Layout in the business of medicine is changing rapidly. Historically also every 8-10 years there is always a significant change in policy and market trend which makes a noticeable change in the bottom line. In the 60s and 70s marked increase in reimbursement led to high salaries and earnings. Then the HMOs came in the 80s and put a serious dent in reimbursements. The 90s was marked by disappearance of HMOs to a great extent. (I am not talking about California!!) But it also started price cutting by insurance companies. So I am going to make a few predictions about salaries of a few specialty.
Internal Medicine: I am noticing a change in Internal Medicine physician salaries. They are rising! And rising much faster than expected. The problem with Internal Medicine is the ability of the medical graduates to go into sub specialty. Since only about 30% stay back to look for primary care job opportunities. This percentage did not change despite increase in number of residency slots. So the shortage of primary care candidates have started and is bound to get worse. Also IM and FP docs for that matter have suddenly realized that they are able to offer procedures in the office rather than in the hospital The reason is much of the hardware required is also bottoming out in prices making it affordable. Thanks to the competition among vendors and the emergence of "refurbished medical equipment" selling companies.
Another big factor is the Hospitalist trend. Remember hospitalist is a high stress, high employee turnover business. So demand of hospitalists is increasing as many of the established primary care docs are electing not to cover the hospital. Hospitals are finding it lucrative to have a hospitalist program because it attracts other physicians to the area due to convenience. Also it does save cost to the hospital by shortening length of stay boosting their profits. As more and more data is pouring in, more and more hospitals are joining the fray to open a hospitalist program. This will significantly accelerate the demand while supply is trickling down. No wonder you see all the NEJM classified littered with hospitalist job openings.