The
Medical Group Management Association (MGMA) conducts a national
survey of medical practices, private and hospital based, annually. It is one of the best indicators
of the state of medical practices. This survey is one of my most reliable resources when consulting
for a medical practice or hospital.
About 12,000 surveys are mailed out with an average return of 18% or about 2,200. The comprehensive
survey requests information on: legal organization, geographic area, specialty, number of physicians,
charges, cash, office and inpatient visits, surgeries, compensation, benefits, relative value units,
hours worked, time off, etc. The results are broken down by 50 or so specialties and sub-specialties.
While each practice is unique, the various benchmarks provide a good idea where it stands relative
to other groups in that specialty. As with most data, you need to take more than just one benchmark
into consideration before coming to a conclusion. For example, you discover your annual visits per
physician are below the median for your specialty, but your time off per physician is above the
median for your specialty. You can't take any one benchmark out of context. I looked at four key
benchmarks: compensation, cash collections, office visits and physician work RVUs for 16 specialties
and compared 2009 to 2010 survey results. While two years is more of a snapshot than a trend, it still
gives you a good idea of where things are going.
On the whole, from 2009 to 2010, median physician compensation increased 1.8% from $340,400
to $346,650; median cash collections increased 2.9% from $551,300 to $567,000; median office
visits increased 9.0% from 3,010 to 3,280; and median physician work RVUs increased 2.8% from
6,672 to 6,858. It appears, in the aggregate, the small increase in compensation was tied to the
similar increase in collections. To gain the slight increase in compensation, physicians worked harder
as noted in the increased office visits and work RVUs.
The specialties that saw median compensation decrease 1% to 3% were: cardiology, hematology/oncology,
ob/gyn, and psychiatry. The specialties that saw median compensation increase 1% to 3% were:
anesthesiology, family practice, internal medicine, pediatrics, radiology and urology. The specialties
that saw median compensation increase 4% to 6% were: gastroenterology, orthopedics, ENT, and
general surgery. Ophthalmology outpaced all specialties with a median increase of almost 8%.
The specialties that saw median cash collections decrease 1% to 5% were: gastroenterology,
ophthalmology, orthopedics, psychiatry and general surgery. Hematology/oncology cash collections
decreased 15%, most likely due to decreased reimbursement for cancer drugs. The specialties
that saw median cash collections increase 1% to 6% were: cardiology, family practice,
internal medicine, ob/gyn, ENT and pediatrics. The specialties that saw the largest increase in
collections were: anesthesiology 11%, urology 7% and radiology 27%.
The specialties that saw office visits decrease 1%-4% were: family practice, gastroenterology,
ophthalmology and urology. General surgery saw the largest decrease in office visits, 8%.
The specialties that saw office visits increase 1% to 4% were: cardiology, hematology/oncology,
internal medicine, ob/gyn, orthopedics and pediatrics. Anesthesiology and ENT saw visits increase
7% to 8%. Visits to psychiatrists and radiologists were up 23%. Leading the way in increased visits
was invasive cardiology at an astounding 37%.
Only two specialties reported 1% to 3% decreases in physician work RVUs: invasive
cardiology and ob/gyn. The largest increases in RVUs were ENT 7% and psychiatry 11%.
The rest of the 16 specialties mentioned here increased physician work RVUs 1% to 5%.
If you look at the four median benchmarks for your specialty, you might see some contradictions.
Psychiatry, for example, saw compensation and collections decline 3% and 1% respectively, while
visits and RVUs increased 23% and 12 % respectively. In this case, there isn't a contradiction
as this specialty has seen its fees significantly decreased in the past few years.
General surgeons saw compensation increase 5% while collections were down 1% and visits
were down 8%. This apparent contradiction is explained by the fact that more hospital based
general surgeons reported than private practice based general surgeons.
The annual MGMA survey of medical practices provides a lot of information on the state
of the American medical practice. It bears out two distinct trends. First, the continued
freeze on Medicare reimbursement and the continuing decline in commercial reimbursements
have taken their toll. Most physicians are working harder to maintain. Second, each year
more and more physicians are employed by hospitals. The survey is good for giving you a
general idea of where you stand in relation to your fellow specialists, be they private
practice or hospital based. It would behoove you to do a comparison to see where your
strengths and weaknesses are and to assist you with your strategic planning.
