Physician Incomes Survey

Medscape has issued its 2017 Physician Compensation Report, rejecting input from 19,200 doctors in 27 specialties.  (Medscape Survey)  Average income across all specialties has risen from $206,000 in 2011 to $294,000 in 2017, a healthy gain.  Despite a system-wide emphasis on the importance of primary care, on a relative basis primary care physicians are not approaching specialist compensation levels.  Specialists average $316,000 per year and primary care physicians $217,000, so specialists average 46% more, the same gap as in 2015.  The highest-compensated specialties are orthopedics at $489,000; plastic surgery $440,000 and cardiology $410,000.  Three of the four lowest categories are primary care:  pediatrics at $202,000; family medicine $209,000; endocrinology $220,000 and internal medicine $225,000.  This pay gap reflects a system that continues to pay more for procedures than prevention and health maintenance.  Specialty averages can be quite variable from year to year, even declining at times, but the multi-year trend is clearly up.  The fastest income growth in 2017 was for plastic surgery at 24% (this is largely a self-pay specialty); allergists 15%; ear, nose and throat 13%; opthamologists 12% and pulmonology 11%.  Cardiology and orthopedics saw little income growth this year, but they have had plenty in past years.  And the primary care doctors had very muted income growth in 2017, whereas in 2016 they had significant income gains.

About half of primary care physicians reported feeling fairly compensated, while specialist income satisfaction was more varied, with ER docs, dermatologists and psychiatrists reporting satisfaction in the 65% range, while nephrologists, endocrinologists and urologists were less satisfied than primary care physicians.  Self-employed physicians earn about 28% more on average than employed ones, but it is much larger for specialists than for primary care doctors.  The average self-employed primary care physician gets around $223,000 in annual compensation compared to $214,000 for an employed one.  Average income is highest in the midwest, among the Great Lakes states and the northern Great Plains.  Adjusted for cost of living, rural doctors make about 13% more than urban ones.  This appears to be largely due to supply factors, as these relatively rural areas have more difficulty recruiting physicians than do the largely urban coastal areas.  There continues to be a gender gap in pay; male primary care physicians earn on average 16% more than female ones; male specialists earn an average of 37% more than female specialists.  Women work part-time more often than men and they are relatively scarcely represented in the higher paying specialties.  They are also more likely to be employed instead of self-employed.  The survey also reports on a number of other aspects of the physician work environment.