At the Becker's Hospital Review 4th Annual Meeting in Chicago on May 10, Jim Carr, partner at HealthCare Appraisers, detailed compensation trends for six physician specialties and explained how physician employment is affected those trends. The basis for Mr. Carr's evaluations was data from MGMA's physician compensation surveys.
Anesthesiology
Anesthesiologists in independent practices had median compensation of $428,000 in 2009, $40,000 higher than those in hospital-owned practices, and that trend has no really slowed down over the past several years. "There's no incentive that's showing anesthesiologists are moving from private practice, and consequently, they're not really being employed," Mr. Carr said.
Internal medicine
More than half of internists have been employed since 2009, and the compensation between hospital-based and independent internists is fairly similar. Because of this, Mr. Carr said, internists are not really being employed in droves either.
Hematology/medical oncology
Mr. Carr highlighted medical oncologists as one of the major specialties that is gradually moving away from independent practice and to hospital employment. In 2009, hospital-based medical oncologists made $317,000, and that figure increased to $401,000. Private practice oncologists still have higher compensation overall, but they are clearly moving toward the hospital setting, Mr. Carr said.
Orthopedic surgery
Orthopedic surgery is typically viewed as an independent, entrepreneurial physician specialty, but in 2009, hospital-based orthopedic surgeons had median compensation of $516,000 compared with $452,000 for those in independent practices. In 2011, those numbers increased to $544,000 and $493,000 for hospital-based and independent orthopedic surgeons, and roughly 43 percent of all orthopedic surgeons are employed. "I was shocked by that," Mr. Carr said. "I had no preconceived notion that compensation for hospital-based orthopedic surgeons would be that much higher, and it's a significant trend of moving over."
Radiation oncology
Reimbursement cuts have completely changed the fair market value analysis for radiation oncologists. In 2009, the median compensation for independent radiation oncologists was $607,000 compared with $468,000 for those in the hospital setting. By 2011, the numbers changed to $528,000 for independent radiation oncologists and $489,000 for hospital-based radiation oncologists.
Interventional cardiology
Mr. Carr said interventional cardiology has been "the most telling" of physician specialties that are jumping to employment. In 2011, hospital-based interventional cardiologists earned median pay of $584,000, significantly higher than $450,000 for those in independent practice. Employment between 2009 and 2011 has jumped from 22 percent to 51 percent.
So what do these figures mean for fair market value analysis? Mr. Carr cautions that while physician compensation surveys have their value, they are also becoming a self-fulfilling prophecy in a way. In addition, as the healthcare sector moves away from fee-for-service and toward value-based care, compensation surveys may need to be coupled with clinical quality surveys and data in the future.
Anesthesiology
Anesthesiologists in independent practices had median compensation of $428,000 in 2009, $40,000 higher than those in hospital-owned practices, and that trend has no really slowed down over the past several years. "There's no incentive that's showing anesthesiologists are moving from private practice, and consequently, they're not really being employed," Mr. Carr said.
Internal medicine
More than half of internists have been employed since 2009, and the compensation between hospital-based and independent internists is fairly similar. Because of this, Mr. Carr said, internists are not really being employed in droves either.
Hematology/medical oncology
Mr. Carr highlighted medical oncologists as one of the major specialties that is gradually moving away from independent practice and to hospital employment. In 2009, hospital-based medical oncologists made $317,000, and that figure increased to $401,000. Private practice oncologists still have higher compensation overall, but they are clearly moving toward the hospital setting, Mr. Carr said.
Orthopedic surgery
Orthopedic surgery is typically viewed as an independent, entrepreneurial physician specialty, but in 2009, hospital-based orthopedic surgeons had median compensation of $516,000 compared with $452,000 for those in independent practices. In 2011, those numbers increased to $544,000 and $493,000 for hospital-based and independent orthopedic surgeons, and roughly 43 percent of all orthopedic surgeons are employed. "I was shocked by that," Mr. Carr said. "I had no preconceived notion that compensation for hospital-based orthopedic surgeons would be that much higher, and it's a significant trend of moving over."
Radiation oncology
Reimbursement cuts have completely changed the fair market value analysis for radiation oncologists. In 2009, the median compensation for independent radiation oncologists was $607,000 compared with $468,000 for those in the hospital setting. By 2011, the numbers changed to $528,000 for independent radiation oncologists and $489,000 for hospital-based radiation oncologists.
Interventional cardiology
Mr. Carr said interventional cardiology has been "the most telling" of physician specialties that are jumping to employment. In 2011, hospital-based interventional cardiologists earned median pay of $584,000, significantly higher than $450,000 for those in independent practice. Employment between 2009 and 2011 has jumped from 22 percent to 51 percent.
So what do these figures mean for fair market value analysis? Mr. Carr cautions that while physician compensation surveys have their value, they are also becoming a self-fulfilling prophecy in a way. In addition, as the healthcare sector moves away from fee-for-service and toward value-based care, compensation surveys may need to be coupled with clinical quality surveys and data in the future.
More Articles on the Becker's Hospital Review 4th Annual Meeting:
3 Observations on Hospitals and the Capital Market Today
GI-Focused Joint Ventures - Why They Can Make Sense for Hospitals
More Than Money: The Changing Landscape of Hospital Consolidation, Affiliation