The survey found that 91 percent of the specialties experienced increases in compensation in 2007, with the overall average increase around 3.5 percent (slightly less than 2006, when 92 percent experienced an average increase around 4.8 percent).
The primary care specialties (excluding hospitalists) saw about a 3.2 percent increase in 2007, while other medical and surgical specialties averaged around 3.7 percent. The primary care specialties saw about a 4 percent increase in 2006, while other medical and surgical specialties averaged around 6 percent.
The survey reported that during 2007 the specialties experiencing the largest increases in compensation were dermatology (8.97 percent), cardiac/thoracic surgery (8.11 percent), hematology and medical oncology (7.66 percent), pathology (7.38 percent), and hospitalists (7.32 percent). Interestingly, cardiac/thoracic surgery saw one of the largest decreases in compensation in 2006 (-2.13 percent).
“The survey indicates that compensation increases continue to fluctuate only marginally for most specialties,” said Donald Fisher, PhD, president and chief executive officer of the American Medical Group Association (AMGA).
“With the negative impact of declining reimbursements, competition for specialists, the cost of new technology, and other factors on practice revenues in most parts of the country, this situation is clearly unsustainable,” he said.
The section of the survey that examined financial operations found that medical groups were operating at an average loss of $4,728 per physician (median performance per physician), reflecting a major overall downturn from 2006 (-$119 per physician).
Again in 2007, on average, only organizations in the Western region were operating at a profit ($4,453 per physician), though profits were significantly down (from $17,317 per physician in 2006).
Organizations in the Southern region, which saw significant losses in 2006 (-$6,049 per physician), saw improvements, though they continued to operate as a loss (-$1,919 per physician). Groups in the Eastern (-5,744 per physician) and Northern (-$5,322 per physician) regions saw an erosion of modest gains achieved in 2006 (-$3,727 and -$2,944 per physician, respectively).
“In the face of the current economic climate, these medical groups continue to rise to the challenge of delivering the highest quality, coordinated care to the patients they serve,” Fisher said. “One of the components contributing significantly to the trends in financial performance of medical groups is the current payment model, and groups are now experiencing an additional burden with changes in work RVU values.
"Most of the groups represented in the survey are large organized systems of care that make substantial investments in technology, operations, and the most innovative care processes to best serve populations under their care, and are able to achieve remarkable results for their patients," he continued. "Our current transaction-based reimbursement system is indifferent to these results and to the efforts of medical groups to elevate the standard of care in the U.S. Currently AMGA is working to address the inequities of the current payment model and develop a model that incorporates a substantial component reflecting achievement of quality results.”