Incomes are higher in the current candidate-driven market than they were a few years ago, but don't expect dollars to have gone up over the past year. Incomes on average remain parallel to last year with pockets of highs and lows. I predict an increase, though, in perks, particularly in the number of hospitals and groups offering loan repayment deals and sign-on bonuses.
At the high end of basic hourly rates, we are still flirting with $200 per hour plus levels in Texas, Mississippi, Florida, Arkansas, North Carolina, Missouri, Ohio, Wisconsin, Illinois, Indiana, and Maryland and with RVU/fee-for service models in California, Oregon, and Washington. EMP/EPMG has increased its geographic scope around the country, and is offering $200 an hour, a $29,000 annual retirement contribution, benefits, and equity ownership potential to physicians willing to travel from site to site within specific regions.
While hourly rates remain static, packages are increasing because of new perks like loan repayment and sign-on bonuses. In some cases, regional highs are slightly lower than last year mostly due to more positions in rural areas in those regions. This compensation report is based on positions currently available, but does not include those “underground” spots that are never advertised and are handled strictly by personal contacts.
As usual, incomes and availability of jobs in desirable lifestyle areas are lower than in the rest of the country. Expect to find the big perks in hard-to-recruit-for areas. If a group or hospital is offering loan repayment, it should be understood that there will be a finite cap, and the full amount will have to be earned over a number of years. Income package averages are based on 1,650 hours a year in urban and suburban areas (all types of employers) and an average benefit package value of $24,000 (not including malpractice). Perks like sign-on bonuses and loan repayment were not included in the income averages, but fee-for-service, RVU, and incentive incomes were averaged into the final numbers.
I was pleased to find one group offering full benefit coverage to domestic partners. Bernhard Beltran, a physician recruiter for EPMG California, said the group felt it was appropriate to recognize domestic partners. This is a tiered partnership with no buy-in and fullshare vesting after six years. The group has 11 sites in California, six in Nevada, and two each in Arizona and Hawaii. Possibly the most stunning deal I found was in upstate New York with a group paying a monthly stipend to any graduating resident who signs on early before he completes residency, along with a host of other perks including loan repayment!
High Incomes in West
Leading the regional income race are the six primary states of the West and Southwest. Income information was unavailable (no one was talking) in Utah, Colorado, and Hawaii, representing seven percent of the jobs available in that region. Texas had the highest overall package reported at $410,000, while California had the highest hourly income reported at $230 an hour. The average hourly rate in the region is $150, and the average package is $280,000. Lows in the rural Southwest are $75 an hour. Doctors in California working with TeamHealth West, CEP America, and EPMG California can make $180 to $230 an hour. In Texas, you can earn $210 an hour in El Paso, and RVU compensation plus partnership is high in Houston. In Nevada, physicians at fee-for-service sites are earning more than $300,000.
The 13 Midwest states have an average annual package of $275,000, with highest average hourly earnings of $160 in Illinois and highest average package of $360,000 in Wisconsin. The average hourly rate throughout the region is $145, and there are large pockets of low hourly incomes due to high rural demand. Notable in the region are high levels of perks being offered by many employers in Ohio, including Premier Health Care Services and EPMG, plus lots of groups offering incomes higher than $300,000 via RVU and fee-for-service models. Significant loan repayment opportunities exist in Illinois and Indiana, and there are great partnership opportunities in south-central Wisconsin and Illinois. Michigan, Iowa, Minnesota, Kansas, and Nebraska feature little of note on the compensation scale, but Kentucky has some high-level incomes to be found through Trover Health and TeamHealth. The Dakotas have low impact on the income average due to high low-paying rural needs.
Perks and Benefits
Running a close third in compensation are the Southeast's 10 states with an average annual package of $270,000. The average hourly rate is $146, the highest is $210 in Mississippi, and the highest annual package, a whopping $500,000, was reported in North Carolina, once partnership is achieved in a year. I found a number of $200-an-hour spots in North Carolina, Florida, and Mississippi (as independent contractors). Night differentials are increasing here, notably in a Tallahassee group offering $300 per shift, and with EmCare offering $50 an hour in parts of Florida. Also of note are some high sign-on bonuses (as high as $50,000) in West Virginia, as well as strong perk potential.
Tennessee, including the Nashville area, is coming in at about $140 to $160 an hour depending upon experience, and national contract groups also are offering some nice perks and incentive incomes. Packages in Georgia, Alabama, South Carolina, and Arkansas average $285,000, with some nice perks, except in most of coastal South Carolina where opportunities are scarce.
The income averages in Virginia, Maryland, and Pennsylvania put the five states of the Middle Atlantic region into the fourth spot. With an average annual package of $260,000, the high dollars are to be found in Virginia at $175 an hour and a $350,000 package, and in Maryland at $200 an hour with a $340,000 package. Pennsylvania, including Philadelphia and Pittsburgh, features an hourly high of $155 and several opportunities providing $300,000 packages. New Jersey incomes average at $145 an hour and $265,000 a year, and Delaware, with a few national group openings, had no income information at all. TeamHealth is paying top candidates in Virginia as much as $175 an hour plus incentives and perks, a $50,000 sign-on bonus plus loan payback up to $200,000 in western Pennsylvania, and an opportunity in the Baltimore area of up to $200 an hour with a few benefits. Perks in the region are good, especially in Pennsylvania. Look for some packages pushing $300,000 in central Pennsylvania with strong perks.
The Northeast's seven states have many available jobs, but compensation is lacking, with average annual packages of $242,000. There is wide disparity between states. Connecticut is way out front with a package high of $315,000 and an average of $270,000, followed by Massachusetts with highs of $300,000 and $165 an hour and an average of $260,000 and $140 an hour. New York has the most of jobs in the region. The reported high package there is $290,000, with a state average of $260,000. The high and average hourly rate is $145. Rural lows in Maine, Vermont, and New Hampshire take the regional averages down. Maine and New Hampshire averages are $220,000 and $120 an hour, with Vermont and Rhode Island about the same. Notable is a hospital employee position in southern Vermont offering a $280,000 package, and another hospital employer in central Connecticut offering a package of $315,000 for 1,328 hours, plus lots of perks throughout upstate and western New York and $165 hour around Cape Cod, MA. New York and Maine offer the highest perks.
As usual, the Pacific Northwest brings up the rear with a five-state average annual package of $235,000. Look for some great opportunities in Washington, including a fee-for-service group in Seattle going as high as $450,000! There are some high packages in Oregon as well, including $200 an hour midstate as a hospital employee, and $160 hour plus full benefits and retirement package near Klamath Falls. Idaho is averaging about $225,000 annually as is Montana. Notable in Wyoming is an employer offering $149 an hour for the first eight hours, then $195 an hour for overtime on each shift, full benefits, pension, bonus, $100,000 loan payback, and a $30,000 sign-on. In Montana, there is a position paying $160 hour plus full benefits, relocation expenses, and sign-on bonuses.
Keep in mind that individual state incomes can vary considerably, even from within. Fee-for-service incomes also can differ from hospital employee incomes in the same area, and benefit packages are as valuable as your specific needs make them. Take a good look at your income needs, and don't let yourself be carried away by pretty perks. Always read the fine print, and think with a longterm career head. Happy hunting!
The Katz Compensation Top 10
© 2008 Lippincott Williams & Wilkins, Inc.