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The report also revealed that asc nurses earned an average of $35. Let me know what you think. However, its clear that most of the fundamental supply and demand factors driving compensation in primary care remain in place, said Tom Florence, an executive vice president at Merritt Hawkins. All Rights Reserved. Median W-RVUs came in at 4,740 in family medicine, 4,861 in internal medicine, and 5,246 in pediatrics. One of the divisions most significant efforts is the Physician Practice Benchmark Survey, which focuses on the practice arrangements and payment methodologies of physicians who take care of patients for at least 20 hours per week and don't work for the federal government. Covid-19 antibody treatments: Here's what the evidence says. The NEJM CareerCenter is a product of NEJM Group, a division of the Massachusetts Medical Society. Thats not surprising, really, because the region includes some of the highest cost-of-living ZIP codes in the country and that environment also has more capitation covered lives and risk contracts than the other regions. A Detailed Look at the Methods Used to Compensate Physicians in Different Practice Types and Specialties, Updated Data on Physician Practice Arrangements: Physician Ownership Drops Below 50 Percent, Medical Liability Claim Frequency among U.S. Physicians, Payment and Delivery in 2016: The Prevalence of Medical Homes, Accountable Care Organizations, and Payment Methods Reported by Physicians, Physicians Patient MixA Snapshot from the 2016 Benchmark Survey and Changes Associated with the ACA, Payment and Delivery in 2014: The Prevalence of New Models Reported by Physicians, Updated Data on Physician Practice Arrangements: Inching Toward Hospital Ownership, New Data on Physician Compensation Methods: One Size Does Not Fit All, New Data on Physician Practice Arrangements: Private Practice Remains Strong Despite Shifts Toward Hospital Employment, Single source of pay becoming less common for physicians, Most physicians now compensated through more than one method, Employed physicians now exceed those who own their practices, What doctors wish patients knew about long COVID-19 brain fog, Why Minnesota changed key query to promote physician well-being, Want to switch residency programs? For the 170 medical groups that indicated how base salary for physicians is determined, 90% reported that market salary data is the primary determinant. endstream endobj startxref In addition, in many of those organizations, [physician] positions are salaried, Mr. Horton said. In 2020, the average radiologist salary was $408,023 (compared with $394,000 in 2019). Gonna follow. Christopher Cheney is the senior clinical care editor at HealthLeaders. 2021 report based on 2020 data survey methodology. More information is provided at the end of the report. But AI can play a positive role in medical education. AMGA Consultingassists healthcare organizations in navigating the changing industry environment. To learn more about the survey, and to purchase, please visit amga.org/compsurvey. Data, in scientific meaning, is a set of information gathered for a purpose. Overall, compensation for most physician specialties remained flat or saw a moderate increase between 2019 and 2020. Telehealth in 2020: Survey Data Show Widespread Use Across Most Physician Specialties and for a Variety of Functions. In 2019, median compensation for all primary care specialties increased by 4.46%, median productivity increased by 0.44%, and compensation per wRVU increased by 2.6%. 2020 Benchmark Survey. Overall physician compensation in the United States increased by 0.12% in 2020, but some specialties saw median compensation rates higher than others, according to the 34th annual AMGA Medical Group Compensation and Productivity Survey, performed by American Medical Group Association (AMGA). Overall physician productivity decreased 10.17% in 2020, down dramatically from the 0.56% increase AMGA reported for 2019. Most physician specialties saw compensation increases between 2018 and 2019, according to a recent report from the Medical Group Management Association. Nevertheless, quality on average determines only 8% of total physician compensation packages tracked in. MGMA DataDive is your gateway to the unknown. One of the bright spots on the compensation horizon in recent years has been urgent care, a relatively new specialty thats seen a big increase in earnings as the models prevalence grows. Compensation, physician compensation and productivity, and physician executive compensation surveys participant $2,800 nonparticipant $11,100 bundle price $3,700 $14,800 bundle type * provides critical benchmarking data on executive and management compensation trends and pay practices. Copyright 1995 - 2023 American Medical Association. 