In Physician Recruiting, Local Needs Trump National Trends

"The era of the independent physician who owns and runs his or her practice is fading," Travis Singleton, senior vice president of Merritt Hawkins, said in the report. "Doctors today are more likely to be employees working for increasingly large health systems or medical groups."

Beyond that, local variables kick in. A report from MGMA -- Physician Compensation and Production Survey: 2011 Report Based on 2010 Data -- finds that compensation growth for primary care and specialty care physicians was all over the board in 2010, and appeared to be determined as much by location as by area of medical expertise.

For example, median compensation for both primary care physicians and specialists was highest in southern states, with primary care physicians earning a median of $216,170, and specialists earning a median $404,000. By comparison, primary care physicians in eastern states earned a median $194,409, and specialists earned a median $305,575.

Hertz says that factors beyond cost of living and demand may explain regional compensation variations. "The Northeast is heavy into … I would hesitate to call it managed care, but certainly more structured PPO/negotiated plans. California has the foundation models, the huge groups, again the heavy negotiations. The South has an aging population, a lot of specialists, and gerontologists," Hertz explained.

Both Merritt Hawkins and MGMA found that some physicians can't necessarily bank on an increase in compensation every year. Five of the Top 20 recruited specialties in the Merritt Hawkins survey saw their average base salary decline between 2009/10 and 2010/11. Family practice base salary fell from $200,000 to $197,000. Neurology fell from a base of $281,000 to $256,000. Hematology/Oncology fell from $385,000 to $369,000. Radiology fell from $417,000 to $402,000, and endocrinology fell from $219,000 to $218,000, the survey showed.