Hospitals employ almost 20 percent of all physicians

As more physicians choose an employment model, what will happen to independent physicians? What will happen to those physicians who are still in private practice?

These days, hospitals and health systems are seeing more requests from independent physicians about employment options. Hospitals are acquiring independent physician practices and offering compensation packages that include financial incentives (bonus payments) that are linked to patient satisfaction ratings and clinical performance and health care quality. These types of financial incentives may currently only be 3-5% of total physician compensation, but it is expected to increase to about 7-10% of physician total compensation.

If you are still in private practice, do you see yourself staying in that model until you retire? Or, will you be one of those independent physicians switching to an employment model?

If you are interested in learning more, read the Sullivan Cotter's 2011 Physician Compensation and Productivity Survey Report by Sullivan, Cotter and Associates, Inc.

Medical School Faculty Salaries 2010-2011

How much does the average medical school faculty make? The Association of American Medical Colleges recently released a publication titled, "Report on Medical School Faculty Salaries 2010-2011." This report is $409.00. I didn't purchase the report, so here's a summary from Modern Physician:

The average physician working as a clinical faculty member at a U.S. medical school made a total of $262,400 in the 2010-11 academic year—an increase of 2.9% over the previous year, according to a new report from the Association of American Medical Colleges.

Almost 59,000 U.S. physicians serve as clinical faculty members, according to the AAMC's Report on Medical School Faculty Salaries, 2010-11.

In comparison, the 1,145 physicians working as basic science faculty saw their compensation rise 2.7% to $150,600. The 12,928 nonphysicians who have a doctorate and work as clinical faculty saw their average compensation grow 2.2% to $123,400.

How does your salary affect your overall job happiness?

These days, doctor salaries are under scrutiny because of the public perception that highly-compensated physicians are driving up health care costs. The reality is that there are some physicians who work full-time and don't even generate a six-figure salary. Of course, there are also medical specialists and subspecialists who generate well over $300,000 to 400,000 each year. I also know some physicians who essentially work 2 jobs (a standard job + moonlighting so much that they're over 80 hrs/week). They make a lot of money, but they're always working.

How does your salary affect your overall job happiness?  If you feel underpaid, that's one thing. If you feel that your salary is a "fair" salary for the type of work you do, then how much happier would you be if your salary went up? How much higher would it need to go up in order for you to feel a sense of greater happiness?

Discussing physician executive compensation at #ACPEfall2011

I've spent the past few days attending the 2011 ACPE Fall Institute. Yesterday, I attended a session titled, "Cejka Search/ACPE 2011 Physician Executive Compensation Survey Panel Presentation."

The eighth biennial survey of ACPE members identifies key trends and factors driving today's physician executive compensation and serves as an essential reference resource for physician executives and healthcare organizations developing leadership roles for physicians.

Overall median compensation for physician executives in 2011 = $305,000

The two-year rate of increase in total compensation – at 5.9% – is well below the 11.6% increase reported in 2009 and the lowest since the 2001 survey reported 5.0% increase. Higher-ranking physician executives experienced a greater reduction in the rate of growth in total compensation than those in other roles.

Findings from 2011 Physician Executive Compensation Survey

Cejka Executive Search and the American College of Physician Executives Release Findings from 2011 Physician Executive Compensation Survey

ST. LOUIS, Oct. 19, 2011 /PRNewswire/ -- Physician executive compensation experienced the lowest growth rate for the first time in ten years, according to the Cejka Executive Search and American College of Physician Executives (ACPE) 2011 Physician Executive Compensation Survey. In this eighth biennial survey of ACPE members, key trends and factors that drive change in physician executive compensation are identified. The results of the survey will be presented at the ACPE 2011 Fall Institute on November 8, 2011 in Scottsdale, Ariz.

@DrJosephKim quoted in this @CNN @Money article about health care #jobs

I'm quoted in this CNN Money article titled, "Health care jobs a bright spot for hiring." Many people choose to pursue careers in health care because of the job stability associated with the health care market. These days, even in a depressed economy, there are many new health care jobs that are being added on a regular basis. Why is this happening? Here's the bottom line: the aging population coupled with changes driven by health care reform will add a number of new jobs in the health care industry.

There are also changing trends in the ways hospitals are hiring physicians or practice groups. Many independent private practice physicians are choosing to be employed by hospital systems and they are choosing salaried models of reimbursement. When a hospital hires a private practice physician to work as a salaried physician employee, that's considered a new job for the hospital. Technically, the physician switched from working as an independent contractor to a salaried employee for the hospital. The hospital records that they added and filled a new job position.

In reality, these health care job statistics published by the U.S. Bureau of Labor Statistics may be a bit misleading right since so many physicians are switching from the private practice model to a salaried model.

