Healthcare practitioners are usually perceived as among the best-compensated professionals working today. But within their ranks, salaries and demand can vary greatly, particularly as the industry works to respond to rapid change.
Listed here are the best-paying jobs for doctors in the most in-demand specialties right now, according to medical search and consulting firm Merritt Hawkins & Associates, a company of AMN Healthcare.
The data here is based on more than 3,100 search assignments for permanent physician and advanced practitioners in which Merritt Hawkins and other AMN Healthcare staffing companies engaged between April 1, 2014 and March 1, 2015. The compensation information listed here reflects base salaries, as opposed to total annual compensation figures that might include bonuses or benefits. As such, the list provides a picture of the incentives offered to medical professionals during the recruiting process.
Of the top 20 most recruited specialties this year, invasive cardiologists command the heftiest average base salary. These professionals can expect offers of $525,000 while being recruited, with some of the top earners bringing in as much as $650,000 in base salary alone. Orthopedic surgeons, often at the top of lists like this one, also fared well, commanding average base salaries of $497,000, with top-tier earners garnering annual paychecks of as much as $800,000.
“This is what the active market is having to guarantee to get someone to come do this job,” said Travis Singleton, senior vice president at Merritt Hawkins. “This is an accurate reflection of demand and supply.”
In pictures: The 15 Best-Paying Medical Specialties
Merritt Hawkins’ report takes note this year of demand for psychiatrists, characterizing the need for this specialty as reaching “an all-time high.”
“It’s quite possibly the scariest section for us,” said Singleton. “It’s one of, if not the oldest specialty in the market. They’re retiring at rates we haven’t seen, and we’re not replacing them.”
The greatest need for psychiatrists, said Singleton, is in inpatient treatment facilities and in rural areas, where access to mental health resources is often lowest. But younger professionals often favor urban settings and outpatient facilities, which often offer psychiatrists better incomes and higher quality of life. Despite the heightened demand for their services, psychiatrists can expect average base salaries of $226,000–far from the top earnings rungs of this list.
At the other end of the earnings spectrum, family practice physicians, though among the top 20 most requested specialties, take in average base salaries of just $198,000 — healthy compensation to be sure, but paltry wages when compared with those of other medical specialists.
Singleton cites the varying salaries of invasive and non-invasive cardiologists as reflective of the general state of compensation for medical professionals.
“Diagnostic cardiologists went down 34% year over year, versus your invasive cardiologists went up 16% year over year,” said Singleton. “At the end of the day, our system still heavily values procedural-based medicine much more than diagnostic medicine.”
The relatively high compensation paid to nurses and physicians is not the primary driver of cost increases in health care, a new Health Affairs study concludes.
Not about the pay
The relatively high compensation paid to nurses and physicians is not the primary driver of cost increases in health care, a new Health Affairs study concludes. Though both nurses and physicians are paid much more than workers with similar qualifications in other sectors, reducing their salaries would cut overall health expenditures by just 6 percent. And that is assuming that employment levels remain the same, according to the study, which was led by Sherry Glied, dean and professor of public service at the Robert F. Wagner Graduate School of Public Service at New York University. The study concluded that physicians make about 50 percent more than comparably qualified workers in other sectors and nurses were paid about 40 percent more. Nonprofessional health care workers earn slightly less. The study notes that taming health care costs will require improved productivity from the sector.
Is there a doctor in the house?
Physicians and surgeons are the most difficult hiring need of health care providers and search firms, according to a survey conducted by Health eCareers. In the survey of 565 recruiters, hiring managers and human resource professionals from hospitals and health systems, single- and multipractice physician offices and search firms named physicians/surgeons as the most pressing hiring need, followed by RNs, 49, physician assistants, 36, and nurse practitioners, 28. Thirty-seven respondents cited family medicine specialists as the most difficult type of doctor or surgeon hiring need.
