Gains in specialists' compensation outpace primary care

MGMA survey data show trend of past few years continues, with demand generating higher increases for anesthesiologists, urologists and cardiologists.

By Julie A. Jacob, amednews staff. Oct. 15, 2001.

Anesthesiologists and urologists posted the biggest gains in compensation last year, thanks to the high demand for their specialties, according to the Medical Group Management Assn.'s 2001 Physician Compensation and Production Survey.

Average compensation for anesthesiologists increased last year 14.5%, to $280,353, a sharp reversal from the specialty's 2.2% decline in compensation the previous year.

Physician compensation and productivity

Compensation for urologists increased an average of 12.3%, to $301,772, which was about the same as the specialty's 12% increase in compensation the previous year.

Another specialty experiencing a strong gain in compensation was cardiologists. Non-invasive cardiologists posted a 7.7% increase in compensation, to $300,073, almost identical to the 7.6% increase, to $365,894, for invasive cardiologists.

Specialists that experienced a decline in compensation included diagnostic radiologists, down 5.1%, and neurologists, down 1.7%.

In contrast to the strong gains in compensation experienced by some specialists, compensation for primary care physicians inched up only slightly last year.

That was a continuation of the trend of small increases in compensation for primary care physicians that has occurred since the mid-1990s.

Compensation for primary care physicians, overall, increased only 2.2% last year, to $147,232. Compensation for family physicians increased 2.6%, to $145,121; for internists, 2.5%, to $149,104.

The trend of the past few years, in which compensation for some specialists outstripped the compensation increases for primary care physicians, is a reversal of the trend of the early- and mid-1990s, said David Gans, the MGMA's director of medical practice resources.

From 1996 to 1999, overall increases in physician productivity outstripped increases in compensation. However, last year overall physician compensation increased 2.2%, which outpaced the 0.4% overall gain in productivity.

But those data should be taken with a grain of salt, said Gans, It could be a one-year blip, instead of the beginning of a trend in which compensation increases faster than productivity.

The only ways for physicians to experience significant increases in compensation are to be in a specialty that is in high demand, cut costs, increase productivity or seek new sources of revenue, he said.

Physicians who have to purchase prescription drugs, such as hematologists and oncologists who administer chemotherapy drugs in the office, have been hit hard by rising prescription drug costs. Oncology practices spent an average of $835,842 per physician last year on chemotherapy drugs that are administered in the office.

The MGMA received survey responses from 1,365 medical groups across the country.

Seventy-one percent were single specialty groups, while the remainder were multispecialty or primary care multispecialty groups. Eighty-two percent of the responding groups had fewer than 25 physicians in the practice. Thirty-five percent of the groups received at least part of their practice revenue from capitated contracts while 65% did not.

ADDITIONAL INFORMATION:

Physician compensation and productivity

          Compensation (Production)      
          Primary Care     Specialist    
          --------------   --------------
1990-91   3.70% ( 7.42%)   7.80% ( 8.87%)
1991-92   6.10% (10.22%)   3.63% (10.02%)
1992-93   7.47% ( 2.92%)  -1.28% (-0.75%)
1993-94   2.70% ( 1.34%)   2.34% ( 4.67%)
1994-95   4.46% ( 0.57%)   1.79% ( 5.59%)
1995-96   1.42% ( 3.36%)   2.58% (10.61%)
1996-97   0.42% ( 2.56%)  -0.48% ( 3.97%)
1997-98   2.54% ( 4.67%)   5.22% ( 6.51%)
1998-99   3.39% (11.33%)   6.01% ( 7.67%)
1999-00   2.27% ( 0.40%)   4.30% ( 4.83%)

Source: The Medical Group Management Assn.'s 2001 Physician Compensation and Production Survey