perspective of an active
primary care physician, and offers behind-the-scenes portraits of
hospital sanctums and the people who inhabit them.
Gut
Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist
at the University of North Carolina School of Medicine, and the
Program Director for the GI & Hepatology Fellowship Program. He
specializes in diseases of the esophagus, with a strong interest in
the diagnosis and treatment of patients who have difficult-to-manage
esophageal problems such as refractory GERD, heartburn, and chest
pain.
I'm
dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic
hospitalist with an interest in basic and clinical science and
education, with interests in noninvasive monitoring and diagnostic
testing using novel bedside imaging modalities, diagnostic reasoning,
medical informatics, new medical education modalities, pre-code/code
management, palliative care, patient-physician communication, quality
improvement, and quantitative biomedical imaging.
Informatics
Professor
William Hersh, MD, FACP, Professor and Chair,
Department of Medical Informatics & Clinical Epidemiology, Oregon
Health & Science University, posts his thoughts on various topics
related to biomedical and health informatics.
Just
Oncology
Richard Just, MD, ACP Member, has 36 years in
clinical practice of hematology and medical oncology. His blog is a
joint publication with Gregg Masters, MPH.
KevinMD
Kevin
Pho, MD, ACP Member, offers one of the Web's definitive sites for
influential health commentary.
MD
Whistleblower
Michael Kirsch, MD, FACP, addresses
the joys and challenges of medical practice, including controversies
in the doctor-patient relationship, medical ethics and measuring
medical quality. When he's not writing, he's performing
colonoscopies.
Medical
Lessons
Elaine Schattner, MD, ACP Member, shares
her ideas on education, ethics in medicine, health care news and
culture. Her views on medicine are informed by her past experiences
in caring for patients, as a researcher in cancer immunology, and as
a patient who's had breast cancer.
More
Musings
Rob Lamberts, MD, ACP Member, a med-peds and general
practice internist, returns with "volume 2" of his personal
musings about medicine, life, armadillos and Sasquatch at More
Musings (of a Distractible Kind).
Musing
of an Internist
Justin Penn, MD, ACP Associate Member,
attended medical school at the University of Washington School of
Medicine and trained in internal medicine at the University of
Rochester, where he is serving as Chief Resident.
Prescriptions
David
M. Sack, MD, FACP, practices general gastroenterology at a small
community hospital in Connecticut. His blog is a series of musings on
medicine, medical care, the health care system and medical ethics, in
no particular order.
Reflections
of a Grady Doctor
Kimberly Manning, MD, FACP,
reflects on the personal side of being a doctor in a community
hospital in Atlanta.
Technology
in (Medical) Education
Neil Mehta, MBBS, MS, FACP,
is interested in use of technology in education, social media and
networking, practice management and evidence-based medicine tools,
personal information and knowledge management.
White
Coat Underground
Peter A. Lipson, MD, ACP Member, is a
practicing internist and teaching physician in Southeast Michigan.
The blog, which has been around in various forms since 2007, offers
musings on the intersection of science, medicine, and culture.
Other blogs of note:
American
Journal of Medicine
Also known as the Green
Journal, the American Journal of Medicine publishes original clinical
articles of interest to physicians in internal medicine and its
subspecialities, both in academia and community-based practice.
Clinical
Correlations
A collaborative medical blog started
by Neil Shapiro, MD, ACP Member, associate program director at New
York University Medical Center's internal medicine residency program.
Faculty, residents and students contribute case studies, mystery
quizzes, news, commentary and more.
Interact
MD
Michael Benjamin, MD, ACP member, doesn't accept
industry money so he can create an independent, clinician-reviewed
space on the Internet for physicians to report and comment on the
medical news of the day.
PLoS
Blog
The Public Library of Science's open access
materials include a blog.
White
Coat Rants
One of the most popular anonymous blogs
written by an emergency room physician.
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