Median compensation for primary care physicians increased by 2.8% in 2002 and specialist pay gained 4.3%, but some high-risk specialists saw declines in income last year despite higher rates of productivity, a new study says.
According to the Medical Group Management Association, Englewood, Colo., compensation for cardiologists fell in 2002 for the first time in several years. Invasive cardiologists took a 6.17% hit last year, while noninvasive cardiology specialists had a median income decline of 3.9%, the report says.
The MGMA announced partial results of the annual physician compensation and productivity survey today, in advance of the release of a comprehensive report later this month.
Median pay dipped by 0.8% for general surgeons, 2.64% for pulmonologists and 3% for urologists last year, while other specialties barely kept up with the rate of inflation, according to the MGMA.
The news is especially painful in urology because productivity actually increased by 6.29% in terms of relative value units, the MGMA reports. Income for gastroenterologists moved up by a relatively anemic 2.87%, even though work RVUs jumped by 11.7%.
"I'm not surprised," says Megan Cohen, associate executive director for health policy and research at the Baltimore-based American Urological Association.
"Urology, as well as cardiology, are specialties that treat a lot of older patients, many of whom are on Medicare," Cohen says. Medicare reimbursements declined by 5.4% between 2001 and 2002 and Medicare covers around half of the patient population in a typical urology practice, according to Cohen.
Cohen also says that higher malpractice insurance premiums and costs associated with HIPAA compliance took a financial toll on urologists last year. "There is a lot of cost involved," she says.
The urologists' experience is in line with that of other specialties, MGMA President and CEO William Jessee, M.D., says.
"The most important factors involving physician compensation are the increasing cost of practice operations, especially in labor, drugs and supplies and malpractice insurance, coupled with cutbacks in both commercial and government reimbursement," Jessee says.
In an MGMA statement, Jessee says that the trend of higher costs and lower reimbursements is likely to continue in 2003 and 2004.
The MGMA findings differ somewhat from numbers reported this week by another organization representing group practices, the American Medical Group Association.
According to the Alexandria ,Va.-based AMGA, primary care physicians generally suffered declines in compensation last year, while gastroenterologists, otolaryngologists and radiologists saw the largest pay increases.