An Overview of the Salaries, Bonuses, and Other Incentives

Written by on May 1, 2014 in Features - No comments

Customarily Used to Recruit Physicians, Physician Assistants and Nurse Practitioners

Merritt Hawkins’ 2013 Review of Physician Recruiting Incentives reveals a number of trends within the physician and advanced practitioner recruiting market, including:

Primary care physicians remain at the top of the wish list for most hospitals, medical groups and other healthcare organizations. For the seventh consecutive year, two types of primary care physicians — family physicians and general internists — were Merritt Hawkins’ top two most requested physician search assignments.

Demand is increasing rapidly for non-physician practitioners, including physician assistants (PAs) and nurse practitioners (NPs). For the first time in the 20 years Merritt Hawkins has been conducting this review, PAs and NPs were among our top 20 recruiting assignments.

Geriatricians, who are members of a relatively new specialty, are being more aggressively sought to supplement or enhance elder care traditionally provided by internists, pulmonary and palliative care specialists. For the first time in this Review, geriatrics is among Merritt Hawkins’ top 20 most requested search assignments, as a growing number of healthcare facilities require assistance in finding physicians specializing in elder care.

Demand also continues strong for physicians providing inpatient care. After family physicians and general internists, hospitalists ranked third among Merritt Hawkins’ top 20 search assignments. Hospitalists can reduce patient hospital stays, medical errors and hospital readmissions while increasing patient satisfaction – all goals central to new delivery models such as Accountable Care Organizations and emerging quality-based payment systems.

Other hospital-based physicians, particularly emergency medicine physicians, are in increased demand, as data show that a greater prevalence of insured patients does not necessarily decrease emergency room visits – a significant trend as millions of the previously uninsured begin to obtain coverage through the Affordable Care Act (ACA) and will seek “convenient care” in the ER.

The dearth of psychiatrists continues to represent a “silent shortage.” Psychiatry was fourth on the list of Merritt Hawkins’ most requested search assignments. Though the shortage of psychiatrists receives less attention than the primary care shortage, the 2013 Review suggests it remains equally acute, and that clinicians other than psychiatrists will be needed to provide behavioral care.

Demand for some medical specialists has decreased. Radiology, which was Merritt Hawkins’ most requested specialty in 2001, 2002, and 2003 did not make the list of Merritt Hawkins’ top 20 most requested specialties in 2013. Anesthesiology, formerly a top recruiting assignment, also did not make the list.

The recruitment of physicians into independent practice settings such as solo practice and partnerships has almost entirely abated. Sixty-four percent of Merritt Hawkins’ search assignments in 2012/13 featured hospital employment of the physician, up from 11% in 2004.

A proliferating number of sites of service, including free-standing emergency departments, community health centers, retail clinics, and urgent care centers, are recruiting physicians, a sign that healthcare providers have adopted a strategy predicated on being “everywhere, all the time.” Like hospitals, these facilities also are employing physicians.

Seventy-five percent of Merritt Hawkins 2012/13 search assignments featured a salary with production bonus. Most such bonuses (57%) are based on a Relative Value Units (RVU) formula. However, a growing number of production formulas also feature quality-based metrics. Thirty-nine percent of the search assignments Merritt Hawkins conducted in 2012/13 offering production bonuses featured a quality-based component, up from 35% the previous year.

Demand for physicians is not confined to traditionally underserved rural areas. Merritt Hawkins worked in 48 states in 2012/13 and 49% of the firm’s search assignments took place in communities of 100,000 people or more, the highest percentage in the 20-year history of the Review.

By Philip Miller
VP Communications, Merritt Hawkins

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