Cardiology pay slips 8% but who, what & where makes difference

Overall compensation for cardiologists dropped almost 8 percent between 2012 and 2013 but the pain was not spread evenly, according to MedAxiom’s annual survey. Pay and pay cuts varied greatly depending on subspecialty, employment model and region.

The consulting firm MedAxiom has been gathering data on physician compensation and production since 2008. The most recent data was extracted in June 2014 from survey responses by 134 practices representing 2,554 full-time physicians. This is the second year the company published a report focused specifically on compensation and productivity.

The 8 percent drop put an end to years of positive pay growth for cardiologists. Between 2010 and 2012, overall median compensation rose from $456,110 to $548,587. In 2013, compensation fell to $505,266. Median compensation per work Relative Value Unit (wRVU) remained the same in 2012 and 2013, at $54.

Analysts suggested the compensation dip could be the beginning of a downward trend although the wRVU data may signal that integration hit a plateau and markets are normalizing.

Interventional cardiologists remained the highest paid among the subspecialists, despite taking a hit of more than $27,000 between 2012 and 2013. In 2013, the mean compensation for interventional cardiologists was $558,824. Electrophysiologists, by comparison, earned $525,664; invasive cardiologists received $504,398; and general cardiologists $454,837.

Electrophysiologists saw their mean compensation drop by more than $50,000 between 2012 and 2013, double the loss felt by general cardiologists.

Physicians who worked in an integrated model received more compensation than physicians in private practice. Overall median compensation for integrated cardiologists totaled a $548,630 vs. $424,380 for private practice cardiologists. Private practices experienced a more precipitous decline in compensation per full-time cardiologist, slipping 8.9 percent vs. 6.9 percent for those in an integrated model, and their median compensation per wRVU was lower, at $42 vs. $57.

Again, the losses were not distributed evenly among subspecialties. In what was a rare uptick in the findings, interventional cardiologists in private practices saw a 6.2 percent increase in median compensation between 2012 and 2013, with compensation totaling $485,041 in 2013. Independent electrophysiologists, invasive cardiologists and general cardiologists reported declines of 4.9 percent, 16.2 percent and 16.9 percent, respectively.

Within integrated systems, all subspecialists experienced declines but they were less disparate. General cardiologists took the smallest cut (1.8 percent), followed by invasive cardiologists (5.7 percent), interventional cardiologists (8.7 percent) and electrophysiologists (9.5 percent).

“[I]nterventaional cardiologists in the integrated model continue their 4-year string of being top earners among all cardiology physicians,” according to the report. Integrated interventionalists had a median pay of $583,829. “This may be due in part to the proliferation of PCI centers across the country, which despite volume declines overall … have increased the need for interventional physicians to adequately cover call burdens.”

Physicians in the Midwest fared best for compensation despite a 5.8 percent drop between the two years, with a median $559,004 per cardiologist. The Northeast had the steepest drop (10 percent) and the lowest pay ($460,815). Compensation in the West increased 1 percent for a median $466,235. Pay in the South dropped 4.5 percent for $525,486. Median wRVU ranged from $51 in the West to $60 in the Midwest.  

Based in Neptune Beach, Fla., MedAxiom serves 320 cardiology practices representing more than 6,200 cardiologists.