Are radiologists getting paid less for working harder?

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A new survey of physician compensation and productivity found that median annual compensation for radiologists in the U.S. declined by more than 3% last year, while their productivity edged up. Still, radiologists remain among the highest-paid medical specialists.

Diagnostic radiologists in the U.S. had a median compensation of $487,239 in 2018, down 3.2% compared with $503,225 the previous year, according to a new survey by AMGA Consulting, a unit of the American Medical Group Association (AMGA). The 2018 numbers also represented a 0.6% decline compared with 2016 figures, in which median compensation for diagnostic radiologists was $483,660.

At the same time, radiologists are being more productive, at least in terms of their output of relative value units (RVUs), the primary measure of physician productivity for most medical groups. While most physician specialties tracked by the AMGA survey saw a decline in median work RVU production, it edged upward for radiologists.

Diagnostic radiologists had average median work RVUs of 9,264 in 2018, up 0.6% compared with 9,212 in 2017. What's more, radiologist RVU production has climbed 4% since 2016, the third-highest growth rate after cardiologists and orthopedic surgeons.

Median salaries and RVU production for major physician specialties in the AMGA report as are follows:

2018 physician compensation & productivity,
compared with 2017
Specialty Median physician compensation % change Median work RVUs % change
Gastroenterology $529,880 2.1% 7,928 -3.0%
Cardiology $497,888 2.5% 7,869 4.7%
Radiology (diagnostic) $487,239 -3.2% 9,264 0.6%
Dermatology $460,238 0.7% 7,477 -0.6%
Neurology $302,060 2.3% 4,739 -0.4%
Internal medicine $258,027 -0.7% 4,939 1.1%
Psychiatry $256,400 -3.8% 4,171 0.0%
Family medicine $244,799 1.1% 4,981 -0.4%

In analyzing the results overall, AMGA Consulting wrote that the numbers for 2018 seemed to be unique in that physician compensation and productivity did not grow as they had in the previous decade. Overall for the U.S., physician productivity in 2018 fell by a weighted average of -1.63%, while compensation only increased +0.89%. Indeed, this year's numbers are the first time in more than a decade that compensation has grown by less than 2%.

"The 2018 survey's results are surely different from those of years past, where we experienced an annual cash compensation increase of 2% to 3% almost across the board," said Wayne Hartley, chief operating officer of AMGA Consulting. "Production has stalled, and since many compensation plans are driven by production, total cash compensation has been impacted."

The AMGA did not provide a definitive reason for the decline in physician production, but it did speculate that the burdens of electronic health record use, patient complexity, and administrative and compliance requirements could be potential factors.

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