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Results from the 2010 ASPHO Compensation/Productivity Survey
Presented byJeffrey Hord, M.D.
Chair, APSHO Practice Management Committee
Methods
In Spring 2010, ASPHO offered an online survey of compensation to its members
The goal was to obtain comprehensive 2009 subspecialty compensation, productivity, and workforce data for members to use in practice management
The primary variables analyzed were region of practice, gender, practice type, academic rank, experience, administrative responsibilities
The survey was offered to 1018 members and was completed by 527 members (36 PT/491 FT) for a response rate of 51.7%.
58% of all PT responders were from the Eastern US 11% of all female responders were PT compared to 4% of all
male responders Compensation results are from FT respondents only.
Characteristics of Survey Responders
Gender of All Responders
Females
Males
214
313
40.6%
59.4%
Years Post-Fellowship- All
28.8%
16.7%
Years Post-Fellowship- by Gender
Clinical Responsibilities
Division Director
Department Chair
How many responders have an Academic Appointment? 458 of 527 (87%)
Academic Rank by Gender-458 of 527 (87%) had an Academic Appointment
Of those with an an academic appointment, what promotion track?
33% of males and 23% of females on Tenure Track32% of males and 46% of females on Clinical Track
Board Certification of Responders
Ped Hem/Onc General Ped
Yes 472 (90%) 433 (82%)
No 55 (10%) 94 (18%)
Note- 21% of males not Board Cert in Gen Pedscompared to 13% of females
Of the 94 not Board Cert in Gen Peds, 86 are Board Cert in Ped Hem Onc
9 of the 106 Div Directors who responded are not Board Cert in Ped Hem/Onc
Practice Characteristics
Practice Type
Note- 11% of males and 7% of females in Pvt Prac60% of males and 68% of females in Univ/Acad
US Geographic Regions
Location of Practice
Compensation
Type of Compensation Plan
Measure of Clinical Productivity (n=166)
Sources of Compensation
Other sources included Fed GME dollars, Military, Federal Govt, State Govt, HMO, Pharm sales, County Taxes
Total Compensation for Full-Time PHO Physicians- 2009
Non-Division Directors
Median for all (n=381)= $162,300
Median for Females (n=160)= $146,500
Median for Males (n=221)= $180,000
Division Directors
Median for all (n=101) = $225,000
Median for Females (n=28)= $203,200
Median for Males (n=73)= $235,000
Median Total Compensation-Comparison with other Sources
Non-Directors
Directors All
ASPHO 162,300 (381) 225,000 (101) 180,000(489)
Sullivan, Cotter, Assoc
181,280 (163) 263,645 (24)
CHCA 209,713 (114)
ECG Mgmt 198,408 (145)
SK&A, Cegedim
205,999 (1138)
MGMA 208,000 (91)
Non-Division Directors- Compensation by REGION
Median Total Compensation of Non-Division Directors by Region and Gender- 2009
Median Total Compensation by Practice Size and Region/ ALL Non- Division Directors-2009
<60 New Onc Pts
60-150 New Onc Pts
>150 New Onc Pts
East 167,000(42)
170,000(41)
145,000(35)
Midwest 164,500(25)
149,000(30)
167,000(27)
SE 195,000(17)
158,500(20)
186,000(11)
Mt. West ---(4)
---(4)
150,500(10)
S. Central 188,000(9)
148,000(11)
151,000(27)
West 210,000(9)
152,500(18)
176,000(14)
( ) = sample size
Median Total Compensation of Univ-Based Non-Division Directors by Region and Gender- 2009
Non-Division Directors- Compensation by EXPERIENCE
Full-Time Non-Directors by Experience (in thousands)- Percentiles
