PHYSICIAN: Compensation Data Sources

By Dr. David Edward Marcinko MBA MEd

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A growing number of surveys measure physician compensation, encompassing a varying depth of analysis. Physician compensation data, divided by specialty and subspecialty, is central to a range of consulting activities including practice assessments and valuations of healthcare enterprises.  The AMA maintains the most comprehensive database of information on physicians in the U.S., with information on over 940,000 physicians and residents, and 77,000 medical students. Started in 1906, the AMA “Physician Masterfile,” which contains information on physician education, training, and professional certification information, is updated annually through the Physicians’ Professional Activities questionnaire and the collection and validation efforts of AMA’s Division of Survey and Data Resources (SDR).  A selection of other sources of healthcare related compensation and cost data is set forth below.

 “Physician Characteristics and Distribution in the U.S.” is an annual survey based on a variety of demographic information from the Physician Masterfile dating back to 1963.  It includes detailed information regarding trends, distribution, and professional and individual characteristics of the physician workforce.

Physician Socioeconomic Statistics”, published from 2000 to 2003, was a result of the merger between two prior AMA annuals: (1) “Socioeconomic Characteristics of Medical Practice”; and, (2) “Physician Marketplace Statistics.” Data has compiled from a random sampling of physicians from the Physician Masterfile into what is known as the Socioeconomic Monitoring System, which includes physician age profiles, practice statistics, utilization, physician fees, professional expenses, physician compensation, revenue distribution by payor, and managed care contracts, among other categories.

The American Medical Group Association (AMGA), formerly known as the American Group Practice Association, has conducted the Medical Group Compensation and Financial Survey (known as the “Medical Group Compensation and Productivity Survey” until 2004) for 22 years.  This annual survey is co-sponsored by RSM McGladrey, Inc., who is responsible for the independent collection and compilation of survey data.  Compensation and production data are provided for medical specialties by size of group, geographic region, and whether the group is single or multispecialty.

The Medical Group Management Association’s (MGMA)Physician Compensation and Production Survey” is one of the largest in the U.S. with approximately 3,000 group practices responding as of the 2023 edition publication. Data is provided on compensation and production for 125 specialties.  The survey data are also published on CD by John Wiley & Sons ValueSource; the additional details available in this media provide better bench marking capabilities.

The MGMA’s “Cost Survey” is one of the best known surveys of group practice income and expense data, having been published in some form since 1955, and obtaining over 1,600 respondents, combined, for the 2008 surveys: “Cost Survey for Single Specialty Practices” and “Cost Survey for Multispecialty Practices.”  Data is provided for a detailed listing of expense categories and is also calculated as a percentage of revenue and per FTE physician, FTE provider, patient, square foot, and Relative Value Unit (RVU). The survey provides information on multispecialty practices by performance ranking, geographic region, legal organization, size of practice, and percent of capitated revenue. Detailed income and expense data is provided for single specialty practice in over 50 different specialties and subspecialties.

The “Medical Group Financial Operations Survey” was created through a partnership between RSM McGladrey and the American Medical Group Association (AMGA), and provides benchmark data on support staff and physician salaries, physician salaries, staffing profiles and benefits, and other financial indicators.  Data is reported as a percent of managed care revenues, per full-time physician, and per square foot, and is subdivided by specialty mix, capitation level, and geographic region with detailed summaries of single specialty practices in several specialties.

Statistics: Medical and Dental Income and Expense Averages” is an annual survey produced by the National Society of Certified Healthcare Business Consultants (NSCHBC), formerly known as the National Association of Healthcare Consultants (NAHC), and the Academy of Dental CPAs.  It has been published annually for a number of years and the “2023 Report Based on 2022 Data” included detailed income and expense data from over 2,700 practices and 4,900 physicians in 62 specialties.

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Medical Specialty Trends

The characteristics of both the practice and the profitability of different physician specialties vary greatly. Information on trends affecting specific specialties should further refine the types of industry information gathered including changes in treatment, technology, competition, reimbursement, and the regulatory environment. For many of the subspecialties, oversupply and under supply issues and the corresponding demand and compensation trends are central to the analysis of potential future earnings and the value of established medical entities. Information that is available and that may be gathered can range from broad practice overviews to, for example, specific procedural utilization demand and forecasts for a precise local geographic area.

