In our last post, we demonstrated the overall decline in primary care physician productivity from 2002 to 2016. The decline has yet to rebound for Family Medicine, Pediatrics and Urgent Care while Internal Medicine and OB/Gyn have seen sharp upticks in productivity in the last several years. This week’s focus is on the medical sub-specialties.
We analyzed the trends in ambulatory encounter productivity across 19 different medical sub-specialties for the same time period, 2002 to 2016. The resulting story is quite different than the primary care productivity trend line. Only 7 of the 19 medical sub-specialties are producing below 2002 levels, while 12 specialties are producing more in 2016 than they did in 2012.
The decline in productivity ranged from 19% to 1% in Allergy & Immunology, Hematology/Oncology, Rheumatology, Dermatology, Reproductive Endocrinology, Neurology and Sport Medicine. That said, the most recent 5 year trend line is positive in all seven of these specialties.
The largest increase in productivity is in Pain Management - the median ambulatory encounters grew from 756 in 2002 to 3,222 in 2016. Electrophysiology and Infectious Disease also experienced triple digit growth in productivity during this same time period. There was double digit growth in productivity in Interventional Cardiology, PM&R, Medical Cardiology, GI, Pulmonary, Sleep Medicine and Nephrology while Endocrinology and Psychiatry remained basically flat.
So, while primary care physicians largely did not expand their ability to treat more patients, medical sub-specialists made great strides in expanding the size of their patient panels from 2002 to 2016.
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