<5(n=106)
5-9(n=85)
10-14(n=52)
15-19(n=58)
>20(n=79)
25th % 119 135 152 159 180
50th % 136 146 173 190 210
75th % 156 171 200 223 255
Median Total Compensation of Non-Division Directors by Experience and Gender-2009
Median Total Compensation (in thousands) by Experience in University-Based Non-Division Directors-2009
Median Total Compensation by Experience and Region/ ALL Non- Division Directors-2009
<5 yr 5-9 yr 10-14 yr 15-19 yr > 20 yr
East 127,050(32)
142,000(26)
162,500(20)
183,000(21)
220,000(28)
Midwest 137.000(26)
146,000(21)
200,000(9)
191,000(14)
212,500(18)
SE 146,250(14)
171,500(14)
---(5)
223,500(7)
231,000(10)
Mt. West 126,500(7)
---(3)
---(4)
---(2)
---(2)
S Central 130,000(17)
148,000(10)
206,500(6)
180,000(9)
192,000(10)
West 151,500(10)
138,500(10)
167,000(9)
---(5)
230,000(11)
( ) = sample size
Median Total Compensation by Experience and Region/ Female vs Male Non- Division Directors-2009
<5 yr 5-9 yr 10-14 yr 15-19 yr > 20 yr
East 123(21)140(11)
139.25(14)168.65 (12)
158(7)170(13)
156(6)200(15)
193(10)256.5(18)
Midwest 127(15)142(11)
147(7)145.9(14)
------
183(7)199(7)
---235(15)
SE 135(7)160(7)
---190(9)
------
---236.75(6)
---250(7)
Mt. West ------
------
------
------
------
S Central 127(8)136(9)
146(7)---
------
------
---199(8)
West ---161.5(8)
137(7)---
---173.5(6)
------
---230(7)
( ) = sample size
Median Total Compensation (in thousands) by Experience and Practice Type/ All vs Female vs Male Non-Division Directors-2009
<5 yr 5-9 yr 10-14 yr 15-19 yr > 20 yr
Private Practice
175 (9)---175 (7)
212 (7)------
---------
---------
270 (6)------
University/Academic
125 (74)122(43)134 (31)
141.25 (62)140(33)145.8(28)
160.5 (36)162(14)160.5 (22)
176 (41)162.5(17)199 (24)
201 (49)172(15)233.5 (34)
Hospital-based
170 (22)157.5 (12)177.5 (10)
182 (9)---187.5 (6)
205 (12)---207 (9)
213.25 (10)---203.5 (7)
215(17)---215 (13)
( ) = sample size
Non-Division Directors- Compensation by RANK
Median Total Compensation by Academic Rank and Region/ ALL Non- Division Directors-2009
Instructor Assist Assoc Full
East 110,500(8)
140,500(55)
175,000(33)
225,000(15)
Midwest ---(2)
140,000(46
180,000(19)
231,000(12)
SE ---(3)
160,000(23)
170,000(10)
250,000(7)
Mt. West ---(2)
130,750(6)
---(4)
---(2)
S Central ---(5)
145,500(22)
157,000(13)
198,000(7)
West ---(0)
140,000(114)
160,000(13)
286,000(6)
( ) = sample size
Median Total Compensation by Academic Rank and Region/ Female vs Male Non- Division Directors-2009
Instructor Assist Assoc Full
East ------
138(31)146.5(24)
155(11)192(33)
---240(11)
Midwest ------
130(23)150(23)
---169(14)
---235(7)
SE ------
151.25(8)175(15)
---212(7)
---250(6)
Mt. West ------
------
------
------
S Central ------
141.5(12)150(10)
153.5(6)182(7)
------
West ------
130(7)160(8)
160(7)165(6)
---286(6)
( ) = sample size
Median Total Compensation by Academic Rank and Region/ University Non- Division Directors-2009
Instructor Assist Assoc Full
East 110,500(8)
140,000(40)
174,000(27)
217,500(12)
Midwest ---(2)
135,300(34)
165,000(13)
235,000(9)
SE ---(2)
138,750(16)
160,000(9)
250,000(7)
Mt. West ---(1)
---(0)
---(4)
---(3)
S Central ---(5)
144,000(17)
151,000(10)
198,000(8)
West ---(0)
140,000(12)
160,000(10)
286,000(6)
( ) = sample size
Median Total Compensation for Full-Time Non-Directors by Region- 2004 vs 2009
2004 2009% Actual Change
Change in CPI-2004 to 2009*
