No One is Seeking, or Wants to Be, Marcus Welby
By Kelley Dunn, Senior Director with Merritt Hawkins // July 11, 2012
Healthcare Trends
EDITOR’S NOTE: Space Coast Medicine magazine and SpaceCoastDaily.com are delighted to welcome Kelley Dunn, Senior Director with Merritt Hawkins, a national physician search firm and a company of AMN Healthcare, back as a guest contributor. The developing professional demographics of the Space Coast medical community, in which “hanging a shingle” for a solo practice is almost unheard of and where large multispecialty groups dominate, typify the findings of this recent survey conducted by Merritt Hawkins that the search by communities, hospitals or health systems for solo physicians has essentially come to an end.
ATLANTA, GEORGIA — Who wants to be a solo physician today, and who wants to recruit one?
The answer to both questions appears to be “nobody.”
Very Few New Independent Medical Practitioners
Hospitals in Florida and nationwide have virtually given up the search for solo physicians, a new survey suggests, as an iconic symbol of America’s tradition of independent medical practice fades from the scene.
The survey, by Merritt Hawkins, a leading physician search and consulting firm and a company of AMN Healthcare, tracks the 2,710 physician recruiting assignments Merritt Hawkins conducted nationwide from April 1, 2011 to March 23, 2012. Of these, only 28 – or one percent – were for solo physicians. In 2004, by contrast, 22 percent of the firm’s recruiting assignments were for solo practitioners.
Fewer and fewer physicians want to be like television’s Marcus Welby, practicing alone or with a partner, and fewer hospitals are seeking solo doctors for their communities. The reason is simple. To incorporate required technology, comply with regulations, and participate in new delivery models like Accountable Care Organizations, physicians today almost have to be part of larger practices or be employed by hospitals. Practicing on an island is increasingly difficult today, even for those physicians who prefer solo practice.
Physician Hospital Employment Escalating, Primary Care In Greatest Demand
Indeed, the survey shows that 63 percent of Merritt Hawkins’ recent search assignments featured hospital employment of the physician, up from 56 percent last year and 11 percent in 2004. Should this trend continue, over 75 percent of newly hired physicians will be hospital employees within two years.
The survey also indicates that primary care physicians, including family physicians and general internists, remain the type of doctors in highest demand.
For the sixth straight year, family physicians were Merritt Hawkins’ most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons.
By contrast, for the first time in the survey’s 19-year history, anesthesiologists dropped from the list of Merritt Hawkins’ top 20 most requested searches. A recession-driven decline in medical procedures and the growing use of certified registered nurse anesthetists (CRNAs) has dramatically reduced demand for anesthesiologists.
Slowly Moving Toward A Value-based Compensation Model
The new survey suggests that in addition to practicing in different settings, physicians are being compensated differently. In the 2010/11 survey, fewer than seven percent of physicians were offered bonuses based on the quality of care they provided. In the 2011/12 survey, that number had risen to 35 percent, underscoring a rapid shift away from rewarding physicians for the volume of services they provide and toward rewarding them for the value of services they provide. However, quality measures generally amount to less than ten percent of a physician’s potential bonus and volume remains the name of the game.
Though the tide is turning, increasing the number of patients they see or the volume of services they provide remains the most practical way for physicians to increase their incomes.
Compensation Highest For Orthopedic Surgery, Lowest For Primary Care and Pediatrics
The survey also indicates the average starting salaries being offered to recruit physicians in 20 specialties. Orthopedic surgeons are at the top of the list with average salary offers of $519,000, while family medicine physicians and pediatricians trail at $189,000. Signing bonuses, production bonuses, relocation, and continuing medical education allowances are standard perks in most physician recruiting packages.
Merritt Hawkins 2012 Review of Physician Recruiting Incentives also includes an extensive analysis regarding the current physician recruiting market. I would be happy to share a copy of the report with Space Coast Medicine and SpaceCoastDaily.com readers who can contact me at 800-306-1330 or Kelley.dunn@merritthawkins.com.
ABOUT THE AUTHOR
Kelley Dunn is Senior Director with Merritt Hawkins, the leading physician search and consulting firm in the United States and a company of AMN Healthcare (NYSE: AHS). She earned a double major in Biology and Chemistry from the University of Georgia, a Masters degree from Florida Atlantic University, and is currently a faculty instructor with the University of Florida. With over 8 years of healthcare staffing experience, Kelley has consulted with over 2,000 clinics and hospitals in Florida.
