The Medscape Physician Compensation Report is the most comprehensive and widely used physician salary survey in the United
States for the seventh year in a row. Over 400,000 US physicians have used this report to access not only salary information,
but also important factors affecting income, such as hours worked, time spent with patients, what they find most rewarding—and
most challenging—about their jobs, and more. More than 19,200 physicians in more than 27 specialties responded to this year's
Medscape compensation survey. Now read the results. (Note: Values in charts have been rounded and may not match the sums noted
in the captions.)
Among all physicians responding to the Medscape survey this year, average annual full-time compensation for patient care is
$294,000. For employed respondents, patient-care compensation includes salary, bonus, and profit-sharing contributions. For
partners and solo practitioners, it includes earnings after taxes and deductible business expenses but before income tax.
This year, specialists reported earnings 46% higher than their primary care physician (PCP) peers' ($316,000 vs $217,000,
Physician incomes have steadily increased over the past 7 years, as seen in the annual Medscape Physician Compensation Reports.
Travis Singleton, senior vice president of physician search firm Merritt Hawkins, said, "The major reason for the increase
in salaries of recruited physicians is intense competition for doctors. There is competition between hospitals and healthcare
systems, and also between urgent care centers, federally qualified health centers, direct care, concierge care, and other
delivery systems, which all employ doctors."
The top three earners among all physicians this year are orthopedists ($489,000), plastic surgeons ($440,000), and cardiologists
($410,000). Orthopedists were the highest earners in the 2016 survey as well ($443,000), cardiologists second highest ($410,000),
and dermatologists third highest ($381,000). This year the lowest earners are pediatricians ($202,000), family physicians
($209,000), and endocrinologists ($220,000). Pediatricians and family physicians were in the bottom last year as well.
Pediatricians', oncologists' and cardiologists' income was virtually unchanged this year while all other survey respondents
reported an increase, the largest among plastic surgeons and allergists at 24% and 16%, respectively.
The vast majority of respondents to the Medscape survey were trained in the United States and reported the second-highest
average compensation, at $301,000 per year. Canadian doctors appear ahead of US doctors in income, largely due to a greater
percentage of younger Canadian physicians.
This year, for the first time, the Medscape compensation survey asked respondents to identify their race. Among racial/ethnic
groups that comprised more than 3% of survey respondents, those who said they are white/Caucasian or Asian earn the most annually,
at $303,000 and $283,000, respectively, followed by Hispanic/Latino and black/African American physicians at $271,000 and
A slightly greater proportion of white/Caucasian (80%) and Asian (75%) physicians chose to specialize than their Hispanic/Latino
(72%) and black/African American (70%) peers.
This year, the highest earnings were reported by respondents in the North Central ($317,000) and Great Lakes ($303,000) regions,
while the lowest were found in the Mid-Atlantic ($282,000) and the West ($290,000).
Perhaps related to government efforts to attract more physicians to rural and economically disadvantaged areas, as well as
general issues of supply and demand, the three top-earning states in this year's Medscape report are North Dakota ($361,000),
Alaska ($359,000), and South Dakota ($354,000). North Dakota had the highest earnings last year as well ($348,000), followed
by New Hampshire ($322,000) and Nebraska ($317,000).
While all three states in which respondents reported the highest compensation this year are west of the Mississippi River,
the three lowest-earning locations are to its east. District of Columbia respondents reported the lowest average annual earnings
($235,000), followed by those in Maryland ($260,000) and Rhode Island and New Mexico (both $261,000).
Physicians who are employed earn less money than those who are self-employed, trading higher salaries for fewer demands from
the administrative and business issues that self-employed practitioners face. Still, self-employed PCPs earn only 4% more
than their employed peers ($223,000 vs $214,000), while self-employed specialists earn 28% more than their employed counterparts
($368,000 vs $287,000). Among all physicians, those who are self-employed earn $343,000 per year on average compared with
$269,000 for their employed peers, a difference of 28%.
This year, male PCP respondents reported average annual earnings of $229,000 compared with female respondents' $197,000. The
gap between men and women decreased very slightly this year, to 16% from 17% last year. Last year, women's earnings were $192,000
and men's were $225,000.
This year's 37% gap between the average annual earnings of male and female specialists ($345,000 and $251,000, respectively)
has grown 4% from last year, when men reported earning $324,000 and women $242,000. This result may be influenced by the relatively
smaller percentage of women in some of the higher-paying specialties.
This year's Compensation Report shows an overall gap of 35% between the average annual earnings of male and female physicians.
Among the younger physician groups, however, the gap narrows to 18%, which is an encouraging sign as more women enter the
Eleven percent of men and 22% of women reported this year that they work part-time (less than 40 hours per week). This represents
a slight decrease for both groups from last year's 12% and 25%, respectively.
Three quarters of this year's respondents say they receive employer-subsidized health insurance, and 74% are provided with
malpractice insurance. In addition, more than half of respondents get paid time off (63%), employer-subsidized dental insurance
(61%), and retirement plans with employer matching (55%). Ten percent of respondents reported that they receive no benefits.
For the first time since Medscape's 2012 compensation survey, dermatologists were displaced as the respondents most likely
to report that they feel fairly compensated, though they remain second highest on the list at 65%. Most satisfied this year
are emergency medicine physicians, at 68%. Satisfaction rates are lowest among nephrologists (41%), endocrinologists (44%),
and urologists and infectious disease physicians (both at 47%). The average among all respondents this year is 54%.
