Primary care physicians experienced a 2.8 percent median increase in compensation last year, and specialists in general reported a 4.3 percent median increase, although some notable medical specialties experienced decreases in compensation. Results are compiled in the Medical Group Management Association's Physician Compensation and Production Survey: 2003 Report Based on 2002 Data.

Invasive and noninvasive cardiologists reported lower incomes in 2002, for the first time in several years. Their compensation declined 6.2 percent and 3.9 percent, respectively, from 2001 to 2002. Other specialties that experienced a decline from 2001 to 2002 include general surgeons (0.8 percent), pulmonologists (2.6 percent), and urologists (3.0 percent).

These compensation numbers differ from our report last month, "Primary Care Pay Falls Again," however. In last month's column, the American Medical Group Association's 2003 Medical Group Compensation and Productivity Survey showed internists receiving less compensation, to the tune of a 1.8 percent decrease, while urologists experienced a 7.9 percent increase from 2001 to 2002. The disparity between the two surveys is also apparent for noninvasive and invasive cardiologists — the trend depicted in last month's column was a lot rosier.

"Differences in sample sizes, different types of groups responding to the surveys could lead to this disparity," says Liz Johnson, a spokeswoman for the MGMA. She also points out that the MGMA survey did not include academic physician groups. "Typically, physicians in academic settings make less than their private sector counterparts and that could bring down the salary medians."

SOURCES: MEDICAL GROUP MANAGEMENT ASSOCIATION PHYSICIAN COMPENSATION AND PRODUCTION SURVEY: 2003 REPORT BASED ON 2002 DATA; ADDITIONAL DATA FROM 2003 MEDICAL GROUP COMPENSATION AND PRODUCTIVITY SURVEY, AMERICAN MEDICAL GROUP ASSOCIATION.

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There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

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Shelley Slade
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Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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