Demand for specialists driving physician recruitment while primary care hiring is down

Hospitals, medical groups and other healthcare facilities are seeking more medical specialists  and fewer primary care physicians, according to an annual report tracking physician starting salaries and other physician recruiting trends.

Prepared by Merritt Hawkins, a company of AMN Healthcare, the 2019 Review of Physician and Advanced Practitioner Recruiting Incentives tracks a sample of 3,131 physician and advanced practitioner recruiting engagements the firm conducted from April 1, 2018, to March 31, 2019.

Now in its 26th year, the report shows Merritt Hawkins is conducting a growing number of search engagements for medical specialists while conducting fewer searches for primary care physicians relative to recent years.

"While demand remains strong for primary care physicians, specialists are increasingly needed to care for an older and sicker population," said Travis Singleton, executive vice president of Merritt Hawkins. "In some medical specialties, shortages are emerging that will pose a serious challenge to public health."

WHAT'S THE IMPACT

The report indicates that 78% of Merritt Hawkins' recruiting engagements in the last year were for medical specialists, up from 67% four years ago. By contrast, the number of searches the firm conducted for primary care physicians -- family doctors, internists and pediatricians -- declined by 8% year-over-year and by 38% compared to four years ago.

In its latest review of physician supply and demand, the Association of American Medical Colleges projects a shortage of up to 67,000 specialists by 2032.

Merritt Hawkins' search engagements are also growing in a number of medical specialties in which severe shortages are anticipated. For example, a study published in Arthritis Care & Research projects that by 2030, demand for rheumatologists will exceed supply by 100%. The number of infectious disease training programs now fill fewer than half their classes, according to Singleton, while deaths due to drug-resistant pathogens are predicted to rise rapidly, resulting in a looming shortage of infectious disease specialists.

There are about 7,300 certified geriatricians in the U.S. today, and the American Geriatrics Society projects 30,000 will be needed by 2030.

The report also shows that, for the fourth year in a row, psychiatry was the firm's second most requested search, highlighting a critical shortage of psychiatrists nationwide.

"The shortage of medical specialists flies under the radar, but it is a serious public health concern that deserves more attention," Singleton said.

WHAT ELSE YOU SHOULD KNOW

Physicians practicing invasive cardiology have the highest average starting salaries tracked in Merritt Hawkins' report at $640,000, followed by orthopedic surgeons at $536,000, gastroenterologists at $495,000, and urologists at $464,000. Family physicians are at the lower end of the physician pay scale with an average starting salary of $239,000. The average signing bonus offered to physicians is $32,692.

Meanwhile, the use of value-based physician payments is gaining momentum. Of those Merritt Hawkins clients offering physicians a production bonus last year, 56% were based in whole, or in part, on value-based metrics such as patient satisfaction and outcome measures, up from 43% the previous year and 39% two years ago.

THE LARGER TREND

In 2018, the Healthcare Financial Management Association and Navigant surveyed 101 CFOs and operations executives and most predicted labor budget increases and continued shortages of physicians, nurses and mental health providers. Because of this, reducing hospital operating expense was a primary focus.

Continued staffing shortages including nurses, physicians and mental health providers.

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com