Teaching behavioral telehealth care
The School of Social Work at Indiana University–Purdue University Indianapolis is adding classes in behavioral telehealth to its online graduate program. “Significant increases in digital network accessibility and affordability are providing the means for expanding telebehavioral mental health and substance abuse services,” says David Wilkerson, an assistant professor of social work at the school, in a news release. Wilkerson says the three courses they are adding are an important first step toward the possibility of creating state licensing requirements in behavioral telehealth.
The U.S. Labor Department is warning companies not to misclassify some workers as independent contractors instead of full-fledged employees. Experts say healthcare companies need to make sure their employment practices are in compliance.
David Weil, the department’s administrator, issued a guidance document this week emphasizing to employers that although independent contractors are widely used, “most workers are employees” under the Fair Labor Standards Act, and therefore deserve protections such as a minimum wage, overtime compensation, unemployment insurance and workers’ compensation. Workers’ compensation coverage can be particularly important to healthcare workers, who suffer from one of the highest rates of musculoskeletal injuries among all U.S. industries.
This move comes after the Labor Department recently proposed a new rule that would make up to 5 million more people eligible for overtime pay, which could affect some healthcare workers who are paid on an hourly basis. The latest document is just guidance, not a new rule, said Maria Greco Danaher, a partner specializing in employment law at Ogletree Deakins in Pittsburgh, but it reminds employers that they need to evaluate the status of their workers.
“It’s a red flag to say, if you haven’t looked at this (regulation) lately, it’s time to review it,” Danaher said. “And if you’ve looked at it and have dismissed it, it’s time to raise this review.”
The department outlines six factors that should guide employers’ understanding of whether a worker should be classified as an employee. Taken together, the factors are intended to indicate whether a worker is economically dependent on the company in question. For example, if a worker performs work that is integral to the company’s business, they’re more likely to be an employee, not a contractor, and they should also be considered an employee if their work is permanent rather than intermittent or indefinite.
The guidance also asks employers to consider whether the employee’s ability to manage himself affects how much money he makes. For example, if a home health worker is able to independently schedule his own work, solicit additional work and promote his own services, then he’s more likely to be classified as an independent contractor, as opposed to a worker who takes assignments determined only by his company.
If the worker is investing a significant amount of money or resources into his or her work, then he’s likely to be an independent contractor. But if a company is providing the employee with most of the tools and resources needed to complete his job, he’s more likely to be an employee, the Labor Department says.
The guidance also advises employers to consider whether the worker is providing a special skill and is offering that skill independently to the employer. Some healthcare companies might consider using independent contractors for specialized procedures, lab tests or technology needs where a provider isn’t needed on a regular basis, said Adam Abrahms, a healthcare and labor attorney with Epstein Becker & Green in Los Angeles.
But in many cases, those specialized contracted providers will come from a staffing agency, Abrahms said, which would in turn employ the workers as full-fledged employees. In that case, it’s important for healthcare organizations to protect themselves with an indemnification clause in the vendor contract, in case the contractor sues both companies regarding employment issues, he said.
Lastly, the Labor Department notes that companies need to consider the amount of control they exert over their workers. If an employer is setting a worker’s hours, wage ranges and implementing other parameters, they’re more likely to be considered an employee. According to one example provided by the Labor Department, a nurse who is matched with clients via a registry that limits how much work the nurse can take on should be considered an employee. A nurse who only uses the registry to find clients, however, is a contractor.
More and more doctors are directly employed by health systems rather than independent contractors. However, physicians are exempt from the Fair Labor Standards Act, so the latest guidance doesn’t apply to them, said John Thompson, a partner specializing in wage and hour law at Fisher & Phillips in Atlanta.
Employers that don’t heed the Labor Department’s guidance could face investigations and lawsuits from the department or their employees.Thompson said recent media attention to the rule could encourage more employees to sue regarding their employment status.
Thompson added, however, that the document does not establish new requirements but rather is intended to remind employers to be aware of their responsibilities for their workers. “What it mainly does is draw together a number of lines of thought that many at the Labor Department and many courts have been applying.”