Physicians find they are working harder but for only a little more money
Incomes are rising, but not as fast as production
In a time when inflation is very low — it was 1.7% in 1997 and currently stands at about 2.3% according to government figures — it might seem reasonable that primary care physicians’ compensation rose an average of just 2.54%. But look at their production numbers in the Medical Group Management Association’s Compensation and Production Survey: 1999 Report Based on 1998 Data and, suddenly, keeping pace with inflation doesn’t seem so good.
Primary care physicians produced 4.67% more between 1997 and 1998, an average of $335,890 per physician. Internists bucked the trend among primary care doctors, producing $327,280, a decrease of about a half percent. Meanwhile, their compensation rose 0.91% to $141,147. (For more on the specific figures for compensation and production, see tables, p. 134.)
The five-year figures show primary care and specialty physicians both had more than 9% increases in compensation, while gross charges vaulted 11.59% and 29.3%, respectively. Among specialists, the average compensation package increased 5.22% to $231,993, while production went up 6.51% to $724,275. (For more on specialist compensation and production, see story, p. 135.)
Even midlevel practitioners had the same kind of trend — an increase of nearly 5% to $60,764 in compensation, while production increased a whopping 15.77% to $188,126. Indeed, the continuing ability of midlevel providers to bill increasing amounts while keeping costs down makes them a true bargain.
Some of the midlevels had increases in earnings that outpaced increases in production, though. Among them, optometrists’ compensation was up 9.82% to $78,000, while their production increased only 6.64% to $254,129. Nurse anesthetists had a similar situation, seeing compensation rising 2.32% to $84,863 while production declined 0.22% to $255,565.
The MGMA data were gleaned from survey responses from 30,838 providers in 1,609 practices. The report lists information by geographic area, level of managed care, years in specialty, and single specialty vs. multispecialty practice. Several productivity measures are reported — gross charges, ambulatory and hospital encounters, surgery/anesthesia cases, and physician work relative value units (RVUs). The report also includes ratios of compensation to production and compensation per physician work RVUs.
Among the new features of this year’s survey is that to measure physician productivity, only the physician work portion was used from the resource-based relative value scale (RBRVS). In previous surveys, total RBRVS — physician work, malpractice expense, and practice expense — was collected. Another new feature is that the definition of part-time physician changed from 50% clinical work time to between 40% and 60%.
For more information about the survey report, call Laurel M. Weinstein, MBA, MGMA survey operations project manager, at (888) 608-5601, ext. 895, or (303) 397-7895; e-mail: survey@ mgma.com.
The Physician Compensation and Production Survey: 1999 Report Based on 1998 Data is $200 for MGMA members, $250 for MGMA affiliates, and $300 for others, plus shipping and handling. To purchase, call the MGMA service center at (888) 608-5602 or (303) 397-7888.
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