Leslie Kane, MA
Executive Editor,
Medscape Business of Medicine
Disclosure: Leslie Kane, MA, has disclosed no relevant financial relationships.
Compare Compensation Across 25 Specialties
How Are You Coping with Income Changes? Join the discussion.
In 2011, radiologists were the highest-compensated of all specialties surveyed, tied with Orthopedists. Respondents earned a mean income of $315,000 – about 10% less than in Medscape's 2011 survey. Fully one third of radiologists earned $400,000 or more, although this proportion was down from the 2011 survey. Almost one half (48%) earned from $300,000 to about $500,000. About 16% of radiologists earned $100,000 or less -- typically, those working part-time -- up slightly from 1 year ago.
For employed radiologists, compensation covers salary, bonus, and profit-sharing contributions. For partners, compensation includes earnings after tax-deductible business expenses but before income tax. Compensation excludes non-patient-related activities (eg, expert witness services, speaking engagements, and product sales).
More than one third of radiologists saw virtually no difference in income between 2011 and 2010. In Medscape's 2011 survey, about one half of radiologists saw no change in income. Another 42% of radiologists saw a decrease in their earnings (compared with about a third last year), while 21% reported an increase (up slightly from last year). Radiologists have faced steep cuts in Medicare and Medicaid pay rates since 2010.
The gap in earnings between male and female radiologists still exists, although the gap is less than with physicians overall. While male physicians overall earned 40% more than their female counterparts, male radiologists reported mean compensation of $330,000, compared with $278,000 mean earnings for women – only a19% difference. The gap was slightly less in Medscape's 2011 survey. Both genders reported declines in mean income over the previous year.
For the second year in a row, radiologists in the Great Lakes region (Ohio, Michigan, Indiana, Illinois, Wisconsin, and Minnesota) earned the most, at a mean income of $345,000; however, this represents a decrease since last year. The next-highest earners were physicians in the Southeast, who earned $340,000, followed by physicians in the South Central region, at $337,000. Radiologists in the Northwest earned the least, at $275,000. In the overall physician survey, physicians in the North Central region earned the most.
Radiologists in office-based, single-specialty group practices earned the most, with a mean income of $373,000; this value has declined since Medscape's 2011 survey. Radiologists employed by healthcare organizations came in second, at $332,000, followed by those in solo practice, at $331,000. Radiologists working for outpatient clinics and in academic settings earned considerably less.
Physicians overall are nearly evenly split about whether they feel fairly compensated. Radiologists are among the top earners in medicine, and that affects their degree of satisfaction with their lot. Almost two thirds (62%) of radiologists said they are fairly compensated for their work, nearly the same as in the prior year.
The vast majority of physicians don't consider themselves to be rich, and that's true for radiologists as well, despite their high earnings. Although the public may perceive most physicians as wealthy, only 14% of radiologists agree with that characterization. A majority (51%) of radiologists said that they don't feel rich because of so many debts and expenses, while another 35% said that their income is no better than that of many nonphysicians.
About one third of radiologists spent 30-45 hours per week seeing patients, nearly the same as in last year's survey. Another quarter of respondents spent 46-55 hours per week, and 26% spent less than 30 hours per week with patients (about the same as last year). Fewer than one tenth of radiologists spent more than 60 hours per week seeing patients.
More than one third of the radiologists we surveyed report seeing 200 or more patients per week. As was the case last year, this was a far greater percentage than in any other specialty. Another quarter of radiologists have fewer than 25 visits, a decline from a year ago. One in 5 radiologists has 25-99 patient visits per week.
Almost one half of radiologists reported spending 9 minutes or less with each patient -- about the same as in last year's survey. About 3 in 10 of radiologists spent 9-16 minutes with each patient, on average, also about the same as 1 year ago. Only 15% of radiologists spent more than 20 minutes per visit.
The amount of time per patient visit excludes the patient's time spent with a nurse practitioner, physician assistant, or medical assistant; it measures only time spent in the presence of a physician.
Radiologist responses were evenly split for 4 hours or less (32%) and 5-9 hours (32%) spent on paperwork and administrative tasks in a given week, a decline from last year's survey. This is in sync with the results from physicians overall: About two thirds of physicians overall spent 9 hours or less on these obligations. Still, 1 out of 8 radiologists reported spending 20 hours or more on paperwork and other administrative activity.
Physician frustration is growing. The 2012 report shows far more dissatisfaction among doctors overall. Despite their high earnings, that's true for radiologists as well. Last year, 66% of radiologists said they would choose medicine as a career; this year, only 44% felt that way. In 2012, about 22% would choose the same practice setting again, compared with 56% a year ago. Some 51% of radiologists said they would choose the same specialty.
Despite the interest in alternative patient-care delivery models, only a small percentage of radiologists are currently involved. About 3% currently participate in Accountable Care Organizations (ACOs), and another 3% say that they plan to in the coming year. Less than 1% of radiologists have a concierge practice, and 1% have a cash-only practice.
An ACO is a payment and delivery model that ties provider reimbursement to quality metrics and reduction in the total cost of care for an assigned patient population. An ACO may initiate bundling of payments for various clinical outcomes. Almost three quarters of radiologists (74%) we surveyed responded believe that ACOs will cause a decline in income (compared with 52% of physicians overall), while 4% say that they will have little or no effect on income. About 23% said it's too soon to tell.
Elements of healthcare reform entail following treatment and quality guidelines set by insurers and Medicare for shared savings programs, but physicians are clearly skeptical that they will improve patients' quality of care. Only 18% of radiologists said these measures will lead to better patient care, compared with 25% for physicians overall. About 57% of radiologists believe the guidelines and quality measures will have a negative effect, while 25% said that they will have no impact on the quality of patient care.
Almost one half of the radiologists we surveyed (47%) said that they have no intention of reducing the amount of tests, procedures, and treatments they perform because they believe that the quality guidelines and cost-containment measures aren't in patients' best interest. Almost half (43%) of all physicians agree. Another 26% of radiologists said that they won't change their routine because of the need to practice defensive medicine. About 18% these physicians said that they would reduce the number of tests and procedures because the guidelines are valid. Another 9% would reduce tests and procedures because the guidelines will affect their income.
A majority (57%) of radiologists said that they occasionally discuss cost-of-care issues if patients raise the subject. About 46% of physicians overall said that they do the same. Another 17% of radiologists said they regularly discuss cost issues with patients, compared with 38% for physicians overall. Some 14% of radiologists never discuss the issue because they themselves don't know the cost of the treatments, while 13% said they never discuss it because they don't believe it's appropriate to do so.
Captions written by:
Mark Crane, Freelance writer, Brick, New Jersey
Disclosure: Mark Crane has disclosed no relevant financial relationships.
