What's the role of the locum tenens internal medicine physician in today's healthcare workforce, in terms of placement, demand and salary? Read on for Staff Care's specialty spotlight on locum tenens internal medicine physicians for 2015.
"Simply put, internists are Doctors of Internal Medicine," explains the American College of Physicians (ACP). "Internists are equipped to deal with whatever problem a patient brings — no matter how common or rare, or how simple or complex.
"They are specially trained to solve puzzling diagnostic problems and can handle severe chronic illnesses and situations where several different illnesses may strike at the same time. They also bring to patients an understanding of wellness (disease prevention and the promotion of health), women's health, substance abuse, mental health, as well as effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs."
According to the Bureau of Labor Statistics (BLS), "there were 48,390 general internists, 124,810 family and general practitioners; 31,010 general pediatricians, including pediatric internists; and 311,320 physicians and surgeons" in the United States in 2014.
Internal Medicine Physicians Today
Staff Care's 2015 Survey of Temporary Physician Staffing Trends ranks internal medicine physicians among the top-hired locum tenens positions for healthcare employers in 2014, representing 34.6 percent of hires (along with other primary care specialties).
"For the fourth consecutive year, primary care (family practice, general internal medicine, and pediatrics) was the specialty area in greatest demand, accounting for 24% of total days requested," the report explains.
The survey authors connect the popularity of internists among locum tenens employers with the nationwide shortage of physicians in this specialty, stating that that "it is almost universally conceded by healthcare policy analysts that there are too few doctors in the three key areas of primary care: family medicine, general internal medicine and pediatrics.
"Internal medicine subspecialists, urgent care specialists, neurologists and many other types of physicians can be in short supply and healthcare facilities may require locum tenens providers to fill gaps until permanent physicians can be found," the report adds.
The supply of internists is further "compromised by the fact that a growing number of internists are choosing to sub-specialize and are not entering primary care practice. In addition, many internists are choosing to become hospitalists, significantly reducing the supply of those available to perform office-based services."
Internal Medicine Salary Report: New Growth Under the ACA
This shortage and concurrent demand for locum tenens internists can actually be welcome news for internists themselves, given that the specialty is traditionally not among the most highly paid. Medscape's 2014 internal medicine income survey ranked internal medicine salaries as 21st out of 25 specialties, at an average of $188,000 per year.
By way of comparison, orthopedics handily topped the list at an average salary of $413,000, with cardiology coming in second at place at $351,000 and urology and gastroenterology tying for third and fourth with $348,000 each.
"As in the past, [physicians] who perform procedures have the highest incomes compared with those who manage chronic illnesses," the Medscape report authors explain.
The Medscape findings sync up with a report by Forbes citing information from the Medical Group Management Association (MGMA) to claim that salaries for internists (as well as family care physicians and pediatricians) were generally flat compared to salaries for specialists.
"Adjusted for inflation, the pay increases for both primary care and specialists from 2011 to 2012 was about 1 percent from 2011 to 2012," the Forbes report notes, comparing the figure to the three percent rise for specialists (like cardiologists and obstetricians).
It should be noted that both reports offer information gathered from before the implementation of the Affordable Care Act (ACA) in 2014. "It is interesting to see a small decline in compensation among some of the specialties involved in procedures and small increases among primary care physicians, which could reflect early changes in reimbursement resulting from the Affordable Care Act," the Medscape authors note.
Staff Care's own recently released 2015 Compilation of Physician Compensation Survey supported the notion that internists may see higher compensation in the era of the ACA. All five sources cited in the report showed that internal medicine physician salaries had increased from 2014 to 2015, from as little as one percent to as much as nine percent.
Also worth nothing is that the Medscape report showed that internal medicine physicians can expect to command the highest salary in the north central U.S. (i.e., Iowa, Missouri, Kansas, Nebraska and the Dakotas), with the North and Mid-Atlantic regions offering the lowest rates of pay.
Locum Tenens Internal Medicine Physicians May Command Higher Salaries
It's absolutely essential to note that the salary trends outlined above refer to permanent employment internal medicine physicians. With locum tenens work, the picture may change dramatically. As noted above, internal medicine physicians are among the most sought-after locum tenens specialties, a fact noted not just by Staff Care's data but other sources, as well.
Because of this current shortage and subsequent demand, internal medicine physicians may command as much as "25% wiggle room in hourly rate negotiation" when establishing locum tenens pay rates, writes Kevin Pho, MD for MedPageToday. (Dr. Pho also recommends the ability to be immediately available and to take longer assignments for raising that asking price even higher.)
Of course, the benefits for internal medicine physicians who choose to work locum tenens assignments transcend salary considerations.
"I have a more defined work schedule," internal medicine physician William S. Gruss, MD told Medscape, describing the appeal of working locum tenens to his career. "When I am on, I am on, and when I am off, I am off. This is a nice change from when I was in private practice, or even as an employed physician with an outpatient setting, where I was getting paged frequently by the answering service."
If you’re an internal medicine physician interested in locum tenens opportunities, we encourage you to search available locum tenens jobs here.