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Medscape Physician Compensation Report

By April 22, 2014Commentary

Medscape regularly releases information on physician earnings.  The most recent is compiled from surveys of 24,000 doctors in 25 specialties.  (Medscape Report)   The highest compensated specialties are orthopedics at an average $413,000; cardiology at $351,000; urology and gastroenterology at $348,000 and radiology and anesthesiology at $340,000.  The lowest average annual compensation is found in infectious disease at $174,000; family medicine at $176 and pediatrics at $181,000.  The fastest compensation growth was for rheumatology at 15%, while psychiatry and general surgery rose at 6%.  Nephrologists, pathologists and radiologists experienced slight declines.  Men averaged $267,00 and women $204,000 but most of this is explained by the younger age of women physicians and choice of specialty.  Geographically, average compensation across all physicians is relatively the same, from a high of $258,000 in the Great Lakes region to a low of $239,000 in the Northeast.  Self-employed primary care doctors averaged $188,000 versus $180,000 for employed ones, and for all physicians the average was $281 in self-employed settings and $228,000 in employed ones.  The highest average compensation was $273,000 among members of office-based single specialty groups and the lowest was $189,000 in an outpatient clinic; while solo practitioners averaged $222,000.

About half of all physicians say they are fairly compensated.  Dermatologists, ER doctors, pathologists and psychiatrists are the most likely to say so and plastic surgeons, pulmonologists, and neurologists the least likely.  Around 43% expect their income to decline as a result of the health insurance exchanges.  Fifteen percent of the self-employed say they will not accept more Medicaid and Medicare patients and 25% are still considering whether they will.  About a quarter participate in an ACO, 6% are in a cash-only practice and 3% in concierge format.  While the numbers are small, they are going rapidly.  Forty-six percent spend 40 hours a week or less seeing patients and 57% of the self-employed and 63% of the employed doctors spend more that five hours a week on administration and paperwork.  Seventy-five percent spend 20 minutes or less per patient.  Thirty-two percent regularly discuss cost with patients and 40% say they occasionally do so.  Only 58% say they would chose medicine again as a career, with the highest paid specialties the least likely to say they would do so.  The primary reward was listed as being good at their work and finding answers for patients by 34% of doctors and relationships with patients by 33%.  To most of us, physicians would seem well-compensated for their work, but there are warning signs in this survey about the levels of job satisfaction.

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