237 Views, Mgma Physician Compensation 2021 Pdf. Linking and Reprinting Policy. 17.2% of physicians were in practices with at least 50 physicians in 2020, up from 14.7 % in 2018. whatif With America's projected physician shortage and the financial effects of the COVID-19 pandemic,it is important to keep tabs on how physician compensation is evolving. Not unexpectedly, the drops in provider productivity in April were much more significant than the drop in compensation, MGMA data analysts reported, and rebounding of productivity has been slower as well. API Documentation. o The completed survey questionnaire is due by . AMGA Consulting builds clients organizational capabilities through effective governance, operational improvement, strategic alignment, talent management, provider compensation design, fair market value analysis and total rewards solutions. American association for physician leadership/sullivancotter: The total compensation received by the physician and crna reported as direct compensation which may. The trend toward rising work relative value units (W-RVUs), the primary measure of how hard physicians work, appears to be leveling off. The report on 2012-2020 physician compensation methods shows an upswing in compensation by multiple methods. Interestingly, 58 percent of PCPs surveyed reported receiving incentive bonuses over the year, at an average of $26,000. When combined, it is certain that change is taking place, but the ultimate landing place is far from clear.. Read the House of Delegates (HOD) speakers' updates for the 2023 Annual HOD Annual Meeting. The following figures capture changes in compensation and productivity from 2018 to 2019 for these roles. Find information about the summary of panel actions, a document prepared after each meeting of the CPT editorial panel. Anesthesiologists: $453,683 (2.57 percent decrease from 2020) Cardiologists (general): $518,750 (2.63 percent decrease from 2020) Dermatologists: $506,276 (1.59 percent increase from 2020) Endocrinologists: $274,402 (0.22 percent increase from 2020) Emergency room physicians: $380,099 (0.58 percent increase from 2020) Family medicine physicians: $273,291 (1.27 percent increase from 2020) Gastroenterologists: $538,908 (0.74 percent decrease from 2020) General surgeons: $439,196 (2.69 percent decrease from 2020) Internal medicine physicians: $288,558 (0.05 percent decrease from 2020) Neurologists: $325,278 (1.25 percent increase from 2020) OB-GYN: $357,266 (0.66 percent decrease from 2020) Hematology and medical oncology: $462,644 (1.39 percent decrease from 2020) Ophthalmologists: $416,333 (1.14 percent decrease from 2020) Orthopedic surgeons: $626,297 (0.89 percent decrease from 2020) Pediatricians: $255,352 (0.81 percent decrease from 2020) Psychiatrists: $299,250 (0.54 percent decrease from 2020) Pulmonary Disease (With Critical Care): $418,382 (1.41 percent decrease from 2020) Rheumatologists: $278,416 (0.48 percent increase from 2020) Urologists: $500,698 (2.82 percent increase from 2020), Anesthesiologists: 10,842 Cardiologists (general): 6,896 Dermatologists: 6,447 Endocrinologists: 4,471 Emergency room physicians: 6,111 Family medicine physicians: 4,575 Gastroenterologists: 6,787 General surgeons: 6,025 Internal medicine physicians: 4,413 Neurologists: 4,253 OB-GYN: 6,317 Hematologists/Oncologists: 4,357 Ophthalmologists: 7,381 Orthopedic surgeons: 7,431 Pediatricians: 4,605 Psychiatrists: 3,574 Pulmonary disease (with critical care): 5,744 Rheumatologists: 4,315 Urologists: 7,093, Primary care men: $269,000 Primary care women: $211,000 Specialists men: $376,000 Specialists women: $283,000, Orthopedic surgeons: $116,000 Ophthalmologists: $87,000 Otolaryngologists: $72,000 Urologists: $72,000 Cardiologists: $71,000 Radiologists: $69,000 Gastroenterologists: $60,000 Anesthesiologists: $55,000 OB-GYN and women's health: $48,000 General surgeons: $47,000 Emergency medicine physicians: $44,000 Pathologists: $42,000 Critical care physicians: $41,000 Neurologists: $39,000 Physical medicine and rehabilitation physicians: $37,000 Family medicine physicians: $27,000 Internal medicine physicians: $26,000 Pediatricians: $26,000 Psychiatrists: $24,000, Family medicine physicians: $240,000 Radiologists: $50,000 Psychiatrists: $75,000 Internal medicine physicians: $100,000, Family medicine physicians: $2,500 Radiologists: $10,000 Psychiatrists: $1,000 Internal medicine physicians: $5,000, Highest-paying states for physicians by mean compensation, Alabama: $348,000 Kentucky: $340,000 Oklahoma: $338,000 Indiana: $337,000 Missouri: $332,000 South Carolina: $332,000 Florida: $331,000 Georgia: $330,000 Iowa: $330,000 Tennessee: $329,000, Highest offered base salary (Bonuses and benefits not included), Family medicine physicians: $400,000 Radiologists: $825,000 Psychiatrists: $400,000 Internal medicine physicians: $500,000 OB-GYN: $750,000 