Changes in Healthcare Make an Impact
Medicine is undergoing significant changes -- some for the better and others less so. Compensation has increased slightly in 19 specialties; the income gap between men and women is narrowing; ACOs are making their impact felt; self-employed physicians earn more than employed ones; and cash-only practices, while still a tiny percentage of all practices, are gaining some traction.
Those are some of the highlights of Medscape's Physician Compensation Report: 2014 Results. The report is based on an extensive survey of more than 24,000 US physicians representing 25 specialties.
Who's on Top?
Orthopedics ($413,000), cardiology ($351,000), urology ($348,000), gastroenterology ($348,000), and radiology ($340,000) are the 5 top-earning specialties, as they were in last year's survey. Radiology has moved down in rank a bit compared with our earlier surveys, and anesthesiology has been knocked out of the top five, where it ranked in earlier surveys.
Primary Care Income Has Gone Up Very Slightly
Compensation for both family physicians and internists is up 1% over last year. While physicians overall have been concerned about income declines due to healthcare reform, this was not the case in 2013 for 19 specialties which saw relatively modest increases. However, inflation in 2013 was 1.5%, so for many, income did not keep up with inflation.
For primary care, some of the increase was probably due to the 10% bonus paid to primary care physicians who see Medicare patients, as stipulated in the Affordable Care Act. And despite the modest increase, family physicians and pediatricians are among the lowest-paid specialists, as they have been in our past surveys.
The Income Gap Between Male and Female Physicians Is Narrowing
Among physicians, men earn more than women, as they have in all past surveys. However, that picture appears to have improved. In 2010, male physicians earned 40% more than females, yet in 2013, males earned 30% more. Those percentages vary by specialty; in primary care, the disparity is smaller and it hasn't changed much. In 2013, among internists, men earned 13% more than women ($195,000 vs $173,000); in family medicine, men earned 19% more ($187,000 vs $157,000).
Although men make more than women in almost every specialty, women tend to be as satisfied as men with their compensation or, in some specialties, even more satisfied. For example, female ob/gyns make $229,000 compared with $256,000 for men, but 47% of women are satisfied with their compensation compared with 38% of men. Female gastroenterologists make less than male gastroenterologists, but 55% are satisfied with their income vs 46% of men.
In our survey, urology was the only specialty in which women made more than men (and female urologists were also more satisfied with their compensation).