Market Overview

Physician Production Declined and Pay Stagnated in 2017, AMGA Report Finds


The AMGA 2018 Medical Group Compensation and Productivity
conducted by AMGA's
subsidiary, AMGA
, found that physician compensation and productivity did
not meaningfully increase in 2017, as it typically has annually over the
past decade.

Overall, the national median showed a decline in physician productivity
by a weighted average of -1.63%, and an increase in compensation of only
+0.89%. Although compensation per relative value unit (work RVU) was
higher than average, 2017 was the first year physician compensation
increased by less than 2% in over a decade.

"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, M.H.A., COO, AMGA
Consulting. "Production has stalled, and since many compensation plans
are driven by production, total cash compensation has been impacted."

Changes in provider productivity and compensation varied by specialty in
2017―in some cases substantially. Certain specialties, like
cardiac/thoracic surgery, experienced a higher than normal compensation
increase, while other specialties, like ophthalmology, faced a notable

The weighted average change in median compensation in all medical
specialties during 2017 was +1.2%. Weighted average change in median
work RVUs was -1.5%, and compensation per work RVU was +3.3%. Data below
illustrate the variability among select specialties.

National Median Specialty Highlights: Specialty Care
        2017-2018 Percentage Change
      Compensation       Work RVU      


per Work RVU

Cardiac / Thoracic Surgery       6.4%       4.7%       2.2%
Emergency Medicine       1.0%       -4.7%       1.5%
General Surgery       0.7%       -1.7%       3.8%
OB/GYN - General       0.9%       -0.6%       3.5%
Ophthalmology       -2.3%       0.7%       -1.7%
Orthopedic Surgery       0.9%       -0.2%       -0.3%
Otolaryngology       0.4%       -0.7%       1.7%
Urology       -0.1%       1.7%       1.1%

Similar results were found in primary care specialties. The weighted
average change in median compensation in primary care specialties in
2017 was +0.8%. The weighted average change in median work RVUs for
primary care was -0.2%, and the weighted average change in compensation
per work RVU was +2.3%.

National Median Specialty Highlights: Primary Care
        2017-2018 Percentage Change
        Compensation       Work RVU      


per Work RVU

Family Medicine       1.1%       -0.4%       1.8%
Internal Medicine       -0.7%       1.1%       1.0%
Pediatrics & Adolescent - General       1.7%       -0.5%       3.2%

A definitive reason for 2017's decline in productivity has not been
established. However, the burdens of EHR use, patient complexity, and
administrative and compliance requirements were identified as potential

"Medical groups today consistently report several factors that have an
impact on their clinical output," said Fred Horton, M.H.A., president,
AMGA Consulting. "These include the use of electronic health records,
increasingly complex patients who require more face-to-face time, and
various administrative and compliance requirements. The production
levels reported this year could be a consequence of any or all of these

About the Survey

Now in its 31st year, the AMGA 2018 Medical Group
Compensation and Productivity Survey
presents data for 140 physician
specialties and 27 other provider specialties, with breakdowns by region
and group size (by physician FTE). The survey provides data on
compensation, net collections, work RVUs, and
compensation-to-productivity ratios.

This year's survey received a record-setting number of provider
responses. The responses came from 270 large, multispecialty medical
groups and integrated health systems, representing more than 105,000
clinical providers. The average number of providers per participant
group was approximately 380. Approximately 72% of respondents were AMGA

Other data include panel sizes, gross productivity, fringe benefits and
benefits expense-to-compensation ratios, patient visits, compensation
for experienced new hires and new residents or fellows, compensation and
productivity for academic facilities, and compensation and productivity
for nurse practitioner and physician assistant subspecialties.

All survey results are segmented by medical specialty and provide
specific breakdowns by size of group and geographic region.

About AMGA

a trade association leading the transformation of healthcare in America.
Representing multispecialty medical groups and integrated systems of
care, we advocate, educate, innovate, and empower our members to deliver
the next level of high performance health. AMGA is the national voice
promoting awareness of medical groups' recognized excellence in the
delivery of coordinated, high-quality, cost-effective care. More than
175,000 physicians practice in our member organizations, delivering care
to one in three Americans. For more information, visit

Limited copies of the survey are available for working press. For
press copies, contact Matt Clarke at
Surveys are also available for purchase at
or contact AMGA at 703.838.0033 ext. 362 or
Survey data is also available in a subscription-based, interactive,
online database. For details, visit

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