A new ranking of the most-sought specialties from physician recruiting firm Merritt Hawkins finds that population health management and a shift to team-based care are driving strong demand for primary care providers (PCPs), but that hospital recruitment of doctors has declined for the first time since 2003-2004.
The report is based on more than 3,100 physician and advanced practitioner search assignments the company received between April 1, 2014, and March 31, 2015. The most-recruited specialties were:
- Family medicine;
- Internal medicine;
- Nurse practitioner;
- Orthopedic surgery;
- Emergency medicine;
- Pediatrics; and
- General surgery.
Demand for PCPs, psychiatrists
Overall, six of the 10 most-recruited specialties were related to primary care. Kurt Mosley, VP of strategic alliances at Merritt Hawkins, says the demand for primary care positions reflects the rise of team-based care and population health management. "For a while the specialists were the key to everything because they generated inpatient revenues," he explains. "Now it is team-based health, the chronic care model."
The relationship between mental health and population health management is also driving increased demand for psychiatrists, Mosley says. The latest report ranks psychiatry higher than it has been in the 27 years tracked by Merritt Hawkins. Demand is expected to increase further, as almost half of psychiatrists are expected to retire over the next five years, according to Mosley.
Hospitals' physician recruitment declines
However, hospitals accounted for only 51% of total recruitment in the survey—down from 64% over the past two years, marking the first decline since 2003-2004.
Merritt Hawkins attributed the drop to:
- Hospital closures, especially in rural areas;
- Budget sequestration;
- Declines in in federal disproportionate share payments;
- States deciding not to expand Medicaid through the Affordable Care Act; and
- Non-hospitals increasing their recruitment efforts.
"It's more of a diversified market," says Travis Singleton, a senior VP at Merritt Hawkins.
Singleton expects hospital recruitment of physicians will increase in the coming years because of the Supreme Court's recent ruling upholding the federal exchange subsidies in King v. Burwell. "We will see more and more hospitals get more into the game," he says. "The course is set."
Pay still lags behind demand
Despite high demand for PCPs, their compensation still lags behind other specialties. Merritt Hawkins found that the average primary care doctor it recruited made $198,000 last year, significantly less than most other specialists—such as urologists (ranked 14th most-recruited), who made an average of $412,000.
Don Beckstead, program director for Altoona Family Physicians Residency, hopes the pay gap will begin to narrow as the role of primary care doctors changes. "I would argue that family docs these days are seeing more and more difficult patients and handling more and more difficult patients and therefore should be reimbursed accordingly," he says (Commins , HealthLeaders Media, 7/15; Commins , HealthLeaders Media, 7/15; Henry, Healthcare DIVE, 7/21).