Modest compensation gains for most doctors

American Medical Group Assn. annual survey also reveals that more medical groups are using RVUs to measure productivity.

By Julie A. Jacob, amednews staff. Aug. 13, 2001.

Earnings for some specialists jumped last year, while earnings for primary care physicians inched up only slightly, according to the American Medical Group Assn.'s 2001 Medical Group Compensation and Productivity Survey.

Median compensation increased the most for urologists, whose average earnings rose 8.5% between 1999 and 2000. Gastroenterologists, 8.1%; anesthesiologists, 7.4%; and dermatologists, 6.4%; also posted significant increases in median compensation.

Compensation for other specialists did not rise as steeply. Cardiologists reported a 3.1% increase; ob-gyns, 2.3%; diagnostic radiologists (interventional), 2%; emergency physicians, 1.6%; and general surgeons, 0.6%.

Earnings for primary care physicians edged up only modestly. Family physicians reported a 1.9% increase in median compensation; internists, 1%; and pediatricians, 3%.

The survey results were not surprising, said Shawn Schwartz, a manager with RSM McGladrey Inc., a consulting firm in Minneapolis that conducted the survey for the AMGA.

Earnings for primary care physicians are likely to remain flat for the next few years, Schwartz said.

While compensation for a few specialties rose significantly, due to increased demand for their services, compensation for many other specialties did not, he noted.

"Overall, there is such pressure on reduced reimbursement and cost containment in medical groups that they are doing the best they can to manage that human resource demand against financial pressures," Schwartz said.

Another significant survey finding was that more and more medical groups are using resource-based relative value units, instead of gross charges, as a measure of physician productivity. The percentage of medical groups reporting that they used RVUs , which measure the professional value of a physician's services, as a measure of productivity jumped from 8% in 1999 to 28% in 2000, he said.

"It's a better unit of comparison across groups or geographic regions than gross charges, which can be at the mercy of a fee schedule that is outdated or extremely low," he said.

Cardiologists, 11%, and dermatologists, 7.7%, reported the biggest jump in work RVUs, according to the survey. Among primary care physicians, internists reported a 0.5% increase in median work RVUs, and pediatricians reported a 1.14% increase. Family physicians reported a 2% decrease in median work RVUs.

Also reporting decreases were: pulmonologists, down 4.6%; cardiac thoracic surgeons, off 4.9%; hematologists, off 1%; and allergists, down 0.6%.

Median gross charges rose the most last year for urologists, 10.4%, and cardiologists, 9.1%, while median gross charges rose 6.2% for primary care physicians, 4.2% for internists and 3.3% for family physicians.

The percentage of single-specialty groups as a percentage of all respondents rose slightly compared with the previous year's survey. Of the 2001 survey respondents, 11.8% were single-specialty groups and 88.2% were multispecialty groups, compared with 8.7% single-specialty groups and 91.3% multispecialty groups for the 2000 survey.

Schwartz said the rise in single-specialty groups may be due to more specialists leaving multispecialty groups and striking out on their own.

"Specialists are starting to look very critically at the medical group model. Do they fit in with that model, or is it better ... to exit that model and go into a single-specialty practice?" Schwartz said.

The AMGA data is based on responses received from 220 multispecialty and single-specialty medical groups across the country representing 27,000 physicians. In terms of group ownership, 54% were physician owned, 22% were hospital owned, 2% were owned by a university or medical school, 2% by a managed care organization and 1% by a physician practice management company.

Nineteen percent were owned by another entity, most of which were an integrated health care system, Schwartz said.