Eight specialties saw slight decreases in their averages in the current survey: Plastic surgery, down 3.3% to $376,849 from $389,727; gastroenterology, down 2.8% to $409,628 from $421,227; intensive medicine, down 1.7% to $257,797 from $262,155; radiation oncology, down 1.7% to $420,661 from $427,865; urology, down 1.4% to $391,406 from $396,778; emergency medicine, down 1.1% to $266,826 from $269,659; invasive cardiology, down 0.9% to $450,016 from $454,253; and noninvasive cardiology, also down 0.9% to $393,181 from $396,597.
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By comparison, in last year's survey, three specialties saw a decrease in average pay: plastic surgery, where the average compensation went down 7.7%; anesthesiology, which fell 1.5%; and radiation oncology, down less than 1%.
“Clearly, there had to be some impact from the economy,” says William Jessee, M.D., president and CEO of the Medical Group Management Association, one of 15 medical associations or search firms participating in the survey. “Actually, I was pleased the numbers were as good as they were given the recession. Certainly, it showed a comeback in the second half of 2009.”
As in last year's survey, orthopedic surgeons topped the compensation list based on total pay. Orthos' compensation ranged from $397,879 to $600,000, and their average compensation rose 1.9% to $485,297 from $476,149.
Once again, too, no specialty saw a double-digit increase in average compensation. Also, for the second consecutive year—with a 5.3% increase—dermatologists saw the highest increase in average compensation, to $371,281. (In last year's survey, dermatologists saw a 6.7% increase.) The specialty's pay ranged from $313,100 to $480,088 in the current survey.
Although pediatricians had the second-highest pay increase—4.5%—they were still second from the bottom based on total pay among the specialties tracked. Pediatrician compensation averaged $193,135 and ranged from $160,111 to $228,750. Only family physicians, whose pay averaged $187,821 and ranged from $175,000 to $220,196, were lower on the list—even with a 2.6% bump in compensation.
Psychiatrists—with an average compensation of $205,934—finished above pediatricians and just behind internists, who saw a 2.2% increase in average pay, to $205,671. Internists' pay ranged from $184,200 to $231,691.
Jessee says that, in total, primary-care physicians saw their pay increase 2.8% in the MGMA survey. He says this indicates that efforts to boost pay for primary-care doctors—which some hope will attract more medical school graduates to choose primary care as a specialty—may be working.
Still, Jessee, a pediatrician, cautions against an overexuberant reaction to this statistic. “Keep in mind the increase is not anything to write home about—2.8% is not a windfall,” he says, adding that it's unknown how factors such as healthcare reform and the trend toward physician employment will affect primary-care compensation.
Psychiatrist compensation always seems somewhat volatile: up 10.9% in 2006; down 5.6% in 2007; up 3.1% in 2008; and now up only 0.8% for 2009 to an average of $205,934, compared with $204,406 last year. Although the pay range was rather small—between $182,724 and $235,101—the range of average increases and decreases among survey participants is huge. The Atlanta-based physician placement firm Pinnacle Health Group reported a 13.2% drop in psychiatrist compensation while Irving, Texas-based Martin, Fletcher reported a 14.4% increase.
For Merritt, Hawkins & Associates, another Irving-based recruiter, a 4.5% increase was reported for psychiatrist compensation, but Travis Singleton, the firm's senior vice president, notes that the company fielded 179 requests for psychiatrists, which is an increase of 47% from the previous year and 121% from three years ago.
“Psychiatry searches were across the board, coast to coast,” Singleton says. “It's not a surprise that demand went up—but it was surprise that it went up so much and so universally.”
He adds that the need for inpatient and adolescent psychiatrists has and will continue to increase, and he also links the demand for psychiatrists to high unemployment rates and the nation being involved in two extended wars. “It's not necessarily so much military personnel” driving demand, Singleton explains. “It's their families.”