Despite the bearish market and sluggish economy, at least one physician class is enjoying comfortable salaries: pediatric subspecialists, including pediatric anesthesiologists, surgeons, cardiologists, and neurologists.

Academic hospitals, which tend to offer lower salaries than private hospitals and clinics, are surprised to learn that the $150,000 to $180,000 they initially budget to recruit a pediatric anesthesiologist falls well short of the going rate.

According to Ron Fasnacht, senior vice president and managing principal of Cejka & Co. , the health care recruiter, to remain competitive, academic hospitals are offering salaries of a minimum of $200,000 to pediatric anesthesiologists, and some are going as high as $275,000. In private practice, these physicians earn as much as $400,000.

Other pediatric subspecialists are being offered comparably lofty sums. In some cases, academic institutions are setting up these doctors in a private practice at a university to lure them with competitive compensation plans.

What accounts for the new popularity of these doctors? "One reason is consumer demand, spurred by easy access to information on the Internet," Fasnacht says. "For instance, parents with a child who needs surgery are increasingly aware of the existence of pediatric subspecialists and now insist that the surgeon and anesthesiologist performing the operation be specially trained to treat children."

In addition, Fasnacht said that hospitals, especially in highly competitive markets, are eager to give those parents what they want. To cope with reduced reimbursement rates from the federal government and an oversupply of beds, many hospitals are introducing new pediatric service lines to maximize their patient censuses.

For example, "a general hospital may open a center of excellence for pediatric care, which may compete for patients with a local children's hospital. The new center, of course, must then be appropriately staffed," Fasnacht said.

That, however, is often easier said than done because the demand for pediatric subspecialists far exceeds the supply.

"This is partly due to managed care's emphasis on capitation and primary care physicians as gatekeepers throughout most of the 1990s," Fasnacht points out.


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