Hospitalist Salary Compensation Survey Data 2014-2009 Details Reviewed

Hospitalist salary data is constantly changing. I am aware of two detailed survey reports that are published yearly. One comes from a joint effort by the Society of Hospital Medicine (SHM) and Medical Group Management Association (MGMA). The other is published annually from Today's Hospitalist, a leading hospitalist publication.  This post on The Happy Hospitalist will update yearly when new information becomes available.  I continue to provide  older data as reference for those who wish to track the trend in hospitalist compensation over time as one easy to find resource.

UPDATE 2014


The 2014 State of Hospitalist Medicine report from September 2014 is now available.  It was a great year to be an adult hospitalist with annual median compensation rising to $252,996.   This 2014 report is based on 2013 data and represented an 8% increase from the prior year's survey.   Median RVUs increased 3.3% to 4,297 in the 2014 report (2013 data)  from 4,159 reported in the data from the year prior.  

UPDATE 2013


In September 2013, John Nelson, a leading hospitalist consultant, provided the most current insight into hospitalist salary compensation in a discussion at The Hospitalist journal.  This yearly data collection is a collaborative effort between SHM and MGMA.  The 2013 MGMA Physician Compensation and Production Survey report, based on 2012 data, showed a median compensation of $240,352 for internal medicine hospitalists, a 2.7% increase from $233,855 reported for 2012 (based on 2011 data).    If you are a physician practice leader, you can expect a 20% premium compensation package over non practice leader physician members.  As of September 8th, 2013, I was not able to find the report available for purchase yet on the SHM website.  Without having personally purchased and reviewed the survey results, I assume this dollar value represents total compensation.  The MGMA has previously defined total compensation as salary, bonus, incentive payments, research stipends and honoraria and distribution of profits.  They state total compensation does not include expense reimbursements, fringe benefits paid for by the practice (retirement plan, health insurance, life insurance, automobile allowances) or employer contributions to 401(k), 403(b) or Keogh plans.  In addition, most recent survey results have excluded academic hospitalist salaries as well.  I can only assume this to be the case for the 2013 report.

What percentage of hospital compensation and what percentage is composed of salary?  The 2012 State of Hospital Medicine report provides insight into that practice management issue here.   There are variations based on the type of practice model (hospital employed vs management companies vs private practice).  Make sure to review the article for more detailed information.  It also give insight into current performance measures being used for compensation. 

The 2013 Today's Hospitalist Compensation & Career Guide, published late 2013, gave us more insight into the state of the hospitalist salary.  According is an excerpt from one article published in that guide:
"According to data from this year’s Today’s Hospitalist Career & Compensation Survey, Dr. Kanikkannan’s earnings place her near the mean for full-time adult hospitalists: $251,360. That figure represents a 7% jump over last year’s reported mean of $234,900, showing that pay for adult hospitalists continues to grow at a very healthy clip."

Today's Hospitalist 2013 Compensation snapshot photo.

Additional data published in their survey indicates 19.6% of hospitalists reported earning more than $300,000 a year, compared with 13.4% in 2012 survey data.  Southwest hospitalists reported the highest total compensation and %change in compensation, rising 8.8% in 2013 to $270,830 from $248,800 in 2012, beating out the Pacific, Mountain, Midwest, South and Northeast areas as the highest paid hospitalist region overall.

If you have not yet subscribed to Today's Hospitalist, you can do so here to view the rest of the detailed salary data.  This detailed survey once again provides valuable insight into other practice characteristics, including staffing and scheduling, work environment, productivity and career satisfaction.   In addition, Today's Hospitalist is selling a complete Excel spread sheet of their data that can be purchased at this link.  Here is a description of their salary survey product.
"The 2013 Today’s Hospitalist Compensation & Career Report contain all of these data—and more—from a survey of nearly 800 practicing hospitalists. This unique report, which is offered as an Excel spreadsheet, offers data on hospitalist pay, group size, type of employer, size of hospital, respondents age and experience, and more."
I  think the take home message is clear.  Total compensation continues to rise, despite increasing hospitalist market saturation and declining hospital reimbursement.  That says to me that hospitals continue to value hospitalists for their front end and back end value  and they are willing to pay for that value.

Here is a comment left by a reader in early 2014:
"Hello, I have seen surveys showing the average salary of a hospitalist as $200-250k. I work with a hospitalist that is a family physician. He and some of his colleagues work for a company called IPC Hospitalist Group. He said he works out schedule with coworkers and get bonuses for productivity. States that he makes between $350-400K annually."

UPDATE 2012


On July 18th, 2012, The Hospitalist published details on the  most up-to-date hospitalist salary compensation data currently available.   This comprehensive SHM/MGMA report  is now available for purchase from the Society of Hospital Medicine (SHM). In addition to the SHM/MGMA report, you can find free 2012 salary survey data at Today's Hospitalist website.    You may need to sign up to get their publication.  If you haven't already, I encourage you to do so.  They provide an excellent free publication all hospitalists can appreciate and enjoy.

