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