A large number of national and state medical associations and organizations gather and produce information on these various aspects of the practice of different individual physician specialties and subspecialties. Information may be found in trade press articles, medical specialty associations and their publications, national surveys, specialty accreditation bodies, governmental reports and studies, and elsewhere. The American Medical Association’s (AMA) as well as the MGMA both publish comprehensive physician practice survey information. 

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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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INVESTING: Keynesian and Hayekian Approaches

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Keynesian and Hayekian Approaches to Investing

The contrasting economic philosophies of John Maynard Keynes and Friedrich Hayek have shaped not only macroeconomic policy but also approaches to investing. While both thinkers sought to understand and improve economic systems, their views diverge sharply on the role of government, market behavior, and investor decision-making.

Keynesian economics emphasizes the importance of aggregate demand in driving economic growth. Keynes argued that markets are not always self-correcting and that government intervention is necessary during downturns to stimulate demand. In the context of investing, Keynesian theory supports counter-cyclical strategies. Investors following this approach might increase exposure to equities during recessions, anticipating that fiscal stimulus will boost corporate earnings and market performance. Keynes himself was a successful investor, known for his contrarian style and long-term focus. He advocated for active portfolio management, believing that markets are driven by psychological factors and herd behavior, which create mispricings that savvy investors can exploit.

In contrast, Hayekian economics is rooted in classical liberalism and the belief in spontaneous order. Hayek argued that markets are efficient information processors and that decentralized decision-making leads to better outcomes than centralized planning. From an investment standpoint, Hayekian theory favors passive strategies and minimal interference. Investors aligned with Hayek’s philosophy might prefer index funds or diversified portfolios that reflect market signals rather than attempting to time the market or predict government actions. Hayek was skeptical of the ability of any individual or institution to possess enough knowledge to outsmart the market consistently.

The Keynesian approach tends to be more optimistic about the power of policy to influence markets. For example, during economic crises, Keynesians may expect stimulus packages to revive demand and thus invest in sectors likely to benefit from increased government spending. Hayekians, on the other hand, may view such interventions as distortions that lead to malinvestment and eventual corrections. They might invest more cautiously during periods of heavy government involvement, anticipating inflation, asset bubbles, or regulatory overreach.

Risk perception also differs between the two schools. Keynesians may see risk as cyclical and manageable through diversification and active management. Hayekians view risk as inherent and unpredictable, best mitigated through adherence to market fundamentals and long-term discipline.

In practice, modern investors often blend elements of both approaches. For instance, they may use Keynesian insights to anticipate short-term market movements while relying on Hayekian principles for long-term portfolio construction. The rise of behavioral finance has also added nuance, validating Keynes’s view of irrational market behavior while reinforcing Hayek’s skepticism of centralized forecasting.

Ultimately, the choice between Keynesian and Hayekian investing reflects deeper beliefs about how economies function and how much control investors—or governments—really have. Keynesians embrace adaptability and intervention, while Hayekians champion restraint and trust in the market’s invisible hand. Both offer valuable lessons, and understanding their differences can help investors navigate complex financial landscapes with greater clarity.

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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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DAILY UPDATE: Retirement Savings Up But Stock Markets Down

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Americans are squirreling away a larger percentage of their earnings than ever before. In the first three months of the year, Americans stashed an average of 14.3% of their income in their 401(k)s, up from 13.5% in 2020, according to Fidelity Investments, which manages millions of accounts. That’s a record, and it also nearly approaches the 15% that’s recommended to be able to maintain your lifestyle after a 40-year career, as per the Wall Street Journal.

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🟢 What’s up

  • Planet Labs exploded 49.37% thanks to the satellite imagery stock beating Wall Street forecasts, posting its first quarter of positive cash flow and record revenue.
  • MongoDB soared 12.84% after the software company crushed analyst estimates last quarter and projected better-than-expected earnings next quarter.
  • Five Below continued the trend of discount retailers beating expectations, rising 5.59% on an impressive beat-and-raise earnings report.
  • Land’s End missed revenue forecasts but beat on profits last quarter. Shares climbed 13.02% after the clothing company promised tariffs won’t hurt its bottom line.
  • Scott’s MiracleGro rose 11.04% after the fertilizer titan reiterated its healthy forward guidance.

