Shifting salary trends

The median household income in the U.S. dropped by about $4,000 between 2007 and 2013. Is cardiology immune?

Merritt Hawkins, a firm that specializes in physician recruitment, released its 2013 review of recruitment incentives and salaries. The analysis is based on 3,097 search assignments for permanent physicians and advanced practitioners between April 1, 2012, and March 31, 2013, which is up from 2,710 in the previous 12-month period.

That suggests demand is strong and growing. Cardiology remained among the most sought after specialties, at 15th place. The specialties leading the “most wanted” category fit under primary care: family medicine, internal medicine and hospitalist. Geriatrics broke into the top 20 this year, a reflection of the growing elderly population, while radiology and anesthesiology fell off the chart.

Average income, which they defined as base salary or guaranteed income only, dropped from $512,000 in 2011-12 to $461,000 in 2012-13 for invasive cardiologists. Noninvasive cardiologists saw an increase of $51,000 for the same period. Seventy-five percent of search assignments added production bonuses to the incentives, so earnings for many physicians likely are higher.

Many other surveys include bonuses in their calculations. Merritt Hawkins argued that its narrower definition offers an indicator of “what is required to attract physicians already established in a practice or those coming out of residency training to particular practice opportunities.”

The tea leaves may prove unsettling for early career cardiologists. The low income offered for invasive cardiologists nosedived from $400,000 in 2011-12 to $300,000 in 2012-13, and for noninvasive cardiologists it declined from $275,000 to $250,000.

The low end of the scale was $325,000 for invasive cardiologists and $315,000 for noninvasive cardiologists in 2009-10.

Today’s early career physicians carry more debt, a topic that will addressed in an upcoming article in Cardiovascular Business. It appears they also may start at a lower pay point than they may have anticipated, putting them in a double-whammy financially.

Merritt Hawkins suggested that reimbursement cuts and pharmaceutical alternatives may be nipping into invasive cardiology’s earnings and that it may be a “temporary market correction.”

Of course, cardiologists entering the profession may be accepting less pay in exchange for other incentives, such as flexible work schedules or loan forgiveness deals. They may be part of the nation’s income trend, but they also may be experiencing a more satisfying career as a result.

Candace Stuart

Cardiovascular Business, editor