2011 Medscape physician compensation report

Are you curious about physician salary results? 

Medscape's 2011 Physician Compensation Report provides physicians insights on current trends regarding pay and hours worked. This comprehensive report represents responses from over 15,000 US physicians and offers details on who is earning how much by specialty, geographic location, practice type, sex and more.

• How much do physicians earn?
• Which practice settings earn the most?
• How much time is spent with patients?

Methodology

• Survey fielded to 455,000 US physicians
• Total respondents*: 15,794 US physicians across 22 specialty areas
• Fieldwork conducted by Medscape from February 2-March 30, 2011
• Data collected via third-party online survey collection site

Find jobs that pay over $100k at TheLadders

Are you looking for a job that pays six figures?

TheLadders.com  provides you with the ability to find high-paying non-clinical jobs in medical affairs, consulting, biopharma, investment banking, venture capital, and many other industries. Their targeted sites list more than 35,000 new $100k+ jobs each month across every industry, in companies of all types and sizes. They only list jobs that pay more than $100,000/year, including many C-level, VP, Director and Manager jobs. So, if you're in the market for a $100k+ job, you won't find a better resource anywhere.  

Find $100K+ Jobs at TheLadders.com. 

TheLadders.com also provides nice career advice articles and other career services.

Impact of a dual PharmD/MBA degree on career opportunities and earning potential

What can medical students and physicians learn from our pharmacy colleagues? Let's take a look at this study titled, "Impact of a dual PharmD/MBA degree on career opportunities and earning potential."

OBJECTIVE: To evaluate the academic experience and satisfaction of students who completed a dual PharmD/MBA degree program and the program's long-term impact on the students' career choice and earning potential.

METHODS: GPAs, job placement, and starting job salaries were compared between graduates who completed the dual PharmD/MBA program and those who completed only the PharmD program. A satisfaction survey instrument was administered to 17 students who completed the dual PharmD/MBA degree program in May 2007. Data from a standardized job placement and starting salary survey instrument completed by all PharmD graduates were also obtained, as well as all students' final grade point averages (GPAs). GPAs, job placement, and starting job salaries were compared between graduates who had completed the dual PharmD/MBA program and those who had completed only the PharmD program.

RESULTS: The graduating GPAs of dual-degree students were higher than those of both pharmacy (3.52 vs 3.41, p > 0.10) and business (3.82 vs. 3.68, p = 0.018) students not enrolled in the dual-degree program. Dual-degree students were slightly less likely to enter a residency (17% vs. 27%, p = 0.44) than other pharmacy graduates. Among those who elected not to pursue a residency, both mean starting salaries ($111,090 vs. $101,965) and mean total first-year compensation ($127,290 vs. $110,388) were significantly higher for dual-degree graduates compared to the PharmD graduates.

Average physician salaries according to the Bureau of Labor Services

What does the U.S. Bureau of Labor Services (BLS) report as the average salary of a physician?

http://www.graduan2u.com/wp-content/uploads/2009/07/salary_jobs.jpg"In 2008, physicians practicing primary care had total median annual compensation of $186,044, and physicians practicing in medical specialties earned total median annual compensation of $339,738."

Let's look at a few specific specialties, in ascending order:

General Pediatricians $161,410
Psychiatrists $163,660
Family and General Practitioners $168,550
General Internists $183,990
Obstetricians and Gynecologists $204,470
Anesthesiologists $211,750
Surgeons $219,770

Physicians and Surgeons, All Other $173,860

These BLS numbers are much lower compared to the salary survey statistics you may find through the Medical Group Management Association (MGMA) or the American Medical Group Association (AMGA). For instance, the AMGA reports the average salary for Anesthesiologists as $366,640. So, who's right? I suppose we'll never know.

Entry-level non-clinical physician job salaries

Let me clarify what I mean by "entry-level" here: I'm referring to non-clinical jobs that physicians may find if they leave clinical medicine to pursue a non-clinical job in a company (such as a medical communications company, a health IT company, pharma/biotech, a consulting company, etc.).

So, let's look at several examples:

• A primary care physician who's making $120k/year leaves clinical medicine and begins to work in a a medical education company. How much could he/she make?
• A medical school graduate chooses not to pursue residency. He/she chooses to work in a consumer health company. How much could he/she make?
• An MD/MBA grad completes residency (earning around $50k/year as a senior resident) and finds a corporate consulting job. How much will he/she make?
• An oncologist who has been practicing medicine for 10 years leaves the practice of medicine to work in pharma. How much could he/she make?

Is there an "average" figure for the examples above? Suppose the range is roughly $80k to $250k/year, so the average is $165k/year. Is that accurate? Not quite. Should we be looking at mean, median, or mode?

