For America's doctors, it's pretty much the status quo for salaries. Continuing a trend that has spanned the past several years, physicians are working longer and harder to maintain mostly modest annual salary increases that do little more than match the rate of inflation. But as usual, the rich keep getting richer-specialists continue to bring home the biggest bucks-while the internists and other generalists are left to play catch-up.
Noninvasive cardiologists, for instance, are averaging about $344,400 this year, an 8% increase from 2004 and one of the steepest annual increases of any of the 15 categories surveyed nationwide. General surgeons were averaging about $281,000 as they enjoyed a 5% across-the-board pay increase, according to Modern Healthcare's annual compendium of doctors' salaries. Meanwhile, pediatricians ranked as the lowest paid in the survey, taking home an average of about $158,900, or a 4% raise from the previous year.
"In terms of physician compensation, just about everything is going up," says Michael Broxterman, chief operating officer of physician recruiter Pinnacle Health Group and immediate past president of the National Association of Physician Recruiters. "Certain specialties, including urologists, cardiologists and neurosurgeons, are especially in demand. In general, salaries are increasing but at a slightly slower rate."
Even the salaries for such supposedly hot specialists as neurologists and obstetrician-gynecologists were flat this year. Neurologists edged up 2% this year for an average salary of about $214,000, according to survey respondents, while salaries for OB/GYNs averaged about $255,000, also an increase of 2%.
"Doctors remain under a lot of pressure, salarywise," Broxterman says. "Reimbursements have been stagnant or have decreased. But doctors still earn in the top 1% of (all professions in) the country. They obviously get a lot of press about decreasing salaries, but they're doing OK."
Now in its 12th year, Modern Healthcare's Physician Compensation Survey tracks the average total compensation by specialty as reported by various independent organizations, including trade groups such as the Medical Group Management Association and the American Medical Group Association and physician-recruitment firms such as Delta Medical Consulting. This year's results are based on surveys by 16 firms, up from 13 in last year's report.
The MGMA, whose 19,500 members work in organizations that employ more than 240,000 physicians, found that specialists' salaries were either flat or slightly higher than last year, while generalists are still struggling to keep pace.
"It seems that compensation is beginning to stabilize," says Dan Stech, director of survey operations at the MGMA. "I'm looking at leading specialties and not seeing a lot of movement in average salaries. In primary care, there are some increases, but we're seeing increases a little bit less than what the specialists are getting. Still, it's consistent with what we've seen over the last three years or so."
Average salaries for anesthesiologists fell 1% in the MGMA's survey to an average of about $338,700. Noninvasive cardiologists registered a 3% increase to about $373,700, and salaries for OB/GYNs increased about 4%, to approximately $272,400. One of the biggest changes in the MGMA survey was for neurologists, whose compensation rose 9%, to about $239,500.
As usual, based on overall survey findings, family practitioners and internists-the profession's generalists-remained at the low end of the salary survey with raises to match. Family practitioners averaged about $162,200, an increase of 3% from 2004, eclipsing the average increase for OB/GYNs by a slight margin; internists were paid an average of about $170,600, or about 2% higher than the previous year.
Salaries for generalists edged up slightly over past years and matched or exceeded the average increases for some specialists, according to the Hospital & Healthcare Compensation Service. Rosanne Cioffe, a spokeswoman for the firm, says the average increase cited by participants in her survey for all physicians was about 4.7%-or nearly 2 percentage points higher than expected. Physicians have generally received about a 3% increase in recent years, she says.
"Primary care went up, but some of the specialists did not go up significantly," she says. "What we did see was a big increase in emergency medicine, which we attribute to the increase in ER use due to a lack of health insurance."
Indeed, salaries in emergency medicine averaged a 6% increase, with compensation ranging from a low of about $188,000 to a high of about $257,000. The emergency room doctors were among the big winners in this year's salary survey, along with cardiologists and hospitalists, whose average salary increase of 11% was the highest of any of the 15 specialties in this year's survey. No specialties saw an across-the-board drop in average compensation.
Still, this year's figures were varied. Compensation for oncologists, for instance, ranged from a low of about $223,000 to a high of about $372,500. The list of salaries for radiologists, meanwhile, ranged from about $209,400 to almost $421,000. Pinnacle's survey showed a 10% decrease in salary for this specialty, while the HayGroup's survey reported a 21% increase. Urologists seesawed from about $261,000 to slightly more than $428,000, with one survey firm reporting a 21% increase and another finding a 26% decrease for the specialty.
The significant variances in some of the salary figures are attributable to several factors, including differing methodologies and the sizes of the samples used by these organizations. In addition, some firms track different pools of physicians from year to year, another reason for the sometimes dramatic percentage changes in compensation.