Demand for Medical Specialists Increasing in US

Megan Brooks

June 21, 2018

Demand for primary care physicians in the United States remains strong, but hospitals, medical groups, and other healthcare organizations are increasingly looking for medical specialists, according to Merritt Hawkins' annual report tracking physician recruiting trends and starting salaries.

"It's a matter of demographic destiny," Travis Singleton, senior vice president of Merritt Hawkins, said in a news release. "Americans are getting older, and it is medical specialists who will be taking care of our aging and ailing bodies and brains. We still need more primary care doctors, but a growing emphasis is being placed on recruiting specialists."

Results of the Merritt Hawkins' 2018 Survey of Physician and Advanced Practitioners Recruiting Incentives are based on a review of 3045 physician and advanced practitioner recruiting assignments the firm conducted from April 1, 2017, to March 31, 2018.

According to the report, 74% of Merritt Hawkins' recruiting assignments in the past year were for medical specialists, up from 67% 3 years ago. Family physicians, internists, and pediatricians were still in high demand, topping the list of most requested recruiting assignments for the 12th year in a row.

However, the number of searches the firm conducted for primary care physicians fell by 32% compared with 3 years ago and by 19% compared with the year before, according to the report.

Demand for primary care physicians is "still strong," said Singleton, "but it is a mistake to believe that physician shortages are confined to primary care. Specialists also are in short supply."

Part of the decline in primary care searches can be attributed to the growing use of nurse practitioners (NPs) and physician assistants (PAs), according to Singleton. The number of search assignments Merritt Hawkins conducted for NPs has jumped 61% year over year, as NPs are being used to fill openings at a growing number of urgent care centers and retail clinics nationwide.

Crisis in Mental Health

Family physicians led the list of Merritt Hawkins' 20 most requested recruiting assignments.

But for the third year in a row, psychiatry was Merritt Hawkins' second most requested type of search assignment, underscoring a pervasive shortage of mental health professionals nationwide, the company said.

According to a report published last year by the National Council for Behavioral Health, 77% of US counties have a severe shortage of psychiatrists, at a time when demand for mental health professionals is increasing.

"Expanding mental health services is considered a key to addressing societal problems such as mass shootings, suicide, and drug addiction," said Singleton. "Unfortunately, the shortage of psychiatrists is a serious impediment to this goal."

Highest Starting Salaries

The 2018 report also provides data on starting salaries. It indicates that physicians practicing invasive cardiology have the highest average starting salaries, at $590,000, followed by orthopedic surgeons, at $533,000; gastroenterologists, at $487,000; dermatologists, at $425,000; and pulmonologists, at $418,000.

Rounding out the top 10 are, in descending order, otolaryngologists ($405,000), urologists ($386,000), radiologists ($371,000), anesthesiologists ($371,000), and emergency medicine physicians ($358,000).

Starting salaries for family physicians reached a record high of $241,000, according to the report. The average physician signing bonus also reached an all-time high of $33,707.


Other Clinicians

The report notes increasing demand for NPs and PAs. "Merritt Hawkins conducted more search assignments for NPs and PAs in the previous year than in any other 12-month period tracked by the Review," the report says.

The average starting salary for NPs is $129,000, the highest amount ever cited in the group's report.

The report points out that "unlike other physician compensation surveys, Merritt Hawkins' Review tracks physician starting salaries and other recruiting incentives, rather than total annual physician compensation. It therefore reflects the incentives physicians are offered to attract them to new practice settings rather than what physicians in general may actually earn."

The report also notes that the use of value-based physician incentives is gaining momentum. Of Merritt Hawkins' clients offering physicians a production bonus last year, 43% based the bonus in whole or in part on value-based metrics, such as patient satisfaction and outcome measures, compared to 39% a year earlier and 32% the year before that. However, the 2018 report indicates that only 8% of total physician compensation is tied to quality- or value-based metrics, suggesting that volume remains the primary method for measuring and rewarding physician productivity, the company says.

The full report is available online.

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