East 125 161 29 15Midwest 145 162.5 12 12Southeast 145 180 24 14South Central 125 151 21 14Mt West 155 153.75 -1 13West 135 165 22 13
*Consumer Price Index data from US Bureau of Labor Statistics
DIVISION DIRECTORS
Total Compensation of Division Directors by Region -2009
Median Total Comp
Mean Total Comp
Range
East $226,250 (28) $252,286 $150K-$450K
Midwest $226,000 (27) $244,741 $154K-$380K
SE $258,000 (13) $275,923 $175K-$420K
Mt. West $212,500 (6) $226,667 $187.5K-$292.5
S. Central $217,500 (15) $232,000 $155K-$300K
West $203,200 (12) $219,450 $135K-$350K
( ) = sample size
Total Compensation of Division Directors by Experience -2009
Yrs after Fellowship
Median Total Comp
Mean Total Comp
Range
<5 (2) --- --- ---
5-9 (6) $215,750 $225,250 $195K-$300K
10-14 (14) $202,500 $205,857 $135K-$333K
15-19 (23) $265,000 $256,800 $187.5K-$380K
>20 (56) $225,000 $254,687 $150K-$450K
( ) = sample size
Total Compensation of Division Directors by Academic Rank/ Tenure Track -2009
Rank Median Total Comp
Mean Total Comp
Range
Instructor (0) --- --- ---
Assistant (1) --- --- ---
Associate (6) $214,000 $233,000 $199K-$295K
Full (30) $235,000 $259,130 $155K-$420K
( ) = sample size
Total Compensation of Division Directors by Academic Rank/ Non-Tenure Track -2009
Rank Median Total Comp
Mean Total Comp
Range
Instructor (0) --- --- ---
Assistant (7) $179,500 $181,714 $135K-$230K
Associate (8) $275,500 $260,750 $180K-$325K
Full (14) $232,000 $269,357 $195K-$450K
( ) = sample size
Total Compensation of Division Directors by Practice Type -2009
Practice Type Median Total Comp
Mean Total Comp
Range
Private Multispecialty(8)
$215,000 $222,188 $180K-$300K
University (54)
$225,000 $241,535 $150K-$425K
Hospital-based (31)
$248,000 $259,581 $135K-$450K
• ( ) = sample size• Only categories with > 5 responses
shown
Total Compensation of Division Directors by Practice Size -2009
New Onc Patients/ Yr
Median Total Comp
Range
<60 (40) $201,750 $135K-$380K
60-150 (36) $232,000 $150K-$450K
>150 (20) $282,750 $191K-$395K
• ( ) = sample size
Median Total Compensation for Full-Time Directors by Region- 2004 vs 2009
2004 2009% Actual Change
Change in CPI-2004 to 2009*
East 175 226.25 29 15Midwest 205 226 10 12Southeast 195 258 32 14South Central 195 217.5 12 14Mt West 165 212.5 29 13West 195 203.2 4 13
*Consumer Price Index data from US Bureau of Labor Statistics
Workforce/ Productivity
Staffing Assessment by Division Directors
Other Support
Fellows Hospitalists for PM/Wkends
Yes 298 (56.5%) 97 (18.4%)
No 229 (43.5%) 430 (81.6%)
Clinical Hours Per Week by Clinical FTE’s
57 clinical hours/week = 1.0 clinical FTE
Clinical FTE Hem/Onc Physicians/ # New Oncology Patients- ALL Centers
13.3 new pts/physician
Clinical FTE Hem/Onc Physicians/ # New Oncology Patients- NON-TRANSPLANT Centers
19 New Onc Pts/Physician
Clinical FTE Hem/Onc Physicians/ # New Oncology Patients- TRANSPLANT Centers
12.2 New Onc Pts/ Physician
Total Clinical FTE’s (Physicians, APN’s, PA’s) for Number of New Oncology Patients
11.7 New Onc Pts/FTE
11.1 New Onc Pts/ FTE
Providers in Programs with 30 New Oncology Patients Annually- DirectorsHgb d/o pts
Bldg d/o patients
# BMT’s / year
Physcns NP/PA’s ClinicFTE’s
Total Providers
Practice Type
20 20 0 1 FT2 PT
0 FT0 PT
1.8 3 Hosp
80 120 0 3 FT0 PT
0 FT0 PT
2.7 3 Univ
20 20 0 2 FT0 PT
1 FT0 PT
3 3 Hosp
300 50 5 3 FT0 PT
? FT2 PT
? 5 Univ
50 100 0 4 FT1 PT
1 FT0 PT
3 6 Univ
