Spe­cial fea­ture : Physi­cians' earn­ing power mak­ing a come­back

An­nual com­pen­sa­tion sur­vey shows who gained the most and who lost ground

Modern Healthcare - - Front Page -

One statis­tic that could be per­ceived as good news in Mod

ern Health­care’s 2010 Physi­cian Com­pen­sa­tion Sur­vey is that among the 23 spe­cial­ties tracked, there was a 260% in­crease in spe­cial­ties that saw av­er­age pay in­creases above the rate of in­fla­tion com­pared with 2009. But since the rate of in­fla­tion was only 1.5%, that statis­tic might not be much for doc­tors to brag about.

Eigh­teen of the 23 spe­cial­ties tracked in the sur­vey, our 18th an­nual, saw in­creases above the Bu­reau of La­bor Sta­tis­tics’ 2010 Con­sumer Price In­dex, three had pay in­creases be­low the CPI (non­in­va­sive car­di­ol­ogy, der­ma­tol­ogy and pe­di­atrics), and two saw de­creases (hos­pi­tal­ists and pathol­o­gists).

By com­par­i­son, only five spe­cial­ties had av­er­age in­creases above the 2.7% rate of in­fla­tion in 2009; while eight spe­cial­ties saw their com­pen­sa­tion fall. In 2008, 11 spe­cial­ties saw av­er­age com­pen­sa­tion in­creases be­low the year’s 3.8% in­fla­tion rate, while three spe­cial­ties saw de­creases. This year’s sur­vey was also the third in a row in which no spe­cialty saw a dou­ble-digit in­crease in pay, com­pared with one for 2008 and three for 2007.

Other con­tin­u­ing trends: It’s the third con­sec­u­tive year that or­tho­pe­dic sur­geons (av­er­age com­pen­sa­tion of $497,776) and in­va­sive car­di­ol­o­gists ($467,808) fin­ished first and sec­ond in the sur­vey, and pe­di­a­tri­cians ($191,455) and fam­ily physi­cians ($190,396) fin­ished sec­ond to last and last, re­spec­tively. There was a chance for an­other “three-peat,” but that didn’t oc­cur as the der­ma­tol­o­gists’ streak of hav­ing the high­est per­cent­age pay in­creases stopped at two years in a row—and it stopped hard.

Af­ter reg­is­ter­ing av­er­age in­creases of 5.3% in 2009 and 6.7% in 2008 to top the sur­vey for per­cent­age in­creases for both years, der­ma­tol­o­gists saw only a 0.9% in­crease in av­er­age com­pen­sa­tion for 2010 (to $372,924 from $369,648). The per­cent­age in­crease champs for 2010 are the ra­di­a­tion on­col­o­gists, whose av­er­age com­pen­sa­tion in­creased 6.4% (to $443,312 from $416,637).

Gen­eral sur­geons were next, reg­is­ter­ing a 5.9% in­crease (to $350,141 from $330,658); and close be­hind were plas­tic sur­geons, whose pay in­creased 5.8% (to $393,570 from $372,130).

The econ­omy, health­care re­form and gen­eral in­dus­try trends had an un­usual ef­fect on physi­cian pay, says Travis Singleton, se­nior vice pres­i­dent with the Irv­ing, Texas-based re­cruit­ment firm Mer­ritt, Hawkins & As­so­ciates, a peren­nial par­tic­i­pant in the Mod­ern

Health­care sur­vey. “I nick­named the last year as ‘The Year of In­te­gra­tion and Align­ment,’ ” Singleton says, ex­plain­ing that ac­qui­si­tion of prac­tices took the place of tra­di­tional physi­cian re­cruit­ment in 2010. He adds, how­ever, that the driver be­hind the physi­cian em­ploy­ment has more to do with seek­ing eco­nomic se­cu­rity than any­thing con­nected to the Pa­tient Pro­tec­tion and Affordable Care Act—for now, at least.

“It’s prob­a­bly in­creas­ing peo­ple’s de­mand to be em­ployed, but it didn’t drive it,” Singleton says. “This em­ploy­ment boom is not a re­sponse to re­form—not yet any­way.”

The em­ploy­ment trend is hav­ing a par­tic­u­larly in­ter­est­ing im­pact on car­di­ol­ogy, says Dr. Therus Kolff, a strate­gic ad­viser for CHG Health­care Ser­vices, a Salt Lake City-based staffing firm. He thinks the days of av­er­age com­pen­sa­tion de­clines (a drop of 0.86% in 2009) and be­low-in­fla­tion in­creases (0.8% in 2010) for non­in­va­sive car­di­ol­ogy will not last.

“An in­va­sive car­di­ol­o­gist gen­er­ates so much rev­enue for a hos­pi­tal,” Kolff says, adding that this adds to the non­in­va­sive car­di­ol­o­gists’ value. “The non­in­va­sive car­di­ol­o­gists are still in de­mand be­cause they want to keep the in­va­sive guys in the (catheter­i­za­tion) lab. You want to have the non­in­va­sive car­di­ol­o­gists see­ing pa­tients in the clinic, to keep the in­va­sive guys—or gals—in the lab.”

Pe­di­atrics was an­other spe­cialty with a be­low-in­fla­tion in­crease in 2010. Their av­er­age com­pen­sa­tion rose only 1% to $191,455 from $189,526. This was af­ter reg­is­ter­ing a 4.5% in­crease the pre­vi­ous year.

They still man­aged to stay a rung above fam­ily physi­cians in terms of pay. Al­though av­er­age com­pen­sa­tion for fam­ily docs rose 3.3% to $190,396 from $184,226, that was still the low­est av­er­age salary in the sur­vey. An­other pri­mary-care spe­cialty, in­ter­nal medicine, saw its av­er­age com­pen­sa­tion grow 2.6% to $207,520 from $202,327.

“I was sur­prised by that,” Kolff says. “I was think­ing there’d be a big­ger in­crease in those pri­mary-care spe­cial­ties.”

Kolff adds that he was also sur­prised by the 3.9% in­crease for emer­gency medicine to $277,144 from $266,815. He was ex­pect­ing some­thing larger.

Singleton and Kolff say they be­lieve there is a doc­tor short­age, and younger physi­cians are adding a new wrin­kle in that they do not want to work as many hours as their pre­de­ces­sors did.

“The bot­tom line is that physi­cians all want a bet­ter life­style,” Kolff says.

The re­sult of this, ac­cord­ing to Singleton, is greater competition for physi­cians. If an in­sti­tu­tion or prac­tice can­not of­fer more in terms of salary, he says they are be­com­ing in­creas­ingly will­ing to con­trib­ute to re­lo­ca­tion costs, on-call pay or stu­dent loan debt re­lief.

“Ev­ery­one is re­cruit­ing, ev­ery­one is com­pet­ing,” he says.

AMER­I­CAN SO­CI­ETY FOR RA­DI­A­TION ON­COL­OGY

Ra­di­a­tion on­col­o­gists saw the largest in­crease— 6.4%—in av­er­age com­pen­sa­tion for 2010.

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