Physician compensation trends

Seven ASC leaders spoke with Becker's on physician compensation trends they've noticed in the last year. 

Editor's note: These responses were edited lightly for clarity and brevity. 

Allan Peck, MD. Gastroenterology specialist (Montgomery, Ohio): Physician compensation will continue to face downward pressures as the federal government becomes more involved with healthcare changes and hospitals increase their share of bundled payments and cost savings. Physicians will need to explore more ancillary opportunities and increase their strength through numbers to overcome the powerful forces of big government and hospital lobbies.

Amar Setty, MD. CEO of Patient Premier (Baltimore): Physician compensation trends are down slightly overall in 2021. COVID-19-related volume declines were offset by government payments. With increasing medical practice inflation, relative salaries are down compared to traditionally small annual increases. Personally, I've seen an increase in working hours combined with a lower annual salary. As physicians in the midst of a global pandemic with so much suffering, we continue to work hard and try to ignore our compensation. 

Bill Rhoades. Medical director of the Harrisburg (Pa.) Endoscopy and Surgery Center: CMS has lowered physician compensation for many things. This trends to the commercial insurance companies as well. The cost of everything has gone up, so in turn this makes the profitability of the ASC lower and thus will make the compensation for the physician owner lower. New physicians are coming out of medical school and fellowships with large debt and then do not have the capability to invest into an ASC, which also plays a role in the future of physician-owned ASCs.

John Prunskis, MD. Interventional pain specialist and CMO of DxTx Pain and Spine (Chicago): There are several private practice models for specialist physician compensation. Good specialist compensation models, such as the one at DxTx Pain and Spine, are usually tied to percentage of productivity, community outreach, patient and referral source satisfaction, collegiality and ability to work well with other healthcare professionals.

Mark Jamieson, MD. Partner at G2 Anesthesia  (Los Gatos, Calif.): Insurance companies, specifically Anthem/Blue Cross, continue to find ways to deny physician anesthesia payments to even contracted physicians. Two recent examples for nonpayment was a checkbox delineating nurse anesthetist versus physician care. The insurance company saying this was not filled out when we are a physician-only anesthesia group seems silly. The other was "nonlegible" names on anesthesia records. These are examples of nonpayment and delayed payment for contracted physicians. There are thousands more stories on noncontracted physicians and payment denials.

Stephen Amann, MD. Gastroenterologist with Digestive Health Specialists (Tupelo, Miss.): Gastroenterology physician compensation clearly decreased in the COVID-19 pandemic. As we work through those losses and work on getting back to full capacity, unfortunately, some insurance companies have made significant cuts in gastroenterology in both physician and ASC reimbursement. This will have a clear effect on the bottom line and continue to put pressure on gastroenterology compensation. Astute practices are continuing to search for ancillaries and other ways they can provide access for patients for complete gastroenterology medical care. This may help offset some of those losses. In addition, many will continue to seek out ways to work with compensation models and risk sharing with payers. 

Russ Arjal, MD. Gastroenterologist at Evergreen Health (Kirkland, Wash.): Associate compensation will continue to rise as private groups try to compete for talent with hospitals. The aging gastroenterology physician workforce and retirements post-COVID-19 and post acquisition will amplify this trend. I am of the opinion that younger physicians are more reluctant to buy into ASCs given uncertainty and potential for disruption. I also believe that gastroenterology will become a virtual-first space in the next five years, and this will change compensation models and talent acquisition as remote cognitive work and flexibility will become a part of the conversation. 

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