Doctors are reacting to changes in the health care system — and their job placements are proof.
Merritt Hawkins, a national health care consulting and recruitment firm, shed some light on the situation through the company’s annual look at physician recruitment trends. The 2013 review was based on a survey of 3,097 permanent doctor and advanced practitioner job assignments conducted by Merritt Hawkins and two other staffing companies.
The job placements spanned 48 states, and included communities of all sizes in both rural and urban settings.
Consistent with the national dialogue about increasing health care access to the underserved, Merritt Hawkins found that hospitals and medical groups are continuing to seek primary care physicians, nurses and assistants.
This year was also the first in which employers requested significantly more geriatricians than in past years. This specialty, which focuses on elderly populations, was among the firms’ top 20 most recruited. With more than 20 percent of the country set to be 65 years old or older by 2050, serving an older population has already changed the need for tailored health care services.
“It’s interesting that our youngest doctors are treating our oldest patients,” said Travis Singleton, senior vice president at Merritt Hawkins. “But I think that some of it is just reclassification, it was happening already.”
Meanwhile, other specialties, such as radiology and anesthesiology, didn’t make the top-20 list for 2013, despite being among the most competitive and desired positions just a decade ago.
The shift reflects both the needs of the country, and anxiety around the practice of medicine, said Dr. Atul Grover, an internist and chief public policy officer at the Association of American Medical Colleges.
“I think people are starting to look at the market and get nervous,” he said, both because of Medicare payment changes that impact doctor’s pay and the growing emphasis on preventive medicine.
Even so, in-demand primary care doctors continue to be on the lower end of the salary scale compared with other medical specialists, with an average salary of $175,000 according to the most recent Physician Compensation Report from Medscape. That’s less than half the average compensation of their peers in fields like dermatology, radiology and cardiology.
Grover said compensation is not the only factor at play. Job placement also includes finding work-life balance, limiting the time spent on paperwork and the ability to work in an interesting field.
There is also the decision of where to work — with more doctors moving to larger group practices and hospitals. Hospitalists — internal medicine doctors who work exclusively in hospitals — ranked third on the top 20 list, as inpatient care needs persist.
And despite the health law’s initiatives to curb the high cost of emergency care, Merritt Hawkins reported an increased demand for ER doctors, who often treat patients who turn to hospitals as a last resort or for convenience.
“I don’t think foresee that changing,” Singleton said, pointing out higher salaries for emergency doctors. “The mantra for doctors is now to ‘be everywhere all the time’ and they’re often the ones to do that.”
Regardless of the path they choose, and their motivation for seeking a particular specialty or field, Grover said thousands of doctors, advanced practitioners and health educators will need to be trained to address the needs of vulnerable communities in the U.S.
“It’s not just getting them access to primary care, it’s about helping them modify their lifestyle,” he said. “And that’s hard enough for well-educated, well-resourced people to do.”