Physician salaries increase, but productivity remains flat, finds AMGA survey

Doctor putting money in pocket
For primary care specialties, median compensation increased by 4.91% last year. (Getty/Niyazz)

Physician salaries for primary care and specialties increased last year, according to a new survey.

Physician pay increased by a median of 2.92% in 2018, according to a survey conducted by the AMGA’s subsidiary, AMGA Consulting. That was compared to a 0.89% increase in 2017.

There was good news for primary care specialties, as median compensation increased by 4.91% last year, up significantly from 0.76% in 2017, according to the survey based on data from 272 medical groups, representing more than 117,000 providers.

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While there was a wide range in compensation based on specialties, overall specialists saw an increase in overall median compensation by 3.39%. That varied from a 15.6% increase for those in psychiatry to a 0.4% decrease for those in gastroenterology.

Pay increases were offset, however, as changes in work relative value unit (wRVU) productivity, the measure used in the Medicare reimbursement formula, remained low, the survey found. Productivity increased by 0.29%, compared to a 1.63% decline in 2017. The survey also calculated compensation per wRVU ratio, which increased by 3.64%, compared to a 3.09% increase the previous year.

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“The 2019 survey shows that physician compensation in 2018 rebounded from a stagnant 2017,” said Fred Horton, AMGA Consulting president. “While productivity also increased, it did not increase enough to surpass the decline we saw in last year’s survey, meaning productivity still has not risen since 2016.”

AMGA’s 2019 Medical Group Compensation and Productivity Survey included 2018 salary data for 143 medical specialties, primary care subspecialties, advance practice providers and other clinical professionals.

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When it came to primary care medicine, family medicine physicians saw a 6.25% increase in compensation, while those in pediatrics reported a 0.04% decrease. While median compensation for all primary care specialties increased more than it had over the past several years, productivity was flat, with wRVUs increasing by only 0.21% in 2018. As a result, the median compensation per wRVU ratio increased 3.57%, the largest increase for primary care specialties in four years. 

“As healthcare organizations move from volume-based to value-based payment models, we’ve observed increased scrutiny on primary care performance. Medical groups continue to focus on delivering care in the most appropriate setting with the greatest efficiency—and often place primary care providers at the center of this strategy,” said Elizabeth Siemsen, AMGA Consulting director. The survey also shows a slow uptick in the number of part-time primary care physicians.

Medical specialties saw an increase of 1.9% in median wRVU production over last year’s survey. The compensation per wRVU ratio increased by 2.65%,

“Data from this year’s survey shows compensation is increasing without an equivalent increase in wRVU production for many specialties. This trend is causing organizations to absorb additional compensation expenses without balancing revenue from production increases,” Horton said.

Transitioning to value-based care is one strategy medical groups can use to mitigate the trend, he said, as it would help them better clarify their organizational strategies and objectives.

Nurse practitioners and physician assistants working in primary care settings also saw an increase in compensation of 2.92% and 2.50% respectively.

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