Primary care physicians in demand, but salaries lag behind those of specialists

Primary care physicians remain in demand, but the health care market is booming for specialists that are outpacing them in average starting salaries.

Orthopedic surgeons landed on top of the starting salary list, earning an average of $565,000. Family medicine physicians in all positions, meaning nonacademic and academic, had an average starting salary of $251,000, up 3% from the year before and a new record for the Review of Physician and Advanced Practitioner Recruiting Incentives, published July 18by recruitment firm Merritt Hawkins and its parent company, AMN Healthcare.

But that amount did not crack the top 10 list of average starting salaries for various medical specialties, according to the 2022 report. It was based on a sample of the 2,695 permanent physician and advanced practitioner searches the company had from April 1, 2021, to March 31, 2022.

Getting paid

In primary care practice, pediatricians had the lowest average starting salary of $232,000, down 2% from the year before. Obstetrics/gynecology (OBGYN) had an average starting salary of $332,000, up 14% from the year before, and internal medicine physicians in all positions had an average starting salary of $255,000, up 5% from the year before.

Those areas of practice did not land on the top 10 list for physician average starting salaries. Along with orthopedic surgery, interventional cardiology ($527,000), urology ($510,000), gastroenterology ($486,000), noninvasive cardiology ($484,000), radiology ($455,000), pulmonology ($412,000), hematology/oncology ($404,000), anesthesiology ($400,000), and oral maxillofacial surgery ($368,000), all had higher average starting salaries.

In demand

The number of searches increased 10% from the year before and the report noted: “Demand for doctors is surging.”

“Demand for physicians, and the salaries they are offered, have rebounded dramatically from the height of COVID-19,” Tom Florence, president of physician permanent placement for AMN Healthcare, said in a news release. “Virtually every hospital and large medical group in the country is looking to add physicians.”

Family medicine ranked second on the list of top 20 most requested searches by specialty, with 280 in the 2021/22 period. That number has dropped every year since the 2016/17 study period, when there were 607 searches.

Family medicine dropped to 14th among the top 15 search engagements when measured by “absolute demand,” or the number of physicians compared to the number of openings, according to the Merritt Hawkins report. “By this standard, it can be argued that specialist physicians now are more highly sought after than are primary care physicians,” the report said.

Age, revenues and market forces

The report noted at least two factors driving specialty care. As the American population ages, patients will need more care specialized for specific body parts and organ systems.

Meanwhile, physicians also are revenue generators for health systems – and specialists generate more revenue. Interventional cardiology ($3.48 million), orthopedic surgery ($3.28 million” and gastroenterology ($2.96 million) were the top three for average net annual hospital revenue generated by physicians, by specialty. Family medicine ($2.11 million) and OB/GYN ($2.02 million) ranked fourth and fifth, respectively.

Primary care physicians “still have an important role to play” for care coordination for older patients, along with implementing value-based reimbursement models and accountable care organizations built on those models. “In these models, primary care physicians are the quarterbacks of the care delivery team, ensuring tasks are allocated appropriately and resources are managed efficiently,” the report said.

There are additional factors that will affect primary care. For the second time in 29 years, nurse practitioners (NPs) topped the list for Merritt Hawkins’ staff searches with 405, an increase of 170% since the 2016/17 study period. Among NPs, 88.9% are certified in an area of primary care and 70.2% of all NPs deliver primary care.

“Market disruptors” such as retailers CVS, Walgreens and Walmart, and insurance company UnitedHealth, all aim to expand primary care clinics and physician affiliations, the report said.

Help wanted

On the search list, obstetrics/genecology ranked fifth on the list of top 20 most requested searches by specialty, with 148 searches; internal medicine specialists ranked sixth with 133 searches; hospitalists ranked 12th with 63 searches; and pediatrics ranked 14th with 53 searches. All those numbers were larger than the year before, although all of them were trending downward at least since the 2018/19 study period.

The top was nurse practitioner, with 405 searches and the search number trending up. Rounding out the top five were radiology, with 162 searches, and psychiatry, with 153 searches and both numbers up from the year before.