I have updated this blog post on a yearly basis in 2010, 2011 and 2012 to help hospitalists understand how  their income and benefit package compares with national survey data.   I started my hospitalist journey in 2003 at a large community hospitalist.  Ten years later I continue to  provided hospitalist services as a partner in my private practice hospitalist group.

Over the years I have watched hospitalist salary trends rise with  strength and conviction.  This is not a mistake.  Our value is being rewarded by our unique position outside third party insurance models of care. The most recent report from the publication  The Hospitalist    is based on 2011 SHM/MGMA data.  The median financial support for hospitalists by hospitals increased to $140,204 per full time hospitalist, per year, an increase of 6.6% from the $131,564 reported in the previous survey.  Confirming this continued rise in hospitalist value, hospitalist salaries rose 6% year over year.  Excluding academic hospitalists, the median hospitalist compensation in this survey was $233,855 per year.  The median number of annual encounters declined by 6.4% while the collections per encounter increased by 13%.   This resulted in a  stagnant 0.17% decline in  work RVU production year over year to 4,159 wRVU per hospitalist per year. This will certainly cause adjustments in RVU compensation benchmarks for hospitalists.

Today's Hospitalist 2012 survey data also provides great insight into income and productivity.  Based on the  the 711 full time respondents who agreed to answer total compensation questions,  hospitalists earned  $235,000 per year, on average,  including all salary, incentives, bonuses and other forms of regular compensation but excluding benefits.  In addition, one-quarter of hospitalists responding to the survey earned under $200,000 and one-third earned $250,000 or more, including 13% who said they earned $300,000 or more as a hospitalist.  See the image below for details.


Today's Hospitalist 2012 total compensation excluding benefits

Why is that?  Why would hospitalist income continue to rise in 2012  in the face of declining RVU production?  It's the market.  The hospital market is speaking loudly and it's telling us that the  value hospitalists provide on the back end is greater than any RVU production number hospitalists can generate on the front end.    I've written about this extensively in the past.   We are worth our weight in gold. 

Hospitalist medicine has left the constraints of the failed Medicare National Bank experiment and has found a partner in hospitals willing to provide payments to  hospitalist  groups that promise returns on investment that would make Goldman Sachs traders' mouths water.  

As witnessed by the 27% rise in average hospitalist salary over the last four years, our value will continue its current trajectory until the day it doesn't.  What day is that?  Nobody knows except the market.  That day will happen when it happens.   That  is exactly how it should be.  If we can't bring value on the backend of the failed E/M model,  then we shouldn't be valued for our contribution.  Fortunately for us, we are.  There is no other medical specialty that is able to fill the much needed void in hospital care that hospitalist medicine can.  As such, our value will continue to grow until the market says we are no longer valued for our contribution. 

I have previously purchased the salary survey report from SHM.   I found it eye opening.    Understanding salary and productivity data is mandatory for any hospitalist who wants to be satisfied  they are getting paid what the market says they are worth.  With so many variables in hospitalist income, including geographic location, size of the group and  the structure of the group,  studying compensation data from SHM/MGMA and Today's Hospitalist   is mandatory if you want to  understand what it means to your specific situation.  Have a great year and I'll update this post when I see the most up-to-date data come across the wire!

     NP and PA Hospitalist Salary Update


Hospitalist medicine continues to welcome nurse practitioners and physician assistants to the forefront of patient care. Their growth has been explosive with 50% or more of practices incorporating midlevels into their business model.  Are there any survey results available to provide insight into the value of their compensation package?  The answer is yes.  In February 2012, The Hospitalist reported on data, although limited, showing NP and PA total compensation valued between $90,000 and $100,000 a year.  Click on the provide link for a more detailed discussion of this data.  

UPDATE 2011  


The SHM/MGMA Hospitalist Salary Compensation Survey for 2011 (based on 2010 data) was initially reported on June 15th, 2011. The national median hospitalist salary for adult internal medicine hospitalists was $220,144, up from $215,000 the year before.  This represented a 2.4% increase from 2010 (based on 2009 data) Data released at the 2011 HM conference indicates current hospitalist subsidies by hospitals have continued their relentless track north, now averaging $136,400 per hospitalist, per year.  That can only mean hospitals continue to see a great return on their investment. In addition, make sure to review   Today's Hospitalist 2011 hospitalist salary survey results to see how rapidly the salary scene is changing.  

UPDATE  2010  


There's only one direction for hospitalist salary compensation these days and that is up!  The 2010 hospitalist salary survey is a bit different this year in that it represents a joint effort by The Society of Hospital Medicine and the Medical Group Management Association (MGMA).  I had a chance to review the summarized version yesterday from the online and interactive September 2010 hospitalist survey report at  The Hospitalist. This report is based on 2009 data.  

