PHYSICIAN: Compensation Data Sources

Posted on January 28, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

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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MEDICAL PRACTICE: Part-Time Physician Employment Difficulties

Posted on October 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Why It Is Difficult to Practice Medicine Part-Time Today?

In the past, part-time medical practice offered physicians a flexible way to balance professional responsibilities with personal or family commitments. Today, however, the healthcare environment has evolved in ways that make part-time medicine increasingly challenging. From administrative burdens to economic pressures and patient expectations, the obstacles are both systemic and personal.

One of the most significant barriers is the rise in administrative complexity. Physicians are now required to navigate electronic health records (EHRs), comply with insurance documentation, and meet regulatory standards such as HIPAA and MACRA. These tasks consume hours of non-clinical time, which is difficult to compress into a part-time schedule. Even seeing fewer patients doesn’t exempt part-time doctors from the same documentation and compliance requirements as their full-time counterparts.

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Another challenge is financial viability. Many physicians are paid based on productivity metrics, such as Relative Value Units (RVUs), which reward volume over quality. Part-time practitioners often struggle to meet these benchmarks, resulting in lower compensation and reduced benefits. Additionally, malpractice insurance premiums and licensing fees remain fixed regardless of hours worked, further eroding the financial appeal of part-time practice.

Continuity of care is also a concern. Patients increasingly expect immediate access to their providers, especially in primary care and specialties like psychiatry or pediatrics. Part-time physicians may not be available for urgent issues, leading to fragmented care and dissatisfaction. This can strain relationships with patients and colleagues who must cover gaps in availability.

From a professional standpoint, part-time physicians may face limited career advancement. Leadership roles, academic appointments, and research opportunities often favor full-time commitment. There’s also a perception—sometimes unfair—that part-time doctors are less dedicated or less competent, which can affect peer respect and influence within medical institutions.

Technology, while beneficial, adds another layer of complexity. Telemedicine, remote monitoring, and digital communication tools have expanded access but also increased the expectation for constant availability. Part-time physicians may find it difficult to manage asynchronous messages, follow-ups, and virtual visits without extending their work hours beyond what they intended.

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Lastly, burnout and work-life balance—ironically one of the reasons doctors seek part-time roles—can still be elusive. The pressure to maintain clinical excellence, stay updated with medical advancements, and meet patient needs doesn’t diminish with reduced hours. In fact, squeezing these responsibilities into fewer days can intensify stress rather than alleviate it.

In conclusion, while part-time medical practice may seem like a solution to modern work-life challenges, the reality is far more complex. The structure of today’s healthcare system, combined with economic, technological, and cultural pressures, makes it difficult for physicians to thrive in part-time roles. Addressing these challenges will require systemic reform, flexible compensation models, and a cultural shift in how we value and support diverse medical careers.

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SPEAKING: ME-P Editor Dr. David Edward Marcinko MBA MEd 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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AMA: 41 Senators Sign Letter to Stop Medicare Cuts

Posted on November 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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In a sign of legislative momentum, 41 senators are supporting efforts to prevent a pending 2.8 percent cut in Medicare physician payments that will go into effect January 1st. The bipartisan letter led by Sens. John Boozman, R-Ark., and Peter Welch, D-Vt., to Senate leaders says the cuts would interfere with the ability of physicians to provide high-quality care. “These continued payment cuts undermine the ability of independent clinical practices – especially in rural and under served areas – to care for their communities,” the letter said.

The Senate letter follows one from the American Medical Association (AMA) and 127 other state medical associations and national medical societies asking Congress to use these last few congressional days to prevent the scheduled cuts. The letter to congressional leaders also urges Congress to provide a positive payment update for 2025. All 50 state medical societies – and DC— as well as 77 national medical societies signed.

Source: AMA

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AMA: Bye-Bye Medicare Billing Codes?

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Robert F Kennedy Jr, who was selected by Donald Trump to run the U.S. health and human services department, is working on plans to rid the American Medical Association from its role in drawing up Medicare’s billing codes, which sets doctors’ fees for more than 10,000 procedures, Oliver Barnes of The Financial Times reports.

