For some specialties, compensation can be linked to supply and demand, but for othersparticularly emergency medicinethis years figures have more-complex explanations. Although the Centers for Disease Control and Prevention released figures last month showing that there were 5 million more emergency-room visits in 2005 than 2004 and total visits reached an all-time high of 115 million, average ER physician compensation increased only 6.25%less than half the increase registered for oncologists.
There is an ER crunch, says Travis Singleton, vice president of marketing with Irving, Texas-based recruiter Merritt, Hawkins & Associates, one of the groups participating in the survey. But just because numbers have risen less than expected doesnt mean there is less of a demand. With ER physicians, I think weve hit a plateau and groups are doing other things to be attractive.
According to the survey, compensation for emergency physicians ranges $272,500 to $207,600. Singleton says salaries have just about reached the threshold that most emergency-medicine groups can afford to offer, so they are offering a shorter workday instead. Where 12-hour shifts were once the norm, he says todays emergency doctor may only have to fill an eight- to 10-hour slot and work during the busiest trauma times only once or twice a month.
The buzzwords for the new physician are quality of life, he says. An ER physician coming out of training can get a job anywhere and be paid something thatby some peoplewould be considered too much.
Singleton also says some rural hospitals now fill emergency positions with family physicians, internists and general surgeons who choose to work in a rural ER because of the quality-of-life benefits provided by shift work.
Gabe Heckt, vice president of the Irving, Texas-based healthcare staffing firm Martin, Fletcher, says that the aging population is affecting the demand and compensation for the specialties that see older patients. Beyond that, another major trend is the rise in employed physicians, which he says is related to quality-of-life issues. He adds that his firm recently placed some general surgeons who walked away from private practices where they were making between $285,000 and $300,000 for salaried positions where they will make between $210,000 and $230,000.
For psychiatrists and urologists, Singleton says compensation increases are more of a straightforward result of supply and demand, while double-digit growth in oncologists compensation and high salaries for orthopedic surgeons are often the result of hospital or medical group marketing strategies.
At 13.9%, oncologists saw the biggest increase in average compensation to $336,676 in 2007. Advances in oncology have led to oncologists salaries advancing past the $300,000 mark, Singleton says.
Similarly, Singleton says, a good orthopedic surgeon is worth their weight in gold, but there is only so much gold available. Groups have hit their limit of what they can offer, and we tell people it can be a very lengthy search for groups or hospitals seeking to hire orthopedic surgeons, he says. Still, orthos registered the fifth-highest compensation increase in the survey. Their average compensation rose about 9.5% to $438,561 in 2007 from $400,579 in 2006. In 2007, their compensation ranges were from $481,221 to $359,000.
Psychiatrists have the third-biggest gain in compensation. Their average compensation rose about 10.9% to $208,108 in 2007 from $187,606 in 2006. The range for this years survey is $288,490 to $177,334.
Ultimately, however, Singleton predicts that the biggest percentage increases in the near future will go to internists (whose average compensation is $185,140 in this years survey) and family physicians (with average compensation of $170,212), with one factor being that offering a $10,000-to-$15,000 raise is more attractive to someone making $180,000 than it is to someone making $450,000. As with other specialties, another key factor will be demand. I think its going to remind people of the primary-care age of the 90s, he says.
Since recruiting new physicians is getting tougher, Singleton offers these important pieces of advice: Make the physicians you have happy, so they dont leave, and understand how quality-of-life issues affect physicians employment decisions.