Toil is the immediate parent of contentment

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Evaluating our contemporary fast-paced, ever-demanding work environments, do the words of the Victorian novelist Anthony Trollope still hold true, or does that promise of contentment remain elusive despite years of toiling? And, hard-working physicians often struggle with this dichotomy. Two reports this week show that cardiologists, specifically, may be working harder without increasing compensation.

Due to the burgeoning baby boomer population, cardiologists are seeing a surge in patients, but are getting reimbursed less and less for their services, according to a survey conducted by MedAxiom. In order to diagnose this patient population, cardiologists performed 5 percent more nuclear studies in 2009, compared with 2008.

"Not only do cardiologists see more new patients, but because treatments are effective, they continue to treat current patients longer. There's a lot of pressure for cardiologists to meet this demand," Patrick White, president of MedAxiom, told Cardiovascular Business News.

While Medicare reimbursements for these tests are slim, MedAxiom said that cardiologists have begun cutting down on overall operating costs to minimize their losses—which is perpetuating the trend of physician practices integrating with hospitals. (For more on this topic, see our roundtable discussion “Physician Practice & Hospital Integrations: Cardiology’s Inescapable Future,” in our June issue.)

The survey found that 14 percent of practices have integrated with nearly 50 percent considering it. White anticipates that 70 percent of his members will have integrated by the end of the year.

However, the economic recession isn’t just affecting practices, as a 2009 American Medical Group Association ( AMGA) survey found that many providers continue to operate at significant losses.

The providers' bottom line differs regionally, as organizations in the eastern and western regions were operating at break-even levels in 2009. Organizations in the southern region continued to operate at a loss (-$1,034 per physician in 2009 versus -$120 per physician in 2008). Groups in the northern region continued to experience significant losses (-$9,943 per physician in 2009 from -$3,254 per physician in 2008).

While the AMGA survey found that certain specialists, like pulmonologists, urologists and dermatologists, experienced single-digit compensation jumps, cardiologists did not make the list of those with increased compensation.

Not to suggest that compensation is the only source of contentment, but even Trollope asked: What is there that money will not do?

On these topics, or any others, please feel free to contact me.

Justine Cadet