From the November 2019 issue of HealthCare Business News magazine
Second, it is possible that primary care physicians have simply reached their productivity ceiling, whether due to time requirements related to electronic health records, efforts to stave off physician burnout, or the impact of increasing utilization of APPs. Nevertheless, increasing compensation with flat productivity is a concern for physicians and practice administrators.
Select specialties
Results from our survey showed that in 2018, median compensation for all non-primary care physician specialties (excluding radiology, anesthesiology, and pathology) increased by 3.4 percent from the previous year, while median wRVU production increased by 1.9 percent. The compensation per wRVU ratio increased by 2.65 percent. A sample of medical specialties with more remarkable changes to their compensation per wRVU ratios were cardiology, dermatology, gastroenterology (GI), hospitalist–internal medicine, and psychiatry.
Of the bellwether specialties in Fig. 2, psychiatry saw the largest increase in compensation at 15.6 percent, while productivity dropped by 1.1 percent and compensation per wRVU increased by 6 percent. This compensation data is especially interesting given that psychiatrists aligned with health systems are often compensated according to a salary-based formula, as opposed to one based on production. Given the growing demand for psychiatric care and psycho-social support, this compensation increase may be a result of health systems attempting to competitively attract psychiatrists. The reduced stigma of mental health services and the recognized integration of mental health as a critical component of value-based care have encouraged organizations to optimize and stabilize their mental health workforce.
While psychiatry saw the largest jump in compensation, general cardiology saw the largest increase in wRVU production at 1.8 percent. This specialty also saw a 4.4 percent increase in compensation, and a 4.3 percent increase in compensation per wRVU. Due to a high demand for cardiology services in general and expanding clinical programs, we expect cardiologist compensation to remain strong in the future.
All five of the specialties in Fig. 2 saw compensation per wRVU increases in excess of 4 percent this past year. By comparison, many healthcare organizations are budgeting approximately 3 percent for salary increases overall. However, as we discuss next, not all specialties enjoyed a compensation increase in 2018.