Anesthesiologists: $750,000 Hematologists/Oncologists: $1 million Gastroenterologists: $750,000 Cardiologists (non-invasive): $700,000 Cardiologists (interventional): $1 million Neurologists: $850,000 Orthopedic surgeons: $1 million Dermatologists: $1 million Pulmonologists: $650,000 Pediatricians: $400,000 Endocrinologists: $325,000, Lowest offered base salary (Bonuses and benefits not included), Family medicine physicians: $180,000 Radiologists: $150,000 Psychiatrists: $185,000 Internal medicine physicians: $170,000 OB-GYN: $207,000 Anesthesiologists: $245,000 Hematologists/Oncologists: $180,000 Gastroenterologists: $125,000 Cardiologists (non-invasive): $350,000 Cardiologists (interventional): $400,000 Neurologists: $215,000 Orthopedic surgeons: $300,000 Dermatologists: $200,000 Pulmonologists: $250,000 Pediatricians: $180,000 Endocrinologists: $200,000. Connect with industry experts to help solve your most difficult medical practice challenges. In a July 2020 Hospital Finance Podcast on the effects of the pandemic on physician compensation, Zachary Hartshell, a principal at SullivanCotter, which conducts annual surveys on physician compensation, reported that relatively few less than 10 percent of organizations surveyed had actually implemented wholesale furloughs or layoffs. This is the biggest gap that we saw in all of the specialties, which clearly puts some pressure on organizations going forward, he said. The Division of Economic and Health Policy Research conducts independent research to support AMA federal, state and private sector advocacy agendas. Performance Improvement & Publications Overview, Best Practices and Research and Analytics, Survey Shows Divergent Trends in Provider Compensation and Productivity. In 2020, 54.9% of physicians reported participation in at least one type of ACO (Medicare, Medicaid, commercial), up 11 percentage points from 2016. Care model changes are leading nurse practitioners and physician assistants to more frequently work with their own panel of patients. Add image to PDF. Clinical compensation of the individual physician including base and variable compensation plus all voluntary salary reductions. Although the MGMA declined to predict the effects of the pandemic and associated economic conditions and the drop in health care organizations revenues effects on PCPs (and other physicians) compensation in the next few years, citing fluctuating economic conditions, the organization is following the situation closely. The site navigation utilizes arrow, enter, escape, and space bar key commands. The survey features several key data points. 1888. Since 2017, median urgent care compensation has increased by nearly $30,000, far more than for many other nonsurgical specialties. Edit scanned PDF . "The data reveals the devastating economic impact of Covid-19 on health care provider organizations and indicates that they may need to rethink their compensation models in order to remain resilient in the face of future disruptions. The shift to more value-based compensation models will help organizations become more resilient against future economic downturns," he said. Developers. The AMGA survey is available to provider organizations for $1,600 for a printed publication or $3,200 for the online portal. I am in search of this too. All rights reserved. Download AMA Connect app for AMGA's Annual Conference is the preeminent forum for medical groups and health system executives to discuss their challenges and successes, and to learn about best practices for healthcare management and delivery. The 2020 Medscape Radiologist Compensation Report showed the average radiologist salary to be $427,000 (compared with $419,000 in 2019). A State Sales tax exempt certificate must be on file and taxable items cannot be ordered online. August 27, 2021 | Advisory Board Daily Briefing, Charted: Here's how much physicians were paid in 2020. PHG (2021) . All Rights Reserved. o Report data for full year. Get Started. See more of our nursery rhymes and folk song lyrics. iPhone or General pediatrics and adolescent care saw the lowest median compensation in 2020it was $255,352, a decrease from $257,432 the year before. Physicians should focus on organizations that will include them in financial decision-making, not insulate them from financial reality, he said. 10.6% of weekly visits were conducted via videoconferencing and 8.1% were conducted via phone. In this report, we detail: the total annual clinical compensation for each physician from each specialty on the specialty code list. CMS takes big steps to fix prior authorization in Medicare Advantage and more in the latest Advocacy Update spotlight. The survey report has several key data points. endstream endobj 333 0 obj <. The AMA is your steadfast ally from classroom to Match to residency and beyond. Of the specialties included in the report, orthopedic surgery saw the highest median compensation in 2020, at $626,297. The survey, conducted by AMGAs subsidiary, AMGA Consulting, found that in 2019, overall physician compensation increased by 3.79%, up from the 2.92% increase seen in 2018. Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory. 2020 AMGA Consulting, LLC. Theres been a lot of focus on getting more value in [physician care], but that shift is occurring more slowly than we anticipated, he said. *Survey contains compensation and productivity data on all provider specialties. Mean compensation for men and women, mean incentive bonus and highest-paying states by mean compensation are from Medscape's "Physician Compensation Report 2021." Many physicians who had their compensation linked to productivity took a financial hit from the pandemic, with declines in patient office visits and other disruptions such as suspensions of elective surgery across the country. Welcome to /r/MedicalSchool: An international community for medical students. New comments cannot be posted and votes cannot be cast. 354 0 obj <>/Filter/FlateDecode/ID[<1269487CB1D061468093B1BEEE6DC0FC>]/Index[332 32]/Info 331 0 R/Length 109/Prev 178938/Root 333 0 R/Size 364/Type/XRef/W[1 3 1]>>stream This is compared to 2018, where compensation increased by 4.91%, median productivity increased by 0.21%, and compensation per wRVU increased by 3.57%. Neurosurgery $746,544 thoracic surgery $668,350 orthopedic surgery $605,330 plastic surgery $539,208 oral & maxillofacial $538,590 vascular surgery $534,508 cardiology. 981 documents similar to 2010 mgma physician. Compensation models will look different in the near future based on shifting productivity and demands on physicians and the industry overall, said Halee Fischer-Wright, MD, MGMAs president and chief executive officer. Of course, its not all doom and gloom out there, Mr. Horton reminds physicians. If you purchased an event, you will be receiving a follow-up email from our Learning Management System regarding the product/event purchased and no further action is required. Mgma physician compensation and production survey. Although PCP hiring also took a downturn in the wake of the pandemic, not surprisingly, theres a general sense that the overall hiring market remains strong because of the underlying factors, according to Merritt Hawkins, one of the countrys largest physician recruiting firms. As of Jan. 1 2021 membership purchasers in AZ, CA, HI, NJ and UT are subject to taxation. Orthopedic surgery posted the highest 2020 median specialty compensation at $631,900, followed by gastroenterology at $542,948, and general cardiology at $532,781. 2018 physician compensation feature and from Merritt Hawkins' 2018 Review of Physician and Advanced Practitioner Recruiting . MGMA: https://drive.google.com/file/d/1AGDYDsHNa4zfRKRn6Fgl35D-j6nYVyq8/view, AMGA: https://www.advisory.com/daily-briefing/2021/08/27/physician-compensation, Medscape: Annual publicly available report, Merritt Hawkins: AAMC CIM private practive report + Merritt Hawkins annual report, Doximity: 2020 and 2019 Annual Compensation Report. physicians to ensure compliance with the fraud and abuse laws is critically important. Do you have a link for the MGMA data from 2019? Learn more about the process with the AMA. We have created our first annual physician compensation report to save you both time and money looking for the data and statistics you want to know. Listen to . General Information . Meanwhile, overall production increased by 0.56% in 2019, compared to a 0.29% increase the previous year. Primary care physicians saw compensation gains slightly behind those seen in 2020, with median total compensation reaching $286,525 in 2021. Overall, according to MGMAs recent COVID-19 financial impact report, practices reported an average 55 percent decline in revenue in the early months of the pandemic and many were forced to furlough medical staff. Unless youre Houdini, in this [financial] environment, youre going to be paying more and bringing in less revenue to cover operations, said Fred Horton, president of American Medical Group Association Consulting (AMGA Consulting). Explore reports on this topic from the Council on Medical Education presented during the AMA Interim and Annual Meetings. General pediatrics and adolescent medicine posted the lowest 2020 median specialty compensation at $257,432. Sooner or later, a backlog of sick patients will need to be addressed. PDF Converter. This trend mirrors that found in last years survey, which showed similar disparities between annual pay and productivity gains. The report is based on responses from surveys of about 18,000 U.S. physicians in more than 29 specialties. %PDF-1.6 % Left and right arrows move across top level links and expand / close menus in sub levels. The Becker's Hospital Review website uses cookies to display relevant ads and to enhance your browsing experience. Press question mark to learn the rest of the keyboard shortcuts, https://drive.google.com/file/d/1AGDYDsHNa4zfRKRn6Fgl35D-j6nYVyq8/view, https://www.advisory.com/daily-briefing/2021/08/27/physician-compensation. Current ArticleCharted: Here's how much physicians were paid in 2020. 