Thursday, September 28, 2023
Endocrinologist Compensation Report 2013
Is your income up or down? How is your practice changing? Are you drowning in paperwork, and would you do it all over again? Nearly 22,000 physicians gave answers to these and other intriguing questions about what it means to be a doctor these days and where their earnings are going.
Captions by Neil Chesanow, Senior Editor, Medscape Business of Medicine
Endocrinologist Compensation in 2012
In 2012, endocrinologists earned a median annual income of $178,000, which represents an increase over 2011. Nevertheless, endocrinologists remain toward the lower end of the earnings spectrum among the specialties in Medscape's surveys, along with primary care physicians and pediatricians. The top-earning specialties were orthopedics, cardiology, and radiology.
About 9% of endocrinologists earn $300,000 or more; about 17% earn $100,000 or less.
For employed physicians, compensation includes 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 fees, speaking engagements, and product sales). Compensation in this chart includes only that for physicians working full-time.
Note: Totals in slideshow may not add up to 100% due to rounding. "Not applicable" (N/A) responses were not included in the charts and graphs.
Endocrinologist Compensation in 2012 vs 2011
Compared with Medscape's 2012 Compensation Report, there has been very little movement in earnings for endocrinologists. In 2012, 48% of respondents said that their compensation remained the same from the previous year, the same percentage as was reported in 2011.
Similarly, in 2012, 23% of endocrinologists said that they earned more than they earned in 2011, and 47% earned less. In 2011, 32% of endocrinologists said that their earnings increased vs 2010, while only 21% said that their income declined.
Do Men or Women Earn More?
There's still a large pay gap between full-time male and female physicians, regardless of specialty. Overall, male physicians earn 30% more than their female counterparts. In endocrinology, however, that gap is 6%, much smaller than in many other specialties. In 2011, the pay gap was 28% in favor of male endocrinologists.
One contributing factor involves women's choice of specialties. There are fewer women in some of the higher-paying specialties, which skews the overall percentages. For example, 23% of anesthesiologist survey respondents were women, whereas in some of the lower-paying specialties, such as pediatrics, 53% of respondents were women; for family medicine, it was 36%.
Endocrinologist Compensation by Geographical Region
Endocrinologist compensation varies significantly by region. Doctors in the North Central region, with the highest compensation (a mean of $210,000 in 2012), earn much more than their colleagues in the Southwest, with the lowest compensation (a mean of $148,000 in 2012).
Why the high income in the North Central region? "There's less managed care, fewer doctors per capita, and a lower cost of doing business," says Tommy Bohannon, from Merritt Hawkins, a physician-recruiting company based in Irving, Texas.
Endocrinologist Compensation by Setting
In contrast with Medscape's 2012 Compensation Report, endocrinologists in outpatient clinic settings are the top earners, with a mean income of $210,000. Endocrinologists in solo practices also saw an increase over the prior year.
Employed physicians earned less than those in solo practice, while partners did fairly well. Endocrinologists working in hospitals earned a mean of $146,000 in 2012. Those working in healthcare organizations did slightly better in 2012 than in 2011. Endocrinologists in single-specialty and multispecialty group practices did about the same in 2012 vs 2011. In 2012, endocrinologists in multispecialty groups earned a median annual income of $188,000. Their colleagues in single-specialty groups made just $1000 less.
Do Endocrinologists Feel Fairly Compensated?
While a significant percentage of endocrinologists feel fairly compensated (42%), the majority do not (58%). Still, this represents a positive turn in feelings about earnings fairness. In 2011, only 38% of endocrinologists felt fairly compensated. In 2010, that number was closer to 50% -- despite the fact that endocrinology is one of the lower-paid medical specialties.
Compared with all physicians, however, endocrinologists feel less fairly compensated: Among all physicians, 48% of doctors are satisfied with their pay.
If You Had to Do It All Over Again, Would You...
Although the changing healthcare environment appears to have affected all doctors to varying degrees, the number of endocrinologists who would choose medicine again as a career has stayed consistent. Some 55% would do so in 2012, vs 57% in 2011.
However, among endocrinologists who said that they would opt in again, 45% would choose the same specialty in 2012, up from 38% in 2011.
On the other hand, there were ripples of discontent about practice setting. In 2012, only 15% of endocrinologists said that they would choose the same practice setting, compared with 19% in 2011.
Endocrinologist Participation in Various Payment Models
Clearly there are changes in the way doctors are earning money.
Healthcare reform is having an impact. Endocrinologists saw a big uptick in participation in Accountable Care Organizations (ACOs). In last year's Compensation Report, only 9% of endocrinologists either participated in an ACO or planned to join one in the coming year. This year saw a large jump, to 25%.
Also, concierge medical practices are still rare among endocrinologists; in 2012, 2% of endocrinologists said that they were involved in that type of practice, compared with < 1% the prior year. The same is true of endocrinologists who are in cash-only practices (3% in 2012 vs 2% in 2011).
Will You Stop Taking Medicare or Medicaid Patients?
Many doctors, worried about potential low levels of Medicare reimbursement, are making the decision to stop taking those patients.
Among endocrinologists, 9% plan to stop taking new Medicare or Medicaid patients, and 2% plan to stop seeing current Medicare or Medicaid patients. Another 38% are undecided.