What’s down

  • Tesla fell yet again today, down another 14.26% thanks to a growing rift between CEO Elon Musk and President Trump.
  • Procter & Gamble fell 1.90% after the consumer goods giant announced it will slash 7,000 jobs over the next two years.
  • Brown-Forman tumbled 17.92% on poor earnings for the alcohol maker and worse-than-expected forecasts for the coming year.
  • Kimberly-Clark lost 2.27% due to an agreement to sell a majority stake in its international Kleenex tissue business.
  • PVH plunged 17.96% after the parent company of brands like Calvin Klein beat earnings estimates last quarter but predicted a much worse quarter ahead.
  • ChargePoint Holdings plummeted 22.49% thanks to a rough quarter for the EV charging company.
  • Ciena sank 12.85% following a much-weaker-than-expected quarter for the communications equipment maker.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

D-DAY: Normandy Landing, 1944.

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DAILY UPDATE: CVS Exits ACA Marketplace as Markets Flounder

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Aetna is waving goodbye to the ACA marketplace. Executives announced during CVS Health’s Q1 2025 earnings call on May 1 that the insurance giant is withdrawing from the individual marketplace created under the Affordable Care Act, as the company expects to lose as much as $400 million from that part of the business in 2025.

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Stocks sank a bit today while investors remain in wait-and-see mode. All eyes are on Jerome Powell & Co. this Wednesday: The market thinks the Fed will stay put until June, while some pros think the next rate cut will be in July.

Among the major indexes, the Dow Jones industrials fared best, though it was only up 0.1%. McDonald’s and UnitedHealth led blue chips with gains of more than 1%. Apple lagged most, dropping 2.6%. Chevron skidded more than 2%. The NASDAQ composite fell 0.4%. Trade Desk outperformed here, rallying more than 3%, while Charter Communications and Fortinet each rose nearly 3%. Meanwhile, On Semiconductor and Grail lagged, diving more than 8% and 4%, respectively. The S&P 500 dropped 0.4%. The benchmark index’s sectors were mixed, but with a slight downside bias. Energy and consumer discretionary were getting hit the hardest. Industrials and consumer staples made the best gains.

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🟢 What’s up

  • Skechers exploded 24.35% after the footwear retailer inked a deal with 3G Capital to go private.
  • Electronic Arts climbed 2.41% on the news that it has teamed up with Major League Soccer to offer four matches via its mobile gaming platform this year.
  • United Airlines rose 1.07% despite its announcement that it’s cutting some flights out of Newark, New Jersey, where apparently flying is terrible.
  • Howard Hughes Holdings gained 2.81% thanks to a $900 million investment in the real estate company from Bill Ackman’s Pershing Square.

What’s down

  • Sunoco sank 5.64% on the oil & gas company’s plans to acquire Canadian gas station chain Parkland Corporation for $9.1 billion.
  • Shell fell 2.28% on reports that the company is considering ways to acquire rival BP.
  • ON Semiconductor lost 8.35% despite outpacing analysts’ estimates on both the top and bottom lines, as shareholders focused on warnings of weaker demand.
  • Tyson Foods fell 7.75% after the meat giant missed sales estimates and warned revenue will remain flat in the coming year.
  • Loews may have beaten analysts’ estimates on revenue, but the luxury hospitality stock still fell 1.77% after missing on profits.
  • Wolfspeed, which is a company name we will never get tired of writing, gave up another 8.52% following a wild short squeeze last week.

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ABOUT State Medical Licensing Boards

A CONTROVERSY?

By Staff Reporters

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DEFINITION

State medical boards are the agencies that license medical doctors, investigate complaints, discipline physicians who violate the medical practice act, and refer physicians for evaluation and rehabilitation when appropriate. The overriding mission of medical boards is to serve the public by protecting it from incompetent, unprofessional, and improperly trained physicians. Medical boards accomplish this by striving to ensure that only qualified physicians are licensed to practice medicine and that those physicians provide their patients with a high standard of care.

The right to practice medicine is a privilege granted by the state. Each state has laws and regulations that govern the practice of medicine and specify the responsibilities of the medical board in regulating that practice. These regulations are laid out in a state statute, usually called a medical practice act. State medical boards establish the standards for the profession through their interpretation and enforcement of this act.

Assembling a quality physician population to meet the needs of the public begins with licensure. During the process of evaluating applicants for medical licensure, state medical boards’ primary focus is on a physician’s qualifications, including undergraduate and graduate medical education, work history, and personal character.

Candidates for licensure also must successfully complete a rigorous examination designed to assess their ability to apply knowledge, concepts, and principles of health and disease that constitute the basis for safe and effective patient care.

