While primary care physicians are still the most in-demand doctors, healthcare organizations clearly began shifting their recruiting efforts to medical specialists last year, according to an annual report by Merritt Hawkins that tracks physician starting salaries and recruiting trends.
The report shows 74% of search assignments were for medical specialists, up from 67% just three years ago.
That contrasts with a drop in the number of searches the recruiting company conducted for primary care physicians—which includes family physicians, internists and pediatricians—which declined by 19% from last year and by 32% compared to three years ago.
Data were compiled based on over 3,000 physician and advanced practitioner recruiting assignments by the firm from April 1, 2017, to March 31, 2018.
The data doesn’t mean there is less of a need for primary care doctors. “We just have a shortage of doctors, period—all of them,” Travis Singleton, senior vice president of Merritt Hawkins, said in an interview with Fierce Healthcare.
“Family medicine was our number one search for the 12th year in a row, so demand for primary care doctors is still strong. But it is a mistake to believe that physician shortages are confined to primary care. Specialists also are in short supply,” Singleton said.
And specialists are still drawing those top salaries. At an estimated $590,000, invasive cardiologists have the highest starting salaries, according to the report. But the demand for family medicine physicians translated to an all-time high starting salary averaging $241,000.
Check out the list of the 10 top starting salaries, according to Merritt Hawkins:
Demand for specialists, nurse practitioners
So, what’s going on with the shift for higher demand for specialists? “It’s a matter of demographic destiny. Americans are getting older, and it is medical specialists who will be taking care of our aging and ailing bodies and brains. We still need more primary care doctors, but a growing emphasis is being placed on recruiting specialists,” Singleton said.
Specialties that provide care for patients with complex and chronic conditions will remain in high demand, he said, including physicians who provide pulmonary, gastroenterology and cardiac care.
The country could see a shortage of up to 120,000 physicians by 2030, with shortages in both primary and specialty care, according to a report earlier this year from the Association of American Medical Colleges. By 2030, the study estimated a shortfall of between 14,800 and 49,300 primary care physicians and an even greater shortfall of specialists, projected at between 33,800 and 72,700 physicians.
Part of the decline in primary care searches can be attributed to the growing use of nurse practitioners (NPs) and physician assistants (PAs), according to Singleton. The number of search assignments Merritt Hawkins conducted for NPs reached a record high and increased by 61% over the previous year, as they are being hired to fill openings at the growing number of urgent care centers and retail clinics nationwide. The demand for nonphysician clinicians is strong and when combined, NPs and PAs represent Merritt Hawkins’ second most requested search. Ten years ago, Merritt Hawkins conducted only a handful of searches for NPs and PAs. The average starting salary for NPs is $129,000, the highest amount ever recorded in the review.
Other results from the report included:
- The shortage of psychiatrists continued. For the third consecutive year, psychiatrists were second on the list of the firm’s most requested recruiting assignments, reflecting a severe shortage of mental health professionals nationwide.
- The average signing bonus for physicians was $33,707, the highest amount recorded in the 25-year history of the report.
- The use of quality/value-based physician compensation is rising. However, Singleton calls it “disappointing” that quality on average determines only 8% of total physician compensation packages tracked in the study.
- Employment rather than independent practice remains the dominant physician recruiting model. Over 90% of Merritt Hawkins’ search assignments feature employed practice settings, while less than 10% feature independent practices.
- There was an uptick in the hiring of hospitalists this year, as more hospitals are looking to employ these doctors directly rather than contract with an outside company for their services, Singleton said.