Physicians are earning more, particularly specialists. But they're also working harder, according to a new survey.
The median compensation of primary care physicians increased 2.5% in 1998 to $139,244. That compares with a 0.42% increase in 1997. Specialists, meanwhile, saw their compensation rise 5.2%, up to $231,993, compared with a 0.48% decrease in 1997, according to the 1999 Physician Compensation and Production Survey. The survey, by the Englewood, Colo.-based Medical Group Management Association and St. Louis-based Cjeka and Co., is based on data supplied by 1,609 group
Dermatologists and hematologist/oncologists saw the biggest increases in compensation, up 9.23% to $193,215 and 8.95% to $212,516, respectively. Pediatricians saw the biggest increase among primary care providers, up 2.43% to $135,000.
Emergency medicine physicians, on the other hand, were the big losers: In 1998, the median compensation of emergency medicine physicians dropped 0.6% to $176,217.
Susan Cjeka, president of Cjeka and Co., says the numbers are evidence of a "re-emergence" of specialists.
"We spent the last five years focusing on primary care and predicting the demise of specialists, and it didn't happen," she says.
Supporting Cjeka's claim is another new study by the physician recruitment firm Merritt, Hawkins and Associates. According to their survey of 300 primary care residents, only 6% received 100 or more job solicitations, compared with 10% in 1997 and 17% in 1995.
The growth in specialist compensation is due partly to increased demands by patients for more direct access to specialists and partly to improved technology, she says. Noninvasive cardiologists, for example, whose compensation increased 7.29% to $278,900, are using more advanced technology than in the past and so have gotten "a lot of big ticket items under their belt," she says.
Mike Burchardt, CEO of the 23-physician Nebraska Heart Institute in Lincoln, Neb., confirms that his group and other single-specialty groups are starting to offer more services in their offices, increasing both revenues and efficiency.
"What I have seen nationwide is a real aggressiveness on the part of cardiac groups to obtain the capability, or develop the capability, to provide services in their offices. Things such as nuclear medicine, echo cardiography and cardiac cath labs," he says. "That has created a lot more available revenue and made them a lot more efficient because they're not having to run back and forth to the hospital."
Although their compensation is up, physicians, for the most part, are working for their money. Production, as measured by increases in gross charges and several other factors, is up in nearly every specialty. Primary care gross charges increased 4.67% to $335,890. Specialists' gross charges rose 6.51% to $724,275. Otorhinolaryngologists saw the biggest jump in gross charges, up 17.87% to $907,934. Many otorhinolaryngologists, like cardiologists, are building freestanding clinics and performing more procedures on an outpatient basis, Burchardt says.
Laurie Foote, a consultant with Healthcare Management in West Springfield, Mass., and chair of MGMA's survey advisory committee, says the practice setting of the future will not be massive multispecialty groups but rather single specialty groups. "We're seeing more and more single specialty groups, which tend to be much more profitable and more efficient," she says.
For example, allergists in a multispecialty group earn $177,862, while their counterparts in a single-specialty group earn $277,791, according to the survey.
Similarly, neonatologists in a multispecialty group earn $167,167, while their single specialty peers earn $372,662.