Healthcare organizations are seeking more medical specialists and fewer primary care physicians, according to a report released by Merritt Hawkins, a physician search provider that is part of AMN Healthcare Services Inc. (NYSE: AMN). The report also found physicians practicing invasive cardiology have the highest average starting salaries at $640,000.

“While demand remains strong for primary care physicians, specialists are increasingly needed to care for an older and sicker population,” said Travis Singleton, executive VP of Merritt Hawkins. “In some medical specialties, shortages are emerging that will pose a serious challenge to public health.”

Merritt Hawkins’ report, the “2019 Review of Physician and Advanced Practitioner Recruiting Incentives,” is based on a sample of 3,131 searches from physicians and advanced practitioner that the firm conducted from April 1, 2019 to March 31, 2019.

It found that 78% of Merritt Hawkins’ recruiting engagements were for medical specialists, up from 67% a year ago. However, searches for primary care physicians fell by 8% year over year and by 38% compared to four years ago. Primary care physicians include family doctors, internists and pediatricians.

In terms of salaries, the second-highest average starting salaries wen to orthopedic surgeons at $536,000. Next were gastroenterologists at $495,000 and urologists at $464,000.

For family physicians, the average starting salary was $239,000.

The average signing bonus offered to physicians is $32,692, according to the report.