Rheumatologist Compensation and Manpower Save

The recent 2016 Annual ACR meeting in Washington, D.C. presented the ACR workforce and manpower report. These results were delivered in 10 abstract presentations, and here are the takeaway messages:

• Dr. Chad Deal said we are facing a “tsunami” of rheumatologist retirements.
• The clinical supply will drop from the current 4,997 to 3,455 by 2030.
• There will be a 138% increase in demand from 6,155 to 8,184 by 2030.
• 50% of the rheumatology workforce is projected to retire over the next 15 years with over 80% of those retiring planning to reduce their patient load by > 25% in the near term.
• The number of men and US graduates going into rheumatology has sharply declined.
• Women will comprise 59% of the workforce by 2030.
• The number of rheumatologists seeking part-time employment is rising.
• Private practice Rheums work fewer hours but see far more patients than academic rheums.
• There is a severe shortage of pediatric rheumatologists, with less than 300 nationwide and many states with no or one rheumatologist. This is complicated by a maldistribution of providers.
• There is limited data on impact of nurse practitioners or physician assistants in rheumatology.

These manpower deficits in rheumatology are multifactorial and partly due to retirements, growing numbers of women, part-time workers and millennials. Income is another important reason why internal medicine trainees may NOT pursue rheumatology as a career. Hence, the impetus for this overview on compensation in rheumatology.

Medscape recently survey 19,183 US physicians from 26 specialties regarding compensation. They also surveyed physicians on work hours per week, time (minutes) spent with patients and anticipated changes to their practice resulting from healthcare reform.

In 2012, this same Medscape survey of US physicians revealed rheumatology as the most satisfying of medical specialties. While that number has waned and rheumatologists are in the middle of the pack in recent years, it remains a high satisfaction specialty.

This recent Medscape survey reports on patient care compensation includes salary, bonus, profit sharing or earnings after taxes and deductible business expenses but before income tax.

The average 2016 compensation for patient care was $234,000, which ranked #8 (from the bottom) among 26 specialties, but was higher than in last year's compensation report, when they earned $205,000. Orthopedists and cardiologists had the top income this year ($443,000 and $410,000, respectively).

Interestingly, rheumatologists and internists noted the greatest (12%) increase in salary in the past year. Yet, only a minority (44%) of rheumatologists feels they are fairly compensated.

Geography dictates salary. The highest rheumatology salaries were seen in the Northwest ($283,000), Mid-Atlantic ($254,000), and Southwest ($253,000), while the lowest were in the Great Lakes ($207,000) and the West ($211,000).

In general these numbers are similar to the AMGA 2015 Medical Group Compensation and Productivity Survey 2015 Report based on 2014 data. The AMGA annually nationally studies physician compensation and is based on 251 practices, representing more than 73,000 providers from 134 medical specialties. (Citation source: http://buff.ly/2gmp95s)

In 2015, US rheumatologists had a median compensation of $247,112, up from $239,112 in 2014. This compares to the internal medicine income of $239,968 in 2015. Rheumatology RVU also increased in the last year from 4,558 to 4800. RVUs increased a mean of 1.1% across 15 medical specialties.

While the lowest salaries were seen in academic, research, government, military ($154,000) or rheumatology hospitalists ($164,000), the highest salaries were seen among office based group practices ($255-260,000); solo practitioners had an average $220,000 per annum income.

Overall, male ($252,000) were better compensated than female ($187,000) rheumatologists.

Growing subsets include those who work part-time (males 8%; females 23%). Important when you consider that in 2010, 48% of all medical graduates were female.

You should use this information to not only fend for yourself but to more accurately guide trainees into a richly rewarding specialty that pays well and has many distinctions to boast of, including high science, hands-on patient interactions and long-term relationships, great hours, lifestyle and family friendly careers.

Our field is in desperate need of high quality, problem-solving practitioners. You have the ability to attract and mentor the future practitioners and leaders in rheumatology. With the promise of a good income, quality patient relationships and the potential to lifetime learners, teachers and researchers, many will follow your lead.

If you enjoy being a rheumatologist, you should bring others into the clan.