This 2010 hospitalist salary compensation survey contained the self reported  results from 4,211 hospitalists in 443 hospitalist groups, a 30% increase from the bi annual SHM 2007-2008 hospital salary survey.  In 2009, Today's Hospitalist gave us their 2009 hospitalist salary survey results, indicating a continued rise in hospitalist salary compensation during the depths of  the greatest recession in 50 years.

And here we are in September, 2010.  What is the state of hospitalist salary and compensation?  It continues to make hyperbolic gains in all areas. We are doing more, billing more, billing higher fees, and making more money. A lot more money. 

The survey creators caution on making direct comparisons with years past. They say the survey this year is different because it contains responses from just under 1% of academic hospitalists while the SHM survey two years ago had about 25% academic hospitalist involvement.  If anything, I would say that makes the 2010 survey all the more accurate for us community hospitalists.  It strips out the skewed economics of academic based medicine, where physicians are often paid for providing other services as well.

Here are the key points for the 2010 SHM/MGMA salary compensation survey (based on 2009 data) for adult hospitalist medicine.
  • The nationwide average for all cash compensation (not including benefits) was  $215,000, a rise of 17% since the 2008 survey.  By region the numbers broke down as follows
    • Midwest $211,715
    • Northeast $205,000
    • Southeast $235,701
    • West $213, 831
  • Median workRVU (wRVU) per FTE hospitalist per year is 4,107, an increase of just over 10% from 2 years ago (but remember the skewed population comparison)
  • wRVU per encounter was 1.86 an increase of  just over 21% ( but again, we are excluding the less productive academic physicians in this survey)
  • Using my own math, if you take 4,107 wRVUs/year and divide it by the 1.86 wRVU/encounter, you can see the average hospitalist saw, on average, 2,208 encounters/year. 
  • The collection per workRVU was $45.57 (compared with $44.97 in 2008, a 1.3% rise in two years).  This number can be affected by payer mix, allowable charges, number of uninsured, aggressiveness of the billing company, and what the government defines as the value of an RVU.  The current rate of payment for one RVU for a Medicare patient is about $35.  Using my calculator, you can extrapolate the average work RVU collections per year per hospitalist comes out to 4,107 * $45.57, or $187,000 in unsubsidized revenue. This amount does not include RVU collections for the  practice expense and malpractice expense components of the  total RVU formula.  If you add an additional 20% conservative estimate for collections from these components, you'll see that the hospitalist is collecting an additional $35,000-$40,000 a year, or about $220,000 in total RVU collections, per year. 
  • Hospital financial support (subsidy) per hospitalist per year by the sponsoring hospital rose to mean average of $111, 486.    If you have 20 hospitalists in your group, your hospital, on average is providing over 2.2 million dollars in financial subsidy.  What that says to me is that hospitals continue to see great value and return on their investment for implementing hospitalist groups aggressively.  If you add this to the $220,000 a year in insurance and self pay collections, the average non academic hospitalist position is worth around $330,000 in total value.  Subtract 10% for administrative expenses (or more if you implement the hiring of secretaries, business managers,  legal and accounting expenses, RNs, PA's or APRNs to help make the practice run smoothly) and I would suggest the total compensation package of hospitalists should be around $300,000 a year.
I find these numbers encouraging.  The average hospitalist position is now worth about $300,000 (if you add in collections plus hospital subsidy).  This article did not describe the average number of hours worked.  However, most hospitalist contracts call for an average of 40 hours of clinical duties per week.  That means, if you are hospitalist looking for a second job doing hospitalist locum tenens work, you are worth about $150 an hour for your efforts, at a minimum. That's the going rate.  If you aren't being paid at least $150 an hour, either the locums company is taking advantage of you, or the hospital is.  You've got the data right here to prove it.  It's time to start asking the appropriate questions.

With that said, I agree about not making significant comparisons between the 2008 survey and the 2010 survey.  We have stripped out the skewed economics of academic medicine and now have a  much more accurate evaluation of community based hospitalist economics.


UPDATE 2009  



This data is a bit outdated but present it here for historical reference.  I was unable to find a link to the actual survey data but was able to pull out an old blog post of mine.  Here is an article from Today's Hospitalist that references the 2009 salary data.
  • The highest total compensation occurred in the Texas, New Mexico and Arizona regions at just over $226,000 a year, a 14% increase.  
  • The lowest total compensation occurred in the Northeast at just over $195,000 a year, a 9% increase.  
  • Just over half of hospitalist salaries are a determined by a combination of salary and bonus incentives.  Only 7% are 100% productivity based, or eat the eat what you kill mentality.
  • The most common sign on bonus was $10,000 at 44% of respondents.  
  • The most common group size was 5-9 physicians at 20% of respondents
  • 32% of groups used nocturnists, who's hospitalist salaries can be 10-20% or more.
  • 50% of hospitalist salaries are support by the shift only model.  The rest carry some call.
Make sure to view all my free lectures on E/M hospitalist coding and my resource center filled with countless articles on practice management to make you an informed hospitalist.


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