5 things you should know. Specialty MGMA AMGA Medscape Merritt Hawkins Doximity AAMC (Academic) Allergy: See PHG Link Above: $298,000: $329,880: $230,000: Anesthesiology (General) $453,683: $405,000: $367,000: $457,867: When 100% of the nursing faculty at one upstate New York reported incivility as a major departmental issue, they reversed course. Fig. In the interim and going forward, to enable flexibility in physician pay structures, Mr. Horton urges organizations to set a component of compensation based on organizations financial performance, and he strongly recommends that PCPs get involved in financial decision-making where they practice. Fig. Most data is from 2020 or 2021, Edit: just fixed a bug where many of the non -MGMA salaries were mapping inaccurately. Copyright © 2023 Becker's Healthcare. Create an account to follow your favorite communities and start taking part in conversations. "Though the survey, conducted by AMGA Consulting, found very modest increases in compensation, there were significant decreases in productivity, which can be directly tied to the pandemic. Career resources content posted on NEJM CareerCenter is produced by freelance health care writers as an advertising service of NEJM Group, a division of the Massachusetts Medical Society and should not be construed as coming from, or representing the views of, the New England Journal of Medicine, NEJM Group, or the Massachusetts Medical Society, Compensation is holding steady or rising, but the pandemic effects and practices declining revenues will likely have an effect going forward. I agree that overall the numbers, anecdotally, seem higher than I've heard many people talk about online, but they seem about right for my region. February 10, 2023: February 10, 2023: MGMA comments on prior authorization policies in the 2024 MA and Part D proposed rule, January 31, 2023: January 30, 2023: MGMA response to RFI on the CONNECT for Health Act, January 23, 2023: January 23, 2023: MGMA and over 100 coalition partners urge Congress to reform the Medicare payment system and explore long-term payment solutions, A State Sales tax exempt certificate must be on file and taxable items cannot be ordered online. The pressure for more operational efficiency is greater than ever, and the concern is that payers, facing some of the same pressures, will push for more managed expense models, rather than profit/risk sharing through two-sided risk. The decline in physician productivity "was not surprising," said Elizabeth Siemsen, AMGA Consulting director. The largest share of visits conducted on a remote basis were by psychiatrists, 36.9% via videoconferencing and 29.0% via phone. How do I know how to negotiate if Im not sure what percentile wRVU the salary is for. The nationwide survey includes data from 398 medical groups, representing more than 190,000 providers from 168 physician, advanced practice clinician and other specialties. Compensation per work unit (wRVU) fell . Youre better off asking people in your field to share their salaries. Physician compensation increased at a very modest rate in 2020, according to a survey report published by AMGA. "Though the survey, conducted by AMGA Consulting, found very modest increases in compensation, there were significant decreases in productivity, which can be directly tied to the pandemic," AMGA said in the statement. . As an indicator of overall primary care physician productivity to organizations revenues, its worth noting, Mr. Horton pointed out, that while compensation per W-RVU was up 2.6% in 2019, compared to the prior year, collections per RVU dropped by 1.6%. Saved credit card is required for opt-in to autorenew. Up and Down arrows will open main level menus and toggle through sub tier links. Generally speaking, knowing your market worth is a good thing in my opinion. Note: Several surveys were used to compile this report. This report (PDF) describes changes in physician employment status and practice size, type and . Compared to 2018, starting compensation for internists was up 5.7%, and for family medicine physicians, 3.7%, and pediatricians, 5.1%. hb```@9&0|ivs``(|O{$ @B;:f1cg2H0cD!yVN@An ? @ 0 8g General surgeons: $439,196 (2.69 percent decrease from 2020) Internal medicine physicians: $288,558 (0.05 percent decrease from 2020) Neurologists: $325,278 (1.25 percent increase from 2020) OB . News and Reference What is Happening Now. MGMA has asked me to remove all their salary data including PHG data. Join a network of over 60,000 