This year, in addition to asking respondents if they are satisfied with their compensation, the Medscape survey asked those
not satisfied how large an increase they feel they deserve. Among PCPs, 46% said an 11%-25% increase would suffice compared with
41% of specialists, while one third of both groups believes that a 26%-50% increase is in order. PCPs were slightly more likely
to choose lower-percentage increases than were specialists.
As discussed earlier, this year's survey showed disparities in physicians' compensation that correlated with race, and satisfaction
with earnings varies similarly. Among groups representing more than 3% of respondents, 57% of white/Caucasian and 51% of Asian
physicians, the highest and second-highest earners, feel fairly compensated.
This year's compensation survey results confirm a sharp upward trend in the percentage of physicians who participate in accountable
care organizations, from 3% in 2012 to 36% in 2017. Participation in cash-only and concierge payment models has increased
only slightly over the same time period, from 3% to 6% and 1% to 3%, respectively.
The 3% of respondents who use a concierge payment model in their practices earn an average $300,000 annually, 2% more than
the $294,000 average among all physicians. The 6% who rely on a cash-only payment model earn $310,000 annually, 5% more than
all physicians' average.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), intended to be the permanent "Doc Fix," went into effect
on January 1, 2017. This year's Medscape survey asked physicians if they expect to participate, and respondents were most
likely to say either that they do (43%) or that they are still undecided (35%). Ophthalmologists were most likely to indicate
that they expect to participate, at 64%, while least likely were psychiatrists, at 19%.
Well over one third (38%) of respondents to this year's survey indicated that the question of dropping insurers who pay poorly
does not apply to them. Forty-three percent said they would not drop such insurers, while 20% said they would.
Just over half (52%) of PCPs reported this year that they have seen an influx of new patients as a result of the Affordable
Care Act, a slight increase from last year's 49%. There has been an even larger increase among specialists, up to 38% from
30% last year.
Over two thirds (69%) of this year's survey respondents said that they will continue taking new and treating current Medicare
and Medicaid patients. Although last year's survey juxtaposed self-employed and employed physicians, percentages of both groups
who responded affirmatively (77% and 84%, respectively) were higher than this year's average.
This year has seen a notable increase in the number of Medscape survey respondents who say they are participating in healthcare
exchanges, from 19% in 2016 to 35% this year. There were corresponding drops among those who said they are unsure (down from
52% to 41% this year) and those who are certain that they will not participate (down from 29% to 25%).
When physicians who participated in health insurance exchanges were asked whether their income had been affected, more specialists
than PCPs reported a decrease (15% vs 13%).
This year, 75% of survey respondents said they either regularly or occasionally discuss the cost of treatment with patients,
down from 85% last year.
This year's survey results show that the more varied the practice, the less likely physicians are to charge patients for missed
appointments. More than three quarters (78%) of respondents in multispecialty group practices said they do not charge for
no-shows compared with 71% of those in single-specialty groups and 65% of solo practitioners. The average among all physicians
The number of hours spent seeing patients has not changed much since last year, with the percentage of respondents who spend
46 or more hours per week decreasing slightly from 35% in 2016 to 33% this year. Those working 30-45 hours per week experienced
a slight increase to 53% from 51% last year.
Most respondents to this year's Medscape survey (59%) spend between 13 and 24 minutes with each patient. Last year's survey
took physicians' gender into account, and 11% of men and 15% of women reported that they spend 25 minutes or more per patient.
This year's rate, which includes both men and women, is 11%. (This chart does not include psychiatrists).
this year's Medscape Lifestyle Report, bureaucratic tasks remain the primary cause of burnout among physicians, and time spent addressing them continues to increase.
In the 2014 report, 35% of employed and 26% of self-employed physicians spent at least 10 hours per week on paperwork. This
year, more than half (57%) of all physicians spent this amount of time.
Less than half (43%) of respondents to this year's Medscape survey who are employed said that they are seeking promotion.
Among employed physicians, gender does not appear to play a role in whether respondents seek promotion. The gap between men
and women is 3%, with slightly fewer male (42%) than female (45%) physicians indicating that they are seeking promotion.
In this year's survey, 33% of physicians cited relationships with and gratitude from patients as the most rewarding aspect
of their jobs. Nearly as high a percentage (31%) named being good at what they do and doing it well. Far lower percentages
chose making good money at a job they like (13%), making the world a better place (12%), and pride in their profession (7%).
A scant 3% said they find nothing rewarding about their jobs.
In this year's Medscape survey, in addition to asking what physicians find most rewarding about their jobs, we asked respondents
to identify what they find most challenging. More than one quarter (28%) chose "having so many rules and regulations." Longer
hours for less pay placed second at 18%, followed closely by dealing with difficult patients, at 15%.
Topping the list this year of physicians who said that they would still choose medicine if they had to make the choice again:
rheumatologists (83%), followed by psychiatrists, infectious disease physicians, and gastroenterologists, all at 82%. With
77% of all respondents indicating that they would choose medicine again, the lowest percentage occurred among neurologists,
Of those who would choose medicine again, dermatologists boasted the highest rate of re-choosing their own specialty (96%).
At the bottom of the list, 64% of internists and 67% of family physicians would choose primary care again.
Senior Editor, Editorial Services
Art Science Code LLC
New York, New York
Disclosure: Sarah Grisham has disclosed no relevant financial relationships.
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