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MGMA Physician Placement Starting Salary Survey Highlights
Sept. – Oct. 2009
Source: “2009 Physician Placement starting Salary Survey,” conducted by the Medical Group Management Association (www.mgma.com) and the National Association of Physicians Recruiters. (www.napr.org). To purchase a copy of the study, visit www.mgma.com/pm/article.aspx; call (877) ASK-MGMA (275-6462); or e-mail support@mgma.com.
Written by Tammy D. Jamison, Director, Physician and Executive Recruiting, Lehigh Valley Health Network; President, National Association of Physician Recruiters; Contact (610) 969-0211 or Tammy.Jamison@lvh.com
Physician recruiters hear daily from doctors who are dissatisfied with their practices and who wish to either find more favorable practice settings or opt out of medicine altogether.
The 2009 Physician Placement Starting Salary Survey, a collaborative effort by the Medical Group Management Association (MGMA) and the National Association of Physician Recruiters (NAPR), was recently released, providing timely data to aid hospitals and medical groups in making competitive and realistic offers. In this increasingly challenging recruitment environment, employers need tools to help determine the right mix of salary, bonus, and benefits that are needed to recruit physicians.
Based on 2008 data, this 2009 report represents the participation of over 600 groups and is based on offers accepted by 3,500 providers across the country. The survey reports on starting salary data by specialty, practice type, geographic region, and practice model and size. Salary data is categorized by years of experience, including in which specialties new graduates salaries are exceeding those of experienced physicians. Also included in the report are data on bonuses production and signing, tail coverage, loan forgiveness, vacation, and CME time. New this year is a section on nonphysician providers, including CRNAs, physical therapists, psychologists, and more.
Economic pressures are complicating employers decisions on the best structures of offers. They must be competitive while still minimizing the groups risk and taking into account financial parameters. Decisions are equally complicated for job-seeking physicians who are balancing the need to reduce high debt but still face the uncertainties of the housing and employment markets. The results of this study will help groups to learn what is being offered and determine the right mix of compensation, benefits, and incentives.
Some states are experiencing more success than others in recruiting physicians. Between 2006 and 2008, only seven states have shown an increasing trend in placements. These states are Virginia, Florida, Kentucky, Louisiana, Missouri, Oregon, and Colorado. Ten states have had a decrease in placements, most notably in Pennsylvania, Wisconsin, Nevada, Arizona, Massachusetts, and Mississippi. Some states that reported high placement numbers (including Illinois and North Carolina) attracted more physicians right out of training, while California, Florida, and Texas hired more experienced physician candidates. Interestingly, many physicians are relocating within a state, such as in Florida, North Carolina, and New York.
The physician recruiting market, largely affected by shortages, is driving up median salaries so much that groups and organizations are being pushed to be more competitive. In fact, in some specialties, graduating fellows are being offered the same or more than experienced physicians. Specifically, fellows in infectious diseases and hematology/oncology are being offered more than their practicing colleagues. This is happening
most notably in hematology/oncology, with median compensation offered to fellows at $350,000 and $300,000 to newly hired, experienced oncologists. Similar trends are noted in emergency medicine and neonatology, though the differences are slight.
There are also differences in compensation level based on the type of model a physician joins, whether a single or multispecialty group practice or an employed hospital group. With the exception of only three specialties surgery, GI, and endocrinology starting salaries were the highest for physicians joining employed hospital practices. Many recruiters have commented on the increasing number of physicians who chose employed hospital practices over private practices.
When looking at how salaries have changed from 2005 to 2008, some specialties have seen significant increases, while other areas have experienced only minor increases and even some decreases. The greatest change in starting salaries has been in pulmonary medicine. In 2005, the median salary offered was $180,000, and in 2008, it was $249,531, representing a 38.6% change. Interestingly, though, the median dropped 2.1% from 2007 to 2008, from a high of $274,358. In dermatology, from 2005 to 2008, the median increased by 36.5% from $197,000 to $270,000. In gastroenterology, the median salary has dropped by 1.5% over the past four years.
In primary care, around which there has been significant dialogue among health care leaders concerning the projected collapse of primary care infrastructure, median salaries increased from 2007 to 2008, most notably in internal medicine
in which a 10% increase occurred. While overall there was a 10% increase in median compensation in all specialties, there were decreases in invasive cardiology, obstetrics/gynecology, otorhinolaryngology, psychiatry, and urology.
The survey represents a broad sampling of physicians and employers. While the majority of placements reported are among physicians with 1 to 2 years of experience (representing 46.8% of the survey group), over 21% of responses are based on offers to physicians with 3 to 7 years experience. Over 18% are with 8 to 17 years. There is more information available on male compensation, comprising over 65% of the surveys results; however, with over half of recently enrolled medical students being women, future surveys will most certainly represent more womens salaries.
The majority of employers represented in this survey are including production bonuses as part of the physician compensation formula. Notably, however, 37% are not. With the increasing use of pay-for-performance measures, the use of bonuses, whether they are individual or group-based, is bound to be reported more frequently. The gap is closing among employers who offer tail coverage. While 52% of surveyed employers are not offering tail coverage as part of their offers, 43.9% are.
The signing bonus is an often-used incentive to get physicians to sign employment contracts. Over half of survey respondents are offering sign-on bonuses. The amounts vary among specialties. In primary care, the average bonus is $15,000; in specialty care, it is $25,000. The highest bonus offered in 2008 was in orthopedic surgery for $45,000. While not part of the survey, a number of employers are evaluating the effectiveness of retention bonuses.
Another incentive to entice physicians to sign on the dotted line is loan forgiveness. It is not prevalent among surveyed employers, however. Only 10% of groups and hospitals are offering loan forgiveness. The majority of employers are paying relocation expenses, with much variety as regards to amounts.
Summary
The 2009 Physician Placement Starting Salary Survey is a valuable tool that recruiters and the hospitals and medical groups for which they recruit can use to develop competitive offers in an increasingly competitive market. Recruiters who submit data for the survey can receive complimentary copies of it. The NAPR encourages greater participation each year to make survey data richer. In fact, respondents can now enter data on a perpetual basis so that the information can be entered when placements are made. They can then be stored, compiled, and submitted at the end of the year, rather than requiring respondents to save the data as its obtained and then enter all of it for the year in one sitting. Depending on the volume, this can be very time-consuming. Recruiting in todays market requires a comprehensive understanding of market dynamics, and the Physician
Placement Starting Salary Survey is one more tool to help build that understanding.
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