The 26th annual review of clinician recruitment by Merritt Hawkins compiles data from more than 3,000 hiring search assignments.
The new report from Dallas-based Merritt Hawkins features a range of clinician compensation and incentives that can be used as benchmarks in the recruitment of physicians and advanced practice providers.
The report features five key findings:
1. Primacy of primary care: For the 13th straight year, family physicians led the list of the 20 most requested recruiting assignments. Demand for primary care physicians is driven by common factors across multiple specialties such as the country's aging population, but new care models that emphasize prevention, quality payments, and care coordination also are pivotal drivers, the report says. "In the population health management model, for example, primary care-led teams coordinate care for defined populations, such as blocks of Medicare patients, under a global payment model where the health system—and, increasingly, its physicians—assume risk."
2. Rising demand for specialists: Recruitment activity is shifting toward medical specialists. Four years ago, 67% of search assignments were for medical specialists. Over the past year, 78% of search assignments were for medical specialists. "Despite the common perception that physician shortages are most acute in primary care, a growing percentage of Merritt Hawkins' search assignments are for surgical, internal medicine, and diagnostic specialists," the report says.
3. Psychiatrist shortage: For the fourth straight year, psychiatrists were second on the list of most requested recruiting assignments. "Today it is widely acknowledged that the shortage of mental health professionals, including psychiatrists, has developed into a public health crisis," the report says.
4. Pay leaders: Over the past year, invasive cardiologists earned the highest average starting salaries for physicians at $648,000. Orthopedic surgeons posted the second highest starting salaries at $536,000.
5. Employed physicians dominate: In a continuing trend for recent years, employment rather than independent practice was the dominant physician recruiting model over the past year. More than 90% of search assignments were in employed practice settings; less than 10% were in independent practice.
"The majority of the organizations recruiting physicians today—hospitals, medical groups, urgent care centers, federally qualified health centers, academic centers, and others—typically employ physicians rather than establishing them in private practices," the report says.
Physician shortage persists
The lead author of the report told HealthLeaders that there is little relief in sight for the physician shortage.
"We are stuck with the shortage for the foreseeable future given the time it takes to train physicians. If the federal government agreed to increase funding for physician training by 30% tomorrow, as some industry experts feel is necessary, we would not see the effects for 10 years," said Phillip Miller, vice president of communications at Merritt Hawkins.
However, there are three bright spots on the medical staffing horizon, he said:
- The number of nurse practitioners (NPs) and physician assistants (PAs) has increased rapidly in recent years. NPs and PAs are addressing a significant amount of patient demand for medical services—often in convenient care settings such as urgent care centers and retail clinics.
- Telehealth allows for the more efficient distribution of physician services. Through telehealth, healthcare organizations can transfer work from areas that have low physician capacity to areas that have higher capacity in specialties such as radiology, behavioral health, and primary care.
- The healthcare sector is transforming the delivery of services from the volume-based fee-for-service model to the population health model, which puts a premium on prevention and patient outcomes. "The hope is this will lead to healthier patients and less need for interventions, hospitalizations, and readmissions, and therefore less need for physicians," Miller said.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
In a new report, primary care physicians lead the list of the Top 20 most requested recruiting assignments.
Specialists are increasingly in high demand. Over the past year, 78% of search assignments were for medical specialists.
The report calls the country's shortage of psychiatrists a "public health crisis."