Physicians in primary care compounded a history of generally flat compensation this year with a reported 2 percent increase (-1.73 percent adjusted for inflation) to a median of $186,044. Specialists' compensation rose 2.19 percent (-1.59 percent when adjusted for inflation) to a median of $339,738. Inflation in 2008 amounted to a 3.8 percent increase in the U.S. Consumer Price Index.

Physicians in internal medicine fared the worst among their primary care counterparts, posting an increase of less than 1 percent in compensation in 2008 (-3.37 percent with inflation considered).

Among specialists, emergency medicine physicians, dermatologists and general surgeons all reported flat salaries before inflation was factored in, with declines of up to -3.2 percent after inflation. Gastroenterology, up 7.38 percent, and pulmonary medicine, up 6.65 percent, were among the few specialties that posted nominal gains in compensation in 2008. Psychiatry posted a 1.32 percent loss in physician compensation before inflation. With an increase of just 7.16 percent from 2004 to 2008, psychiatry's five-year compensation increase was half that of other specialties. 

"Physician practices endure tough economic challenges to stay solvent, especially these days.  For physicians to have a chance to hold their incomes steady, it's vital that they pay close attention to their bottom line and benchmark their practices and compensation levels against their peers," said William F. Jessee, MD, FACMPE, MGMA president and CEO. "With physician payment rates lagging behind inflation, physician practices need as many tools as possible to maintain their incomes."

MGMA observed that median collections for professional charges (the money a practice receives for a physician's professional services) were generally flat in primary care and declined moderately (-6.53 percent) for specialties. This decline may signal the leading edge of the economic downturn in 2008, demonstrating the trend of patients electing to postpone care.

For 25 years, MGMA's Physician Compensation and Production Survey Report has been one of the most respected benchmarking reports in the industry. It offers detailed information rigorous in-house data validation and analysis. This year's report provides data on nearly 50,000 providers – the largest provider population of any physician compensation survey in the United States. The 2009 report includes data for physicians and nonphysician providers in more than 110 specialties, including new data for hand, hip and joint orthopedic sub-specialists; spine surgeons; plastic and  reconstructive surgeons, ophthalmologists: corneal and refractive surgeons, and pain management specialists doing procedures not requiring anesthesia.