The reality is that many entry-level jobs will not pay above $150k/year unless you're a medical specialist. If you lack corporate experience, then you're in a different category compared to physicians who have extensive corporate work experience.  Some sources will tell you that entry-level job salaries for an "average" physician ranges roughly between $90-130k/year.  How do you make an argument that you deserve $130k/yr if a company offers you $90k/yr?  Several key factors impact this salary range. They include:

• Geography. Living costs will greatly influence your salary.
• Budgets. Some companies have much more negotiating "flexibility" around budgets. Others have very rigid budgets.
• Risk. Some managers have a "high risk/high reward" mentality and they may be willing to take a big risk by paying a high salary to acquire the best talent. 
• Gender. Even today, men tend to earn higher salaries compared to women. It's not fair, but it's what frequently happens.
• Type of industry. Salaries for a "medical director" in industry #1 could vary tremendously compared to industry #2. Some companies simply have deeper pockets and bigger budgets. 
• Your negotiation skills. 

To ensure that you receive a competitive salary, you need to have very strong negotiating skills. I've found that most physicians lack such salary negotiating skills because they haven't had much experience in this area. If you're considering a new job, make sure you don't undersell yourself.

Physician Executive Compensation

The American College of Physician Executives (ACPE) has a nice article on physician executive compensation on their website. Here are some snippets from the 2009 Physician Executive Compensation Survey:

According to the 2009 survey results, physician executive median compensation averages $288,000, representing a two-year increase of 11.6 percent from the 2007 survey at $258,000 and a 10-year increase of 44 percent over the median compensation reported in the 1999 survey at $200,000.

The respondents to the 2009 Physician Executive Compensation Survey represent 57 medical specialties. Of these, eight specialties are represented by at least 50 respondents and account for 67 percent of the total respondents.

Practice of Clinical Medicine	Yes	No
Does your organization compensate you for time lost from clinical productivity?	25%	75%
Do you continue to practice medicine?	68%	32%
Is maintaining clinical hours a requirement of your job?	42%	58%

Visit the ACPE website to read the 2009 Physician Executive Compensation Survey.

Medical Director salary ranges

What is the average salary of a "Medical Director?" The next question should be, "what type of medical director?" What industry are we referring to?

Medical directors in one industry may have an annual salary of $130k while medical directors in a different industry may average over $300k per year. That's quite a difference, isn't it?

Where do medical directors make less? Generally in industries such as non-profit organizations, medical education/publishing companies, government organizations, smaller companies, etc.

Where do medical directors make more? Managed care organizations, pharmaceutical and biotechnology companies, consulting firms, hospital settings, etc. Click here to view managed care medical director salary survey results from the December 2009 Managed Care Magazine (Source: Cejka Search, 2009 Physician Executive Compensation Survey)

So, what is the salary range for a medical director? There's actually an active discussion in the American College of Physician Executives (ACPE) group on LinkedIn where one physician asked, "What resources would you suggest that are accessible (meaning free) that can be used to benchmark appropriate salary levels for a medical director?"

Top 10 Highest Paying Non-Clinical Careers

The other day, I was having a discussion with a physician about non-clinical careers and salaries. The person asked, "what are the highest paying non-clinical careers for physicians?"

If you search on Google, you won't find the answer. You may find this article on Monster.com that lists 10 non-clinical careers (but most of these positions are not for physicians).

1. Healthcare Administrator
2. Health Educator
3. Medical Social Worker
5. Medical Equipment Preparer
4. Mental Health Counselor
6. Athletic Trainer
7. Rehabilitation Counselor
8. Medical Records and Health Information Technician
9. Medical Secretary
10. Medical Transcriptionist

Annual salary of Los Angeles County's Superior Court judges

This may seem a bit off-topic, but I was reading a fascinating story on CNN about Richard Fine who's been held in solitary confinement at Los Angeles County Men's Central Jail for 14 months, even though he's never been charged with a crime. Fine, a 70-year- old taxpayer's advocate who once worked for the Department of Justice, is being held for contempt of court.

Here's the interesting part of the story:

For the last decade, Fine has filed appeal after appeal against Los Angeles County's Superior Court judges. He says the judges each accept what he calls yearly "bribes" from the county worth $57,000. That's on top of a $178,789 annual salary, paid by the state. The county calls the extra payments "supplemental benefits" -- a way to attract and retain quality judges in a high-cost city.

I have no way of knowing what's true vs. false, but I'm simply quoting a segment from CNN.

So, why am I blogging about this CNN story? It's to talk about the issue of salary. So many people think that doctors make very high salaries. Some certainly do, but so many don't. When we compare ourselves against other professions, how do we view ourselves? If we look at the legal sector, we know that judges aren't necessarily making more compared to private attorneys. Medical attorneys who work in the private sector may bill doctors $300-500 per hour for their services related to medical employment contract review/negotiation, medical malpractice defense, etc. Plus, lawyers get to charge for their time on the phone. Physicians generally don't charge their patients for a phone consultation.

