2010: Specialist Salary Cuts & Primary Care Pay Raise?

This had to happen some day...Medicare recently proposed readjustments in their payment amounts and here are numbers that reflect an approximate effect on payment to different physician specialties. Biggest losers seem to be Cardiology and Radiology. While Primary care (Internal medicine, Family Medicine, Geriatrics) would see higher payments...

SPECIALTY                       OVERALL
                       PAYMENT CHANGES
1 ALLERGY/IMMUNOLOGY            -3%
3 ANESTHESIOLOGY                 6%
4 CARDIAC SURGERY               -2%
5 CARDIOLOGY                   -11%
6 COLON AND RECTAL SURGERY       5%
7 CRITICAL CARE                  3%
8 DERMATOLOGY                    3%
9 EMERGENCY MEDICINE             2%
10 ENDOCRINOLOGY                 3%
11 FAMILY PRACTICE               8%
12 GASTROENTEROLOGY              0%
13 GENERAL PRACTICE              6%
14 GENERAL SURGERY               4%
15 GERIATRICS                    8%
16 HAND SURGERY                  3%
17 HEMATOLOGY/ONCOLOGY          -6%
18 INFECTIOUS DISEASE            3%
19 INTERNAL MEDICINE             6%
20 INTERVENTIONAL PAIN MGT.      6%
21 INTERVENTiONAL RADIOLOGY    -10%
22 NEPHROLOGY                    2%
23 NEUROLOGY                     3%
24 NEUROSURGERY                  2%
25 NUCLEAR MEDICINE            -13%
26 OBSTETRICS/GYNECOLOGY         1%
27 OPHTHALMOLOGY                11%
28 ORTHOPEDIC SURGERY            3%
29 OTOLARNGOLOGY                 1%
30 PATHOLOGY                     0%
31 PEDIATRICS                    4%
32 PHYSICAL MEDICINE             7%
33 PLASTIC SURGERY               5%
34 PSYCHIATRY                    3%
35 PULMONARY DISEASE             3%
36 RADIATION ONCOLOGY          -19%
37 RADIOLOGY                   -11%
38 RHEUMATOLOGY                 -1%
39 THORACIC SURGERY              2%
40 UROLOGY                      -7%
41 VASCULAR SURGERY             -1%
42 AUDIOLOGIST                 -10%
43 CHIROPRACTOR                  5%
44 CLINICAL PSYCHOLOGIST        -7%
45 CLINICAL SOCIAL WORKER       -6%
46 NURSE ANESTHETIST             2%
47 NURSE PRACTITIONER            7%

Other Healthcare Workers

48 OPTOMETRY                     12%
49 ORAL/MAXILLOFACIAL SURG        1%
50 PT/OT                         10%
51 PHYSICIAN ASSISTANT            5%
52 PODIATRY                       6%

Source: Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010.

The big cuts for Cardiology and Radiology comes due to cuts to the money paid per procedure - for example, Medicare plans to pay 38% less per stress test, 31% Less per cardiac Stent and 32% less per Left Heart Catherterization.

Cardiologists are obviously not happy about this. "Robbing subspecialist Peter to pay general practitioner Paul is a dangerous proposal for our patients. Instead of devaluing subspecialist services in order to find the revenue, why not implement some simple new practices for our country that will yield huge payoffs immediately?", Says Cardiologist Dr Melissa Walton-Shirley, also the owner of TheHeart.org

I am not sure if this might bring down the number of procedures, in fact the there might be a temptation to perform more of them to make up for the lost income ! What the American Health System needs is an uncoupling of payments from procedure volume.

Also Read:

- Cardiologist gets 10-year jail for excess procedures