http://www.rsna.org/Publications/rsnanews/November-2010/salaries_feature.cfm
Radiology Salaries Remained Flat in 2009
The changing face of healthcare and the faltering economy are among factors continuing to impact radiology salaries, which hovered just above the rate of inflation or flatlined altogether in 2009. Nevertheless, experts say those numbers should begin rebounding in 2010.
Brad Vaudrey, M.B.A., C.P.A.
Stephen Chan, M.D.
"I expect compensation to gradually start picking up again, but the days of double-digit increases are behind us at this point," said Brad Vaudrey, M.B.A., C.P.A., a director with RSM McGladrey's Health Care Consulting Group, which administered the 2010 American Medical Group Association (AMGA) 22nd Annual Medical Group Compensation and Financial Survey. "I don't see a lot of groups planning to significantly increase their physician compensation just yet, but I still expect the future trend to be a little bit above inflationary rates when taking into consideration increases in productivity."
Based on 2009 data, AMGA's findings are the result of the survey sent to more than 2,700 medical groups in January 2009. RSM McGladrey received responses from 248 medical groups representing 49,700 providers.
Cardiac/thoracic surgeons were the highest paid specialty, with a median salary of $533,084, while orthopedic surgeons ranked second with a salary of $500,672; compensation for both increased 5.1 percent.
Of the 30 specialties surveyed, interventional radiologists scored third highest and diagnostic radiologists earned the fifth highest salary for 2009.
With a median salary of $454,205, diagnostic radiologists' compensation increased by 3.7 percent in 2009, while interventional radiologists reported a median salary of $478,000, which was unchanged from the year before.
Specialties with the highest compensation increases from 2008 to 2009 were pulmonary disease at 10.4 percent, dermatology at 7 percent and urology at 6.4 percent. Median salaries for the specialties were $267,148 for pulmonary disease, $344,847 for dermatology and $383,029 for urology.
The survey's finding of an overall weighted average increase of 3.4 percent was slightly lower than the 4.1 increase averaged over the last four years, Vaudrey said. "Radiology wasn't the only profession hit this yearit was widespread."
"Ebb and Flow" Impacts Specialty
Salary increase percentages for both specialties dropped from 2008 when diagnostic radiologists' compensation increased by 4.8 percent and interventional radiologists received a 3.19 percent pay increase. Flat salaries for interventional radiologists in 2009 were partially caused by market adjustments, Vaudrey said. "In 2005 and 2006, interventional radiology had double digit growth due to new technology creating higher revenue and higher demand," Vaudrey said. "After a surge like that, we expect an adjustment period to follow and compensation to level off.
"Even with the lower reimbursement pressures, considering the number of interventional radiologists and the continuing demand, I don't expect to see compensation going down in the specialty," Vaudrey said. "It will probably keep going up but at a much slower pace. It's an ebb and flow."
The steady increase in salaries for diagnostic radiologists was in keeping with the overall consistency of the specialty, Vaudrey said. "For traditional diagnostic services there is a more consistent service line, consistent work effort and consistent reimbursement," explained Vaudrey.
Overall, approximately three in four specialties reported compensation increases, including primary care specialists who received a 3.8 percent increase, according to Vaudrey. Salaries for that specialty are likely to continue rising, Vaudrey said.
"We are seeing a lot of investment in primary care with the medical home model," Vaudrey said. "The specialty is experiencing physician shortages and better reimbursement after four or five years of non-increases. As they catch up to the market, those factors are coming into play."
While the sweeping new healthcare reform law will undoubtedly have financial ramifications, it is soon to predict the impact on radiology compensation increases, Vaudrey said. "We do know that medical groups have a strong interest in how compensation pay plans will be restructured," Vaudrey said. "In coming years, we will likely see significant changes in terms of greater focus on incentivizing quality and cost saving metrics."
Interventional Radiologists Work More for Same Pay
Despite a flat compensation, interventional radiologists did register an increase in one category in 2009: workload. Interventional radiologists showed a 5 percent increase in Relative Value Units (RVU)the primary measure of a physician's productivity at the majority of participating medical groupsin 2009. "The amount of work that went into maintaining their salaries had an above average increase," Vaudrey explained.
For non-interventional radiologists, RVUs increased by 1.1 percent in 2009. "This increase in work effort is more in line with other specialties," Vaudrey said.
Cardiac/thoracic surgeons showed the largest increase in RVUs, jumping 6.68 percent in 2009, while the average increase in work RVUs was 1.2 percent for the specialties surveyed, Vaudrey said. Primary care remained fairly flat, while other medical specialties increased by 2.7 percent and surgical specialties went up an average of 3.0 percent, he said.
Outlook Relatively Bright
Although radiology salaries were essentially stagnant in 2009, the specialty will "continue to do well in the long term," despite increased competition from other specialists including cardiologists and neurologists, said Stephen Chan, M.D., an academic radiologist at New York's Columbia University and a member of RSNA's Professionalism Committee. Dr. Chan received a 2001 Education Scholar grant from the RSNA Research & Education (R&E) Foundation for graduate study in educational informatics to develop a program in radiology management.
"With the contracting healthcare dollar, radiologists can expect to face more competition," Dr. Chan said. "Nevertheless, we have always had this concern. In 1993 we started worrying about healthcare reform under the Clinton administration, in the late 1990s no one was hiring and we worried about the future of our profession," he continued. "Next, we worried about the growing number of subspecialists. All those worries were followed by a radiology job boom in 2000s."
Despite a lackluster year salary-wise, the future bodes well for radiology, given the significant increase in imaging volume and anticipated physician shortages, Dr. Chan said.
"Radiologists are well placed," Dr. Chan said. "As long as we are valued by the people who send us patients, I have full confidence we will continue to thrive. Wherever we maintain robust connections within the medical structure, our practices will continue to remain strong."