If you're a physician, how do you view your salary expectations if you're considering a career change? Do you expect to see a dramatic change? Maybe you'll still find yourself moonlighting so that you can live and maintain a certain lifestyle.

A discussion about physician salaries on Sermo

On Sermo, you'll find physicians (and only physicians) discussing all types of things. A recent discussion has focused on the validity of national physician salary surveys.

Here's what one physician posted on Sermo:

I've researched average physician compensation for a number of specialties, including my specialty using stats from AGMA, MGMA, and other sources. I am consistently struck by how low these figures are compared with individuals I know and others I know about.

I know the limitation of these statistics is that they usually only represent employed physicians. I thought it might be interested to see whether you believe the average income (and upper and lower ranges) for your specialty is correct, and what you think the implications are.

The reality is that most physicians voted that these numbers are inflated. In some cases, they're up by 25-30%. In other cases, over 50%. As a result of these published figures, new graduates are feeling entitled to very high salaries.

Top Ten Highest Paid Medical Specialties

Here's some data from the 2009 AMGA Medical Group Compensation and Financial Survey. I got this table from National MedPoll. Do you think these numbers are accurate? If these are self-reported figures, then they could be inflated. Physician salary ranges tend to vary quite a bit based on your geography and your practice setting. Let's take a look: 

Specialty	Median Salary in 2009
Orthopedic Surgery – Spine	$641, 728
Orthopedic Surgery – Joint Replacement	$580,711
Neurological Surgery	$548,186
Cardiac and Thoracic Surgery	$507,143
Diagnostic Radiology – Interventional	$478,000
Orthopedic Surgery	$476,083
Trauma Surgery	$465,773
Orthopedic Surgery – Hand	$465,006
Diagnostic Radiology – Non-Interventional	$438,115
Transplant Surgery – Liver	$433,333

Source: 2009 AMGA Medical Group Compensation and Financial Survey

Alternative Careers in Science and Medicine

There's an old PowerPoint presentation by Carl Clay, PhD titled, "Alternative Careers in Science and Medicine." You can easily find it out there on the Internet by performing a search on Google or by clicking on the links below. The data appears to be from 2004 (salary data from HotJobs.com and Abbott-Langer.com), but the slides contain some very useful information for any physician or scientists interested in scientific/medical writing.

He starts with a section called, "Careers in Science and Medical Writing."  Then, he provides some details about his company, and then moves to "What Employers Look For" and "What Employees Look For." Then, he tackles the topic of salary (What Kind of Salary can I Expect?) and ends with a section titled, "Writing and Job Search Resources." It's a nice presentation, even though the day is from 2004.

A difference of $3.5 million

There's a great story on Bloomberg Businessweek titled, "For Health Care to Work, These Doctors Need a Big Raise." It starts with this:

Specialists earn $3.5 million more, on average, than general practitioners over the course of a career. A federal panel wants to reduce the discrepancy.

In this story, James Warren writes how a family physician or general internist averages about $160,000 a year, according to the nonprofit Robert Graham Center. A specialist averages $267,000 (seems low to me). That means the generalist will earn about $3.5 million less over a lifetime.

If we do the math (sorry, I can't help it because I went to MIT), we'll see that the difference is $107,000 per year. If we continue to work backwards, we see that to get $3.5 million, the average doctor is working approximately 32.7 years in his or her career. Does that seem right? We must remember that a generalist has a 3-year residency whereas most specialists have a longer residency (anywhere from 3 to 10+ years if we're including fellowships). So, is this calculation accurate?

5 frequently asked questions from physicians considering non-clinical career transitions

I speak with many physicians who are interested in leaving clinical medicine to pursue an alternative career (non-clinical job) and they always seem to ask the same types of questions. Let's dig into some of those "Frequently Asked Questions (FAQs)" by exploring some common questions that are rooted in myths and misconceptions.

Here are some questions that I get all the time from physicians who are considering a career transition:

1. How do I "break in" to the industry (such as pharma) when I don't have any pharma experience? All the jobs seem to require industry experience.
2. What type of salary ranges can I expect?
3. Do I need to complete a residency? 
4. How much travel is generally involved with these types of jobs?
5. Do I need to get an advanced degree like an MBA, an MPH, (or an MS in informatics for a health IT job)?

The answers to some of these questions can be rather complex, but let me address a few issues:

First, you don't need to complete a residency or get an advanced degree to be successful in the non-clinical world. Board certification is helpful (and is necessary for certain types of positions in medical management, managed care, etc.). An MBA, MPH, or MS offers no guarantee that you'll succeed. It may provide you with additional resources,