The plan would result in an upheaval of a system that has been in place for decades. Publicly traded companies in the healthcare space include CVS Health (CVS), Centene (CNC), Cigna (CI), Elevance Health (ELV), Humana (HUM), Molina Healthcare (MOH) and UnitedHealth (UNH).

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Activity-Based-Medical-Cost Accounting and Management

Posted on May 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

A Non-Traditional Accounting System

[By Dr. David Marcinko MBA MEd CMP]CPA

Sooner or later you will want to ascertain and then demonstrate the cost effectiveness of your medical care. By using the process of Activity Based Cost (ABC) management, you will be able to do so.  But, if you’re using a traditional accounting system, you won’t know a thing about your activity costs. Here’s how. 

Traditional Cost Accounting Methods 

In a traditional medical practice cost accounting system, costs are assigned to different procedures and services based on volume.  In others words, office costs are spread over the entire office’s product line and you may not know the true profitability of any single medical activity. So, if the office is doing more “procedures” than general medicine, for example, more indirect office overhead costs will be allocated to the procedural portion of the practice. 

ABC management, on the other hand, determines the actual costs of the resources that each service consumes. Because general medicine requires more human resources than “technical procedures,” ABC management will assign more costs to the general medical portion of the practice. 

Accordingly, most physicians, office managers, and their accountants are surprised that a prior notion of office profitability is different than previously thought. ABC management is just more accurate in measuring medical service profitability than traditional accounting methods. 

Medical Activity Cost Drivers 

Examples of medical activities that are office cost drivers include such items as monitoring vital signs, taking radiographic images, removing dressings or casts, performing laboratory tests or veni-punctures, surgical set-ups or operative procedures; etc.  

However, in the office setting, the most economically important activities are listed as specific CPT codes for each medical specialty.  The most important end result of ABC management is the shift of general overhead costs to low volume services from high volume services. These effects are not symmetrical as there is a bigger dollar effect on the per-unit costs of the low volume service.  

ABC Managerial Accounting Improvements 

ABC management improves office managerial cost accounting systems in three ways: 

  1. It increases the number of cost pools used to accumulate general overhead office costs. Rather than accumulate overhead costs in a single office-wide pool, costs are accumulated by activity, service or procedure.
  2. It changes the base used to assign general overhead costs to services or patients. Rather than assigning costs on the basis of a measure of volume (employee or doctor hours), costs are assigned on the basis of medical services or activities that generated those costs.
  3. It changes the nature of many overhead costs in that those formerly considered indirect, are now traced to specific activities or services. The office service mix may then be adjusted accordingly, for additional profit.   

Methodology 

In order to perform an ABC analysis for your medical office, calculate the cost of delivering a single unit of medical or surgical activity using only the work component of the resource based relative value scale (RBRVS).

Do this by adding up your office’s average variable expenses for the prior 1-3 years.  Now, count the number of work resource based relative value units (RBRVUs) delivered for each CPT code for the same time period, using the latest edition of the Federal Register to obtain the latest list of RVUs by CPT code. Then divide total variable expenses by the total number of work RVUs in order to arrive at the marginal cost of a single unit of service for the time period being evaluated.

For example, if your office had variable expenses of $480,000, and produced 80,000 work RVUs last year, it cost $6, on top of the office’s fixed expenses, to deliver one unit of work product. So, if an HMO plan offers to reimburse you at a rate of $11 per member, per month, and you can expect to reasonably deliver on average of one RVU pm/pm, you’ll earn enough on the contract to cover your marginal costs and some of your fixed and direct expenses. 

CASE MODELs: CVPA 4 and CVPA 3

dhimc-bookAssessment

Remember, this method assumes that you have the excess operating capacity and time slots, available and unused, to see the additional patients of the new plan without adding extra overhead expenses to service the contract.

If not, or if you plan for capitation to become a major portion of your practice, you might want the capitated contract(s) to cover all your office expenses, so be sure to include both the fixed and other direct costs to your variable cost calculations. ABC determines the actual costs of resources rendered for each activity and represents a real measure of practice profitability. Office service mix can then be changed to either maximize revenues or better suit your practice personality.

