Medscape Physician Compensation Survey

Despite all the stress in their work lives, and there is a lot of stress, doctors are pretty well-compensated, as the most recent annual Medscape compensation survey finds.   (Medscape Survey)   The survey is based on responses from 20,000 doctors in 29 specialties.  The average compensation for specialists in 2018 is $329,000, up from $316,000 in 2017; and the average primary care pay is $223,000 in 2018, up from $217,000.  The top paid specialties and average compensation are plastic surgery–$501,000; orthopedics–$497,000; cardiology–$423,000 and gasteroenterology–$408,000.  The lowest paid are public health–$199,000; pediatrics–$212,000; diabetes–$212,000; family medicine–$219,000 and internal medicine–$230,000.  You can see that many of these are primary care; earning less than half of the top specialists, which makes no sense if we truly value primary care.  The biggest gains in compensation were 16% for psychiatrists (where there is a huge shortfall in supply, but then who wants to listen to crazy people all day?  oh wait, most of us do that already); 14% for plastic surgeons (keep me beautiful, please, or maybe, make me beautiful, since I wasn’t that great looking to begin with); 13% for physical medicine and rehabilitation and 10% for oncologists.  Losers include general surgeons with a 9% decline; urologists with a 7% one, and ENT and endocrinologists with a 4%.

Where you are educated can affect compensation, if it was Canada, your average compensation is $324,000; if the US, $305,000; if India, $292,000 and if the Philippines, $261,000.  The North Central and Southeast regions have the highest compensation; the North East and South West, the lowest.  Indiana and Oklahoma are the highest paying specific states; DC, Maryland (MD, ironically), and New Mexico are the lowest.  Self-employed doctors, who are only 26% of the total, have average pay of $350,000; which those who are employed, 69% of the total, average $275,000.  Women are 60% of pediatricians and ob/gyns, 50% of plastic surgeons, but only 8% of orthopedists and 12% of cardiologists.  About 10 percentage points more of women doctors are part-time than male ones.  55% of doctors say they are fairly compensated.  The highest positive responses are from ER doctors, 74%; pulmonologists, 70% and dermatologists, 70%, while the lowest are physical medicine, 46% and diabetologists and allergists at 47%.

2% of doctors are in a concierge practice and 5% in a cash only one.  These doctors have above average compensation.  27% participate in an ACO.  Only 20% would drop a low-paying health plan.  85% say they discuss costs with patients regularly or at least occasionally.  70% say they will continue taking new Medicare and Medicaid patients.  29% of physicians see patients for 46 or more hours a week, 70% spend more than 10 hours a week on paperwork or administration.  55% spend an average 16 minutes or less with each patient.  Patient relationships and doing good are the most rewarding part of the job and regulations, long hours and EHRs the least, according to most doctors.  Always interesting insights in this report.