Physician Recruiting and Compensation

Merritt Hawkins is a large physician recruiting firm and releases regular reports on compensation trends, particularly for newly-hired doctors.  The 2017 version is out.  (MH Survey)  The report is based on over 3000 searches the firm conducted in the 12 months prior to release of the report, so it gives a good picture of where there is strong demand for certain health care services.  90% of the searches were for employed positions, not an owned private practice.  43% were for hospital positions and 27% for group practices, and interestingly 15% were for community health centers.  Family Medicine physicians were far and away the most recruited type, accounting for almost 20% of all searches, likely reflecting the emphasis on strong primary care as a cost control mechanism, and if internal medicine doctor searches are included, primary care is over 25% of searches.  Given the increased need from parity legislation and a highly stressed population, psychiatrists being second in demand also isn’t surprising.  A combination of nurse practitioners and physician assistants came in third; as they represent a less expensive way to provide most primary care services.  Urgent care doctors were the 12th highest number of searches, as demands for convenience from consumers and cheaper alternatives to ERs from payers has led to a rapid expansion of this site of care.  Pulmonology is a specialty showing increased demand from prior years, as were radiology and anesthesiology, two high-paying specialties which had shown reduced demand in the last few years.

Primary care doctors were offered an average of $231,000 in 2017, up from 198,000 in 2015.  Internal Medicine was at an average $257,000 versus $207,000.  Nurse Practitioners were offered $123,000 in 2017 compared to $107,000 two years ago.  Assuming similar productivity, unit cost would be about half for the same service from an NP than from a primary care physician.  Among specialties, psychiatrists were at $263,000 versus $226,000; ER doctors at $349,000, fairly stable against the two years earlier average of $345,000; orthopedic surgeons were at $579,000 compared to $497,000 and invasive cardiologists at $563,000 versus $525,000.  Hospitals tend to pay more than other practice settings.  Almost all offers included a relocation allowance and payment of Continuing Medical Education expense.  Three-fourths included a signing bonus and one-fourth help in paying off student loans.  While value and quality metrics are an increasing aspect of incentive compensation, with 32% of offers including that as a component, productivity metrics are still far more important and quality-based payments are only 4% of total compensation on average.  The report indicates very strong compensation for physician hires, which likely translates to compensation increases for the other physicians in a setting.  Someone has to pay for all this compensation, and it undoubtedly is a factor in ongoing spending growth.