Physician Recruitment and Employment Trends (Part 3)

by Carrie Abramson

Healthcare reform continues to affect the United States, and in turn, directly impacts physician workplace settings including their compensation and quality of life. In the first and second editions of the Recruitment and Employment Trends, we discussed the latest developments in physician recruitment and employment in Neurology, Emergency Medicine, Pathology, Hospital Medicine, Infectious Disease, and Urology. The following information is the third installment of the series.

Pediatrics. This field of medicine offers a variety of options for pediatricians to shape their careers including anything from a child’s general needs to specializing in a particular area. Depending on several factors, the career outlook for this field looks fairly favorable. Although the birthrate in the United States is decreasing compared to the past, the population is still consistently growing. With that being said, demand for pediatricians is not expected to dramatically lessen. The American Academy of Pediatrics predicts that health care reform laws increasing insurance coverage will play a major factor in the increasing need for pediatricians among other advances. In Illinois, experts expect to see faster-than-average employment growth through the year 2018 for pediatricians, with around 40 pediatrician openings annually within the state. In addition, A 2010 survey of children’s hospitals conducted by the National Association of Children’s Hospitals and Related Institutions found shortages in pediatric subspecialties, including areas such as neurology, developmental-behavioral medicine, general surgery and pulmonology. The best employment opportunities for pediatricians will be in rural or low income areas, according to the U.S. Bureau of Labor Statistics.

Psychiatry. The demand for general psychiatry services are predicted to increase by 19% from 1995 and 2020. The demand for child and adolescent psychiatric services are predicted to increase by 100% in the same time frame. Currently, there are more than 29,000 psychiatrists in patient care and 32% of those are international graduates. The demand for psychiatrists is increasing but this specialty is attracting fewer American graduates. Another problem is that three quarters of psychiatrists are older than 50, nearing retirement. Compensation depends on the location and industry in which a psychiatrist works. States where psychiatrists were paid the most were Oregon at $229,040 followed closely by Minnesota at $216,360. Most psychiatrists work in physician offices even though positions hired by the the local or state government tend to get paid more with an average wage of around $198,730 annually, followed by outpatient centers at $194,610 annually.

Anesthesiology. Most anesthesiologists work in hospitals or surgical outpatient clinics. They are usually in charge of providing pre and post-operative pain management, as well as local or general anesthesia during surgery. Some work for research institutions where they study ways to improve care for anesthesia recipients and manage pain. Average compensation for anesthesiologists depends on geographical location as well as industry with physician offices paying the highest at  an average wage of $241,910. California employs around 5,000 anesthesiologists, which is the most out of any state. The following are five trends said to be affecting the employment of anesthesiologists: provider non-discrimination language removing patient safeguards; patient safety placed before financial benefits to the facility; questionable data giving nurse anesthetist studies undue weight; “meaningful use” rules including incentives for perioperative EMR systems; and shortage in residency positions may mean a shortage of anesthesiologists.

Rheumatology. Rheumatologists are physicians who are fellowship trained and/or board certified in adult rheumatology, pediatric rheumatology, or both. In a recent study, there were about 5,000 adult rheumatologists and a little over 200 pediatric rheumatologists. Most adult rheumatologists are between 50-60 years old. The consequence of this is that a substantial proportion of the workforce will be retiring over the next 15 years. The prevalence of disease across demographic groups, population change, income, insurance coverage, and other factors contribute to the growing demand for rheumatologists. In particular, the aging of the baby-boom population is causing an intense increase of musculoskeletal diseases including rheumatoid arthritis and osteoarthritis. Proactively taking steps to practice more efficiently, improve quality of care, and to adequately staff practices for the number of patients is essential to maintain sufficient job satisfaction for rheumatologists. Compensation wise, a recent Medscape survey reported that on average male rheumatologists make around $228,000 while female rheumatologists make less at $181,000.

Obstetrics and Gynecology. The work of an OB-GYN is challenging in many ways because of long hours and they are responsible for two lives when they manage labor and childbirth. OB-GYNs have been concerned about their professional futures. Presently, OB-GYNs treat more patients a month (320), on average, than other physicians (253). However, they are doubtful they can maintain this number of patients, and possibly their practices, in the coming years. A long-term trend of declining birthrates would mean less need for obstetrical services. High out-of-pocket costs because of the Affordable Care Act may mean that patients will be unable to pay for procedures. Also, higher malpractice premiums compared to other specialties also may have an effect on job prospects. The liability factor is likely to lead to a decrease in the number of OB-GYNs, but may improve the prospects for those in the profession. The majority of OB-GYNs, almost 17,000, work in physician offices. These OB-GYNS make an average of $217,780 annually. The estimated 50 OB-GYNs working at specialty hospitals are the highest compensated at a yearly salary of 226,450.

Gastroenterology.  While Gastroenterologists are skeptical about their future, they are less pessimistic than many of their peers. The U.S. will require an additional 10% increase of trained gastroenterologists by 2020. The need for the increase is not due to the lack of medical students choosing gastroenterology as their specialty, but instead, to meet the growing demand of cancer screenings with the aging population. reported that the median salary for a gastroenterologist is $320,389. The same report showed that gastroenterologists on the lower end of the pay scale make about $224,000 and those on the higher end made closer to $468,000. A 2011 compensation survey published by Medscape found that gastroenterologists were among the top 6 specialties, when it comes to earnings. States that show a significant growth in gastroenterologist job postings are Ohio, California, South Carolina, Indiana, and Illinois.

References / works cited: Bureau of Labor Statistics – Pediatrics; What Is the Projected Future of a Pediatrician?; Bureau of Labor Statistics – Psychiatry; 5 Current Trends Affecting Anesthesiologists; What Is the Employment Outlook for Anesthesiologists?; Bureau of Labor Statistics – Anesthisiology; A New Breed of Practice; Medscape Rheumatologist Compensation Report 2014; What Is the Job Outlook for an OB-GYN?; Bureau of Labor Statistics – OB-GYN; What is a Gastroenterology?.
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