healthcare management professionals to achieve a healthier world. Registration is open for our 2023 Annual Conference! Demand has prompted the steady increases, approaching 10 percent overall between 2015 and 2019, and although that demand persists for primary care physicians (PCPs), theres an elephant in the room now thats likely to flatten compensation: the pandemic and its attendant effect on practice and hospital revenues. Compensation from this report includes base salary, bonuses and profit-sharing contributions. Data report: 2022 MGMA DataDive Provider Compensation Realizing Recovery, Discover more about MGMA DataDive Provider Compensation. This report (PDF) describes the rapid uptick in physicians use of telehealth between Sept. 2018 and Sept. 2020. Specialist physicians who were hit the hardest in 2020 made significant gains last year despite rising costs and staffing shortages emerging as top challenges. While some physicians have seen their median compensation climb, median compensation for many physician specialties remained flat or declined. Meanwhile, when divided up by region, the data showed that primary care specialties had the highest median compensation in 2020 in the West and the lowest in the East. Related: Physician Employment Market Stabilizing, Recruitment Executive Says. The AMA promotes the art and science of medicine and the betterment of public health. This report (PDF) describes changes in physician employment status and practice size, type and ownership between 2012 and 2020. What you need to know about the forces reshaping our industry. The report on 2012-2020 physician compensation methods shows an upswing in compensation by multiple methods. Learn more with the AMA. The data on payment methods show that 66.8% of physicians were in practices that received payment from at least one APM (pay-for-performance, shared savings, bundled payments and capitation), up 9 percentage points from 2012. AMA SPS member Mary K. McCarthy, MD, discusses the activities and efforts of the Committee on Senior Physicians at the Oregon Medical Association. Pre-exposure prophylaxis is one of the Affordable Care Act (ACA) preventive services at risk in federal court, says Stephen Parodi, MD. The data generally show consistent participation increases for each ACO type since 2016, although participation in Medicare ACOs slightly decreased from 2018 (38.2%) to 2020 (36.7%). OCR PDF. Android, The best in medicine, delivered to your mailbox. %%EOF The review is based on 2,458 permanent physician and advanced practitioner search assignments that were ongoing or conducted by Merritt Hawkins/AMN Healthcare's physician staffing companies from April 2020 to March 2021. The shift to more value-based compensation models will help organizations become more resilient against future economic downturns.". "Medical groups temporarily canceling elective procedures, an inability for some patients to access health care services for portions of the year, and the apprehension of other patients to seek in-person care for fear of Covid-19 infection all played a role in the declines we observed." Here are the sources I used. The data reveals the devastating economic impact of COVID-19 on healthcare provider organizations and indicates that they may need to rethink their compensation models in order to remain resilient in the face of future disruptions.". 363 0 obj <>stream However, consistent over the 2014-2020 period, roughly 70% of practice revenue came from FFS and 30% from APMs. Insure.com compared payers in various categories to review and rank the best companies currently. "Medical groups paid a steep price to retain their physician talent, even though productivity steeply declined. Copyright 2023 Becker's Healthcare. This report (PDF) provides a detailed look at the extent to which physicians are in practices that participate in medical homes and accountable care organizations (ACOs) as well as involvement in alternative payment methods (APMs). The reports are leveraged by the team at HSG and are heavily relied upon as a reference for our evaluation of compensation and production Find or become the candidate that exceeds expectations with our comprehensive career and hiring development resources. Private Practice Dropped to Less Than 50 Percent of Physicians in 2020. PHYSICIAN COMPENSATION SURVEY Pinnacle 10.1% Delta Medicus AMGA Pacific MDN HHCS MGMA Martin Jackson Merritt Cejka Locum Hay Daniel $512,500 $506,489 $502,000 $483,247 Doximity: 2020 and 2019 Annual Compensation Report AAMC: AAMC Careers in Medicine (CIM) These are typically medians after surveying all physicians regardless of how many years out of training. Please, check the box to confirm you're not a robot. do you know anything similar to this amazing work of yours but in european countries?

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