A New Physician Compensation Report

Medscape has released its annual survey regarding physician compensation.  (Medscape Report)  The survey covered 19,500 doctors across 25 specialties.  On average, specialists received $284,000 and primary care doctors $195,000 in compensation for 2014. The highest paid specialties were orthopedics at an average $421,000; cardiologists, $376,000, and gastroenterologists at $370,000.  The lowest compensated were pediatrics $189,000; endocrinologists, and internal medicine at $196,000 and family medicine, $195,000.  In terms of change from year earlier, rheumatologists saw a 4% decline and urologists a 1% decrease; while HIV/infectious disease doctors got a whopping 22% increase, which in some manner must be related to the new hepatitis C drugs.  Pulmunologists also saw a 15% increase while emergency medicine and pathology physicians’ compensation rose 12%.  Geographically, compensation is fairly even, ranging from $281,000 in the northwest to about $253,000 in the northeast and mid-Atlantic regions.  The highest paying states are North Dakota at $330,000 (go fracking figure!), Alaska $330,000, and Wyoming, $312,000.  The lowest paying states are D.C. at $186,000, Rhode Island at $217,000 and Maryland at $237,000.

63% of physicians now say they are employed, a radical shift from ten years ago when only 11% reported that status.  Just 32% are in private practice, but they earn substantially more on average.  3% of doctors report being in a concierge practice, 5% in a cash only setting and 30% say they participate in at least one ACO.  Women earn less than men but also are more likely to be employees, to work less and to be in lower paid specialties.  24% of female physicians are part-time versus 13% of men.  Women account for 50% of ob/gyn and pediatric doctors but only 8% of urologists and 9% of orthopedists.

Physicians report relatively low career satisfaction scores, with primary care doctors giving the lowest ratings.  Only about half of specialists and primary care physicians feel fairly compensated.  While 64% of all doctors say they would choose medicine again, only 45% say they would pick the same specialty (primary care doctors, who we are relying on to transform the system, are particularly low here) and 24% say they would select the same practice setting, indicating that being employed is not raising job satisfaction.  Most physicians say they are still taking new Medicare and Medicaid patients.  Only 25% regularly discuss cost with patients.  And 65% say they do paperwork and administrative chores more than ten hours a week.