In the wake of healthcare reform, continuous changes in healthcare delivery are affecting physician careers, lifestyle choices, compensation, and work settings. These changes are also impacting how healthcare facilities are recruiting new physicians. The following is a list of the latest employment and compensation trends that are shaping various medical specialties across the country:
Primary Care. In California, one-third of active physicians are practicing primary care and there is an uneven distribution of physicians throughout the state. The Association of American Medical Colleges (AAMC) reported that 60% of California’s physicians are practicing in only five counties. These counties are mostly metro areas, leaving rural communities in desperate need of more primary care physicians. Similar trends are being found in states all across the country. To help address the primary care physician shortage and uneven distribution, more medical schools are establishing community-based training programs to entice medical students to practice in rural and underserved areas. In fact, at least 17 new schools have opened in the United States this year.
Cardiology. In a recent study conducted by the American Hospital Association, employment of cardiologists by hospitals rose 32% from 2000 to 2010. Similarly, the American College of Cardiology reported that 40% of hospital administrators have acquired and integrated independent cardiology practices into their own healthcare facilities. An additional 20% of hospital administrators are planning future acquisitions. As more facilities employ cardiologists, compensation has become increasingly competitive. In a recent survey, physicians in the Northwest were cited to have the highest mean compensation of $403,000, which is 30% higher than in the Northeast. Compensation for cardiologists also varies by practice setting. Cardiologists in single-specialty groups earn the highest salaries, while the physicians who work in academic settings earn the lowest.
Orthopedics. With a growing demand for orthopedic services, particularly from baby boomers, recruitment of orthopedic physicians has become increasingly competitive. According to Jim Carr of HealthCare Appraisers, the number of orthopedists employed by healthcare facilities has increased by 30-50% between 2009 and 2011. In addition, more hospitals are utilizing orthopedic hospitalists and surgicalists to address on-call emergency coverage. Compensation for orthopedic physicians is also competitive, with those practicing in the Northwest earning the highest income. Orthopedists in Mid-Atlantic communities are on the bottom of the pay scale. Compensation also depends on practice setting, with physician partners earning the most. Orthopedists in academic settings and outpatient clinics earn the least.
General Surgery. In a recent workforce study by the Sheps Center for Health Services Research, the percentage of general surgeons who are in private practice has decreased 33% between 2001 and 2009. This in turn has increased the number of general surgeons who are employed by hospitals or other healthcare organizations. The study also noted that younger general surgeons and female general surgeons are focused on work-life balance and mostly desire full-time employment arrangements in large group practices.
Oncology. The Medical Group Management Association reported that between 2006 and 2011, 22-50% of medical oncology physicians shifted from private practices to full-time employment. The Community Oncology Alliance reported that 426 out of 1,042 medical oncology clinics have been acquired by hospitals and healthcare groups over the past few years. There is also an increasing demand for oncology services with the American Society of Clinical Oncology projecting demand to increase by 48% between 2007 and 2020.
Gastroenterology. John Poisson, executive vice president and strategic partnership officer of Physicians Endoscopy, reported that 25% of the ambulatory surgery center market is driven by gastroenterologists. He also noted that only about 225 new fellows enter the specialty annually. Since more gastroenterology-related procedures such as endoscopy are performed in hospital settings, 50% of gastroenterologists shifted to full-time hospital employment in 2012. The Affordable Care Act is effecting compensation for gastroenterologists. Future compensation impacts include shared savings, bundled payments and re-priced GI procedure codes.
We hope you enjoyed learning more about these specialties. We will continue sharing more information in a series of articles that will cover physician recruitment and employment trends. Be on the lookout for our next issue!