Primary care and psychiatry specialties are among the most-requested recruiting searches, but pay continues to lag behind other specialties, data from Merritt Hawkins shows.
As the nation grapples with a widespread and persistent provider shortage, salaries for the 20 most-sought physician specialists and advance practice nurses spiked over the past year, according to a report from physician recruiters Merritt Hawkins.
"You could say universally every single salary segment went up, and most of them did it in double-digit style, which is abnormal," says Travis Singleton, senior vice president at Merritt Hawkins.
The Irving, TX-based recruiter's 23rd annual review is based on in-house findings for 3,342 physician and advanced practice nurse recruiting requests between April 1, 2015 and March 31, 2016.
Annual starting salaries and year-over-year increases for select specialties include:
- Family medicine, $225,000, up 13% year-over year;
- Psychiatry, $250,000, up 11%;
- Obstetrics-gynecology, $321,000, up 16%;
- Dermatology, $444,000, up 13%;
- Urology, $471,000, up 14%;
- Otolaryngology, $380,000, up 15%;
- Non-invasive cardiology, $403,000, up 21%;
- General surgery, $378,000 up 12%
"This paints a picture of a healthcare system that is at capacity. It's busting at the seams no matter where you look," Singleton says.
"It's created this feeding frenzy for all physicians, and that includes advanced practitioners. It doesn't matter how you segment it out."
"If you want to look at major disease groupings that drive our healthcare system, chronic disease management, mental health, geriatrics, you can almost pick from that what our most requested specialties should be, and they are."
Primary care specialties, nurse practitioners and physician assistants represented seven of the 10 most-requested recruiting searches, and for the first time family medicine starting average salaries breached the $200,000 threshold.
However, primary care specialties continue to lag significantly behind other specialists, and Singleton says that's not going to change.
"Unless we completely overhaul how we pay physicians, unless we flip on its head a system that favors procedures and puts diagnostics at a monetary disadvantage this is what you are going to get," he says.
"You are going to see some tweaks when you get into value-based care and certain snippets of the market that are going to pay a little better, but we are not going to wake up one day and find that family practitioners are making $300,000. That's not possible."
Psychiatrists were the second-highest search request behind family physicians. The federal government has designated 3,968 whole or partial counties as Health Professional Shortage Areas for mental health, and close to half the counties in the U.S. have no mental health provider.
Singleton says the demand for psychiatrists comes with the growing realization that mental health is a key component of population health and has the potential to greatly influence care regimens, outcomes, readmissions and reimbursements.
"When you look at the absolute demand, psychiatry is in more demand" because there aren't that many psychiatrists, Singleton says.
"I knew the demand was prevalent but I didn't expect it would be our second-most-requested specialty. And so far this year we are already ahead of last year's pace."
Singleton says the "simple explanation" is that there aren't enough psychiatrists in the pipeline to replace their retiring older colleagues.
"Even when you look at those who are coming out of training, it's not even close to the numbers who are going to retire in the next four to five years," he says.
"There is also a severe mal-distribution. Most psychiatrists are in urban and we need them in rural. Most are in outpatient and we need them inpatient. This is all happening as we're going through a re-emphasis on the importance of mental health."