The Federation of State Medical Boards of the United States, Inc., and the National Board of Medical Examiners (NBME) have collaborated to establish a single, 3-step examination for medical licensure in the United States, known as the United States Medical Licensing Examination (USMLE). The USMLE provides state medical boards with a common evaluation system for all licensure applicants. To assure the continued relevance of the exam, the NBME uses basic science and clinical faculty from the nation’s medical schools as well as practicing physicians, some of whom serve on state medical boards, to generate the examinations.

Cite: https://journalofethics.ama-assn.org/article/role-state-medical-boards/2005-04

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OPINIONS

“… I am persuaded that licensure has reduced both the quantity and quality of medical practice…It has reduced the opportunities for people to become physicians, it has forced the public to pay more for less satisfactory service, and it has retarded technological development…I conclude that licensure should be eliminated as a requirement for the practice of medicine”

-Milton Friedman, Nobel prize-winning economist

“As a rule, regulation is acquired by the industry and is designed and operated primarily for its benefit”

-George J. Stigler Nobel Prize-winning economist

“Licensing has served to channel the development of health care services by granting an exclusive privilege and high status to practitioners relying on a particular approach to health care, a disease-oriented intrusive approach rather than a preventive approach….By granting a monopoly to a particular approach to health care, the licensing laws may serve to assure an ineffective health care system”

-Lori B. Andrews, Professor of Law, Chicago-Kent College

“Let us allow physicians, hospitals and schools to spring up where they’re needed, abolish the restrictive licensure laws, and simply invoke the laws against fraud to insure honesty among all providers of health care …That will make health care affordable for everyone”

-Ron Paul, MD former Texas Congressman

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BONDS: Tobacco

By Staff Reporters

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Tobacco bonds are a form of municipal debt securities and securitized debt whose payment obligations are tied to a master medical lawsuit settlement agreement between 46 states and several major U.S. tobacco companies.

In exchange for the states settling their lawsuits against the tobacco industry for recovery of tobacco-related health care costs and exempting the tobacco companies from private tort liability regarding harm caused by tobacco use, the companies agreed to curtail or cease certain tobacco marketing practices and to pay, in perpetuity, various annual payments to the states to compensate for the medical costs of tobacco-related illnesses.

These tobacco industry payments have been securitized into municipal bonds. One underlying risk, among others, is that if certain conditions are met, the tobacco companies may reduce or suspend part of their payments.

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PODCAST: Impact of Education on Employee Health Care

HEALTH INSURANCE DEMOGRAPHICS

By Eric Bricker MD

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On this Blogging and Writing Lifestyle

About My Morning Routine

[By D. Kellus Pruitt; DDS]

For lack of anything else to write about at the moment, let me describe my morning routine on the weekends.

I like to get up early – 5:30 am yesterday morning. More often than not, Bo, our sheltie, is waiting to greet me because he knows we get to go after the newspaper. That’s exciting. Bo is a morning dog as well. I brew up some coffee, read the newspaper – headlines mostly – and then I sit down in an overstuffed chair with my laptop to check my Google alerts and email before I start writing on whatever strikes me as interesting.

Commencing this Lifestyle                                  

Many writers; like my friend Jill Kring Carter who writes professionally for DentalTown and other publications, do their best work late at night. My mom, who painted professionally, liked the hours between 10 pm and 2 or 3 am for her art when she didn’t have to teach school the next day.

My sons, Ryan and Kellus, like the late hours as well. Sometimes on the weekends, I’m getting up when they are going to bed after having played online video games with friends across the nation all night. That means that while they are sleeping, and before Marci gets up and turns on electrical appliances, I sit nice and cozy, hammering away – constructing sentences out of words and then rearranging it to say with surgical precision what I intend to say. I enjoy it.

Shutting off the Laptop 

About the time I run out of battery for my laptop is when dogs start whining and barking, the TV comes on and the day springs to life. After I turn off my computer, sometimes Ryan and I go out for breakfast and sometimes Marci fixes eggs and bacon, pancakes or French toast. Otherwise I heat up a bowl of oatmeal to eat, visit some, and then head to the office where it’s quiet all day long.

Assessment 

If you are a doctor, medical management consultant, or any sort of accountant, economist or financial advisor; please tell us how you spend your non-professional time /day. Is this post appropriate for a professional forum like the ME-P. Or, is it TMI and better suited for a social network site? Does anyone even care?

Conclusion

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