A Caveat

Suppose however, that a medical service is competitively priced but still shows that the CPT code is unprofitable. For example, the costs of special requests can adversely affect office profits. Yet, special patient requests are one of the biggest reasons that a CPT code or procedure isn’t profitable.

In this case, look closely at activity costs and determine which ones are being performed inefficiently. Improving the efficiency of those kinds of medical services, or referring them out or abandoning them all together, will increase office profitability.

MORE: ABCM

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PODCAST: How Doctors are Really Paid?

Posted on January 29, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Learn the Incentives in Physician Compensation

BY ERIC BRICKER MD

RAND and Harvard University Researchers Recently Published a Study in the Journal of the American Medical Association Examining How Doctors are Paid by Hospital System-Owned Practices. The Study Found that only 9% of Primary Care Physician Compensation was Based on Value (Quality and Cost-Effectiveness) and only 5.3% of Specialist Compensation was Based on Value.

The Study Concluded: “The results of this cross-sectional study suggest that PCPs and specialists despite receiving value-based reimbursement incentives from payers, the compensation of health system PCPs and specialists was dominated by volume-based incentives designed to maximize health systems revenue.”

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RELATED: https://medicalexecutivepost.com/2008/09/12/how-doctors-get-paid/

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PODCAST: The “Secret” to Doctor Pay = RVUs

Posted on February 17, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Relative Value Units

By Eric Bricker MD

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PODCAST: Explaining Relative Value Units As a Physician

Posted on January 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Business Savvy Physician

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PODCAST: Value-Based Care

Posted on November 22, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Ochsner Health Has Real Hospital Success

By Dr. Eric Bricker MD

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PODCAST: Physician Relative Value Units?

Posted on August 28, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

HOW DOCTORS GET PAID!

By Eric Bricker MD

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Understanding CPT® Code Payment Components

Posted on February 7, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Determinations More Complex than Most Believe

By Staff Reporters

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Currently, there are more than 10,000 physician services designated by the current procedural terminology (CPT®) or healthcare common procedure coding system (HCPCS) codes.  Each reflects the three major cost drivers of a particular procedure:

  • Physician work effort or the relative value unit (RVUw) of medical providers’ work efforts, pre-service, intra-service and post-service time.

Patients may exhibit anxiety when examined orduring procedures resulting in the need for additional timeand effort by the physician to respond to and prepare for the examination or procedure. This uniformly adds moretime and stress to the pre-service and intra-service period as doctors respond to constantly changing behavior, questionsand level of cooperation in varying specialties.  Follow-up communicationwith employers, family, friends and concerned others requires increased post-service times.

  • Practice expenses (RVUpe), including non-physician costs but excluding medical malpractice coverage premiums.

The practice expense component of the resource-based relative value scale (RBRVS) includes clinicalstaff time, medical supplies, and medical equipment.  Often, the costsof supplies and equipment are not proportional to practicesize.  Major factorsaffecting practice expense are the volume of telephone, cell, or Internet management services, and the case management and administrative work required. For example, high patient turnover requires more examination rooms to maintain physician efficiency. High volume requires moreclerical staff to deal with larger patient-flow volume and resulting phone calls, difficultiesdressing and undressing patients, and is marked by increasedcomplexity and time in collecting laboratory specimens.  Thesefactors must be accounted for in any resource-based practiceexpense study and in the resulting practice expense calculationsfor medical services; and

  • Malpractice (RVUm) representing the cost of liability insurance.

The RBRVS system assigns RVUs to cover the malpractice expensesincurred by physicians. These malpractice RVUs, originally calculatedfor office-based physicians, may systematically undervaluethe practice liability costs for some specialties. The prolonged statutes of limitation on some legalactions may result in increased malpracticerisk exposure for physicians providing such services [i.e., pediatricians]. The differences in exposure may not be calculated in theRBRVS system, and were not included in initial studies.  Specialty specific survey data for malpractice expenseshould be used for this component when assigning final RVU valuations.  Without specialty-specific CPT® codes, however, there was no wayto do this objectively.

Conclusion

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