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Survey Finds Demand for Medical Specialists On Rise

— Several factors are making specialists hot commodities, but psychiatrist shortage persists

MedpageToday

In an annual healthcare staffing , family physicians rank as the top requested recruiting assignment for the 12th year in a row, but demand for specialists is trending upward.

Recruitment activity is shifting toward medical specialists, according to the 2018 Review of Physician and Advanced Practitioner Recruiting Incentives. The survey, published by Dallas-based Merritt Hawkins, found that 74% of search assignments were for specialists, up from 67% 3 years ago.

In , the survey found that invasive cardiologists had the highest average starting salaries, at $590,000. Orthopedic surgeons were second, at $533,000.

Three factors are driving increased demand for medical specialists, starting with the country's aging population, said Travis Singleton, Merritt Hawkins executive vice president.

"It is specialists such as cardiologists, orthopedic surgeons, pulmonologists, and others who care for the ailing organs, bones, and brains of our fastest-growing patient cohort -- seniors, who are disproportionate users of care."

Lifestyle-related disease and behavioral health are also increasing the demand for specialists, he said. "Rising rates of obesity, diabetes, drug abuse, and mental health problems are creating a sicker patient population, the kind commonly treated by specialists."

The third factor boosting demand for specialists is the cyclical nature of the physician employment market, Singleton said. "Hospitals, medical groups, and other healthcare facilities have emphasized primary care recruitment in recent years, and now they need specialists to whom their primary care doctors can refer."

The survey was conducted from April 2017 to March 2018, and is based on a sample of 3,045 clinician search assignments. In addition to the medical specialist and top compensation findings, the survey has six other key points:

  • Reflecting an , psychiatrists were second on the list of Merritt Hawkins' most requested recruiting assignments for the third year in a row
  • Demand for nurse practitioners (NPs) and physician assistants (PAs) is rising; Merritt Hawkins conducted more search assignments for NPs and PAs than in any other 12-month period tracked by the company
  • While the tying of physician compensation to value is spreading, value was linked to only 8% of compensation in the survey
  • In record highs for the survey, the average physician signing bonus was $33,707, the average starting salary for family physicians was $241,000, and the average starting salary for an NP was $129,000
  • Employment remains the dominant physician staffing model, with more than 90% of Merritt Hawkins' search assignments set at employed practice settings and less than 10% at independent practices
  • In a record high for the survey, 62% of recruiting assignments were in communities of 100,000 or more; the survey authors linked the trend to the rising demand for medical specialists, who tend to practice in large communities

The shortage of psychiatrists has been worsening for years, Singleton said: "In 2005, psychiatry was number 13 in our list of most requested types of searches. Five years ago, in 2013, psychiatry was number four on the list. For the last 3 years, it has been number two, trailing only family medicine."

Psychiatrists are a dire pain point in the nation's clinician shortage, he continued. "We judge the shortage in psychiatry to be more severe than in any other specialty we recruit.

"There is little relief in sight. Though there has been increased interest in psychiatry among medical graduates selecting residency programs recently, our ability to train more psychiatrists remains limited because residency positions are limited."

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