Some 20 years ago, when Dr. Michael Steinberg was already well into his radiation oncology career, physicians in his specialty enjoyed a good lifestyle as well as a good income.
“In the 1990s, the day wasn't as full,” said Steinberg, immediate past board chairman of the American Society for Radiation Oncology. “When you got good at this, you could get it done pretty quickly.”
Now, however, he and his colleagues often work 60-hour weeks. And according to the 21st annual Modern Healthcare Physician Compensation Survey, radiation oncologists are doing this for 7.9% less pay than they earned the year before.
The pay cut for radiation oncology was the largest year-over-year change seen in the 2014 survey, which compiled data from 13 recruiting firms, consultants and professional organizations. Most of the 23 specialties tracked by Modern Healthcare saw little or no income gain or loss. Twelve specialties saw increases, while 11 reported decreases. But with a few exceptions, most of the changes were statistically insignificant.
Experts say there are many reasons for the flat income trend, including the sluggish economy, the slow transition from volume- to value-based payment, growing physician employment, productivity-enhancing technology, productivity-depressing electronic health records, a declining U.S. birth rate, lower utilization, lower insurer payments and younger physicians' desire for fewer work hours.
“It's a complicated time,” said Dr. Lynn Massingale, co-founder and executive chairman of TeamHealth, a Knoxville, Tenn.-based physician-outsourcing firm. “And it's an easy time for doctors to be pessimistic.”
Modern Healthcare's physician compensation figures in this article for each specialty are averages compiled from physician pay surveys published by 13 associations and companies, including the Medical Group Management Association, the American Medical Group Association, Jackson & Coker and Compdata Surveys. Organizations used different methodologies for their doctor-pay surveys.
The MGMA, for example, obtained tax information from almost 4,200 healthcare organizations on how they compensated more than 51,000 doctors in terms of salary, bonuses and incentive payments in the first quarter. The Hospital & Healthcare Compensation Service surveyed 283 organizations and received information on how much nearly 41,500 physicians were compensated between December 2013 and February 2014. (For a description of each data supplier's methodology, see p. 32).