That number (will stop taking new Medicare or Medicaid patients) is somewhat higher for the primary care specialties of internal medicine (11%) and family medicine (15%). Be that as it may, 51% of endocrinologists are not conflicted and will continue seeing current and taking new Medicare and Medicaid patients. This compares with 59% of all doctors in 2012.
Will You Drop Insurers That Pay Poorly?
Most practice management experts advise doctors to review their payments by insurers on a yearly basis and be ready to drop those who are paying the worst or creating the most denials and problems.
In 2012, nearly 1 in 3 endocrinologists (32%) were planning to take this advice, or perhaps they do it already. But 15% were planning to keep all insurers because they felt that even poor payers represent revenue. Another 22% felt that dropping insurers that pay poorly was inappropriate behavior.
Have You Started Offering New Ancillary Services?
We asked doctors whether they have started providing additional medical services that were previously not considered standard offerings for their specialties, in order to increase income.
Across all specialties, only 19% of doctors said that they had begun to do so. That percentage was identical to that reported by endocrinologists. By contrast, 21% of ob/gyns, 22% of dermatologists, and 29% of plastic surgeons added ancillary services.
Do You Discuss Cost of Treatment With Patients?
Cost of treatment is a big issue, particularly when there are options for different treatments. Given the increasing number of high-deductible health plans, treatment choices may be influenced by cost.
In 2011, almost half of endocrinologists (49%) said that they regularly discuss cost with patients, although another 46% said that they occasionally discuss costs, if a patient brings it up. In 2012, about the same number of endocrinologists -- 48% -- said that they regularly discussed the cost of care with patients, although fewer -- 39% -- would discuss cost if the patient brought it up.
In contrast, among all doctors, 30% regularly discussed the cost of treatment with patients in 2012, another 38% did so if the patient brought it up, and 6% deemed costs inappropriate to discuss with patients.
Hours Spent Seeing Patients per Week
The largest percentage of endocrinologists (35%) spends 30-40 hours per week seeing patients. That figure has remained constant over the past few Medscape compensation surveys. In contrast, among all physicians, the greatest percentage (30%) worked a 30- to 40-hour week in 2012.
Along the majority of the time continuum, the number of hours worked were fairly similar from one year to the next. In 2012, 17% of endocrinologists worked a 41- to 45-hour week (the same as in 2011); 10% worked 46-50 hours (a little less than in 2011), 5% worked 51-55 hours (about the same), and 7% worked 56 or more hours a week (in 2011, it was about 10%).
Number of Patients per Week
The sweet spot for endocrinologists is 50-75 patient visits per week. In 2012, that accounted for 29% of endocrinologists, vs 24% in 2011 and nearly 26% in 2010. The next-largest group -- 19% in 2012, 23% in 2011, and slightly more than 22% in 2010 -- see 25-49 patients per week. Patient loads in excess of 100 patients per week are pretty uncommon in endocrinology. Only 19% of endocrinologists saw that many patients in 2012, down from about 21% in 2011.
Amount of Time Spent With Each Patient
For the largest percentage of endocrinologists -- 27% in 2012 -- a mean of 13-16 minutes was the norm per patient visit.
That percentage represents an increase in the number of endocrinologists who saw patients for that long in recent years. In 2011, 20% of endocrinologists saw patients for 13-16 minutes; in 2010, that number was about 25%.
About 11% of endocrinologists see patients for 12 minutes or less, a percentage that has remained stable over the past 3 years. The same could be said for the number of endocrinologists who see patients for 21 minutes or more: In 2012, it was 39%; in 2011, it was 40%.
Hours Spent Seeing Patients in the Hospital
Endocrinologists, because of their specialty, spend very little of their time in the hospital with patients. A mere 4% spend 25 hours or more per week seeing patients in the hospital.
By contrast, specialists who spent a considerable amount of time seeing patients in the hospital were cardiologists (24% spent more than 25 hours a week in the hospital) and critical care physicians (72%). Among internists that number was 29%, and among family physicians it was only 5%.
Hours Spent per Week on Paperwork and Administrative Activity
Most jobs entail paperwork and cumbersome chores. And endocrinologists were more bogged down with such tasks than were many other specialists.
Just 10% of endocrinologists spent 1-4 hours on paperwork and administration each week, and another 23% spent 5-9 hours. Some 27% (more than 1 in 4) had 20 hours or more of paperwork per week.
That's in stark contrast to some other specialists: For family physicians, 17% had 1-4 hours of paperwork a week, and another 17% had 20 hours or more. Like endocrinologists, oncologists were also on the higher end of the paperwork continuum: Only 10% had 1-4 hours of paperwork per week, and 20% had 20 or more hours.
The Most Rewarding Part of Your Job
No matter what the public thinks, it's not all about the money. For endocrinologists, there are clearly plenty of emotional rewards that still have a strong impact. Being good at the practice of medicine was the paramount reward for 40%; for physicians overall, that number was less: 34%.
For 31% of doctors overall, relationships with patients ranked next on the list in 2012. Among endocrinologists, 32% felt the same, although it was still second as a factor in career satisfaction.
Knowing that they're making the world a better place ranked third in importance, with 12% of endocrinologists citing it in 2012, the same percentage as for physicians overall.
However, when it came to the most rewarding part of their job, endocrinologists were less likely than doctors overall (4% vs 7%) to note "being proud of being a doctor" as the chief reward.
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