Merritt Hawkins’ 2018 Review of Physician and Advanced Practitioner Recruiting Incentives found that for the 12th straight year, family physicians are the most requested recruiting assignments, which shows hospitals, medical groups and other healthcare settings are increasingly seeking primary care help.
The second highest in demand recruitment assignments are psychiatrists for the third consecutive year, which shows the “severe shortage of mental health professionals nationwide,” Merritt Hawkins said.
Though primary care remains the most in demand, recruitment activity has picked up for medical specialists over the past three years, according to the paper.
The Merritt Hawkins report showed an increase in recruiting assignments across multiple areas, which highlights the shortages throughout healthcare. There was also an increased demand for nurse practitioners and physician assistants. Search assignments for NPs and PAs topped any one-year period since the review began 25 years ago. That echoes a recent Health Affairs study that found NPs made up about 25% of the provider workforce in rural areas and 23% in nonrural areas in 2016, up steadily from the rates in 2008.
These increases show that health organizations are looking more to NPs and PAs to deliver care and fill in primary care gaps connected to both physician shortages and the move to a team-based care approach.
The increase in medical specialist recruitment also points to the need for physicians to tackle more complicated health issues. “This trend is being driven by both population aging and by the growing prevalence of lifestyle and socially derived medical conditions commonly treated by specialists, such as obesity, diabetes, drug addiction, mental health and others,” Merritt Hawkins said.
The report found that invasive cardiologists topped the list for highest average starting physician salaries ($590,000) with orthopedic surgeons second ($533,000). Meanwhile, family medicine physicians finished at $241,000, which was well below the top specialties but was still the highest amount recorded for primary care in the review. There was also an all-time high for physician signing bonuses, which averaged $33,707.
Concerning payment structure, Merritt Hawkins found that less than 10% of total physician compensation deals with quality, despite the greater push for value-based care. This shows healthcare still has a long way to go on risk-based contracting.
Physician employment continues to become more of the norm. More than 90% of Merritt Hawkins’ search assignments were for employed practice settings. More complex payment structures involving multiple insurers have led many physicians to shy away from independent practices in favor of a hospital setting with fewer administrative tasks.
Most of the recruiting assignments in 2018 were for metro areas, with 62% for communities of 100,000 or more people. Merritt Hawkins said this is an all-time high and reflects “rising demand for medical specialists who tend to practice in larger communities.”
Meanwhile, healthcare continues to drive the U.S. economy. The Bureau of Labor Statistics said this month that healthcare has added 318,000 jobs over the past year. There were 29,000 jobs added in May, including in ambulatory care services, which increased by 18,000 jobs in a month, and hospitals, which increased by more than 6,000 positions.