40 600 0 1 FT0 PT
1 FT0 PT
2 2 Hosp
Providers in Programs with 60 New Oncology Patients Annually- AllHgb d/o pts
Bldg d/o pts
# BMT’s / year
Physns NP/PA’s Clinic FTE’s
Total Providers
Practice Type
450 300 New 3 FT0 PT
5 FT0 PT
8 8 Univ
200 30 24 2 FT1 PT
3 FT0 PT
? 6 Univ
110 600 0 3 FT0 PT
0 FT0 PT
3 3 Hosp
20 2 0 4 FT0 PT
1 FT1 PT
5 6 Pvt MultSpec
175 180 10 4 FT1 PT
2 FT0 PT
6.25 7 Univ
20 20 75 12 FT0 PT
10 FT1 PT
? 23 Univ
Providers in Programs with 100 New Oncology Patients Annually-All
Hgbpthy pts
Bldg d/o pts
# BMT’s / yr
Physns MLP’s Clinical FTE’s
Total Providers
Practice Type
250 100 80 25 FT0 PT
12 FT0 PT
37 37 Univ
400 300 12 4 FT 1 PT
3 FT0 PT
7.8 8 Univ
950 200 50 45 FT0 PT
12 FT0 PT
57 57 Univ
275 500 100 30 FT0 PT
10 FT0 PT
10 40 Univ
75 50 80 5 FT0 PT
5 FT0 PT
8 10 Univ
200 200 30 4 FT5 PT
4 FT0 PT
11 13 Hosp
Providers in Programs with 120 New Oncology Patients Annually- Directors
Hgb d/o patients
Bldg d/o patients
# BMT’s / year
Physcns NP/PA’s Clinical FTE’s
Total Providers
Practice Type
380 100 20 4 FT2 PT
2 FT0 PT
6 8 NP Med Grp
160 200 20 20 FT0 PT
10 FT2 PT
20 32 Univ
750 300 20 12 FT1 PT
5 FT0 PT
15 18 Univ
100 250 14 7 FT1 PT
3 FT2 PT
11.5 13 Hosp
Providers in Programs with 200 New Oncology Patients Annually
Hgbpth pts
Bldg d/o pts
# BMT’s / yr
Physns MLP’s Clinic FTE’s
Total Providers
Practice Type
0 0 55 20 FT0 PT
6 FT0 PT
26 26 Univ
200 200 45 24 FT2 PT
8 FT4 PT
18 38 Univ
1000 600 35 14 FT5 PT
10 FT0 PT
29 29 Univ
1500 250 30 12 FT2 PT
15 FT0 PT
? 29 Hosp
800 1200 35 16 FT2 PT
10 FT0 PT
? 28 Univ
500 200 25 13 FT0 PT
5 FT2 PT
14.5 20 Univ
2009 wRVU’s By Clinical FTE
CHCA median wRVU- 3547/providerECG median wRVU- 3673/provider
1.O Clinical FTE= 3750 wRVU’s
2009 wRVU’s by Hours Spent Per Week Caring For Patients
To earn 3750 wRVU’s must work 61.5 hours/ week
SUMMARY
There is a Gender Gap
Conclusions 40% of respondents are < 10 years out from training and
most of them are female (54%) 68% of respondents care for both hematology and
oncology patients The ASPHO self-reported compensation results are less
than those reported by national benchmarking groups Compensation in our subspecialty has increased between
2004 and 2009 at about the same rate as the consumer price index
Compensation gradually increases with increasing experience and rank (and practice size for directors)
Regional compensation differences are small
Conclusions
Compensation for non-directors in private practice > hospital-based > university/academic
Compensation for directors at hospital-based practice> private practice> university/academic
Median total compensation for female non-division directors was 18.6% less than that of males
Median total compensation for female division directors was 13.5% less than that of males
Multivariate regression analysis quantified gender inequality of $16,012 when controlling for all other significant factors
Conclusions
Assessment of staffing by directors balanced between “adequate” and “insufficient” for present time, in 5 yrs, and 10 yrs
1.0 Clinical FTE should generate between 3550-3750 wRVU’s annually
A full-time clinician must spend 57-61 hours/week seeing patients to generate 3750 wRVU’s
Ratio of new onc diagnoses/1.0 clinical FTE physician is about 19/1 for non-transplant centers and 13/1 for transplant centers but there is great variability in staffing between centers with similar volumes