Thursday, September 21, 2023
Pathologist 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? Almost 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
Pathologist Compensation in 2012
Physicians have done well in 2012, and pathologists are in the middle of the ranks. Pathologists were the 16th highest-ranked specialty, with a mean income of $247,000. Topping the list were orthopedists, cardiologists, radiologists, gastroenterologists, and urologists.
Historically, pathologists have ranked high among the specialties in Medscape's surveys, although there has been a slight decline. In our 2012 report, pathologists ranked 15th highest.
About 12% of pathologists earn $400,000 or more; about 9% 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.
Pathologist Compensation in 2012 vs 2011
Compared with Medscape's 2012 Compensation Report, there has been some movement in earnings for pathologists. In 2012, 52% of respondents said that their compensation remained the same from the previous year, compared with 45% in 2011.
However, other measures were nearly the same. In 2012, 30% of pathologists said that they earned more than they earned in 2011, and 19% earned less. In 2011 compared with 2010, 33% saw earnings increases and 22% experienced income declines.
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 pathology, however, that gap is 9%, less than in many other specialties.
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, 38% of pathologist 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%.
Pathologist Compensation by Geographical Region
Pathologist compensation varies significantly by region. Doctors in the Northwest, with the highest compensation, earn considerably more than their colleagues in the South Central region, with the lowest compensation.
In 2011, the spread was not as wide. Pathologists earned the most in the Great Lakes region and the least in the Southwest.
Pathologist Compensation by Setting
In Medscape's 2012 Compensation Report, pathologists in multispecialty group practices are the top earners by practice setting, with a mean income of $324,000. This is a good deal higher than last year's figure, when pathologists in multispecialty groups ranked second, behind those in single-specialty groups. Pathologists in single-specialty groups, who are also among the highest earners, saw an income decline from the prior year.
Employed physicians earned more than those in solo practice, although partners beat them all. Pathologists working in hospitals earned a mean of $254,000 in 2012. Those working in healthcare organizations earned somewhat less in 2012 than in 2011. Pathologists in academia were at the bottom of the pack in 2012 although they saw a large increase from 2011.
Do Pathologists Feel Fairly Compensated?
More pathologists feel fairly compensated than not (64% vs 36%), nearly identical to 2011, when the number who felt fairly compensated was 62%, despite the fact that pathologists are in the middle of the pack in physician earnings overall.
Compared with all physicians, pathologists feel more fairly compensated: Among all physicians, only 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 pathologists less so than other doctors, the number of pathologists who would choose medicine again as a career has declined nevertheless. Only 44% would do so in 2012 vs 51% in 2011.
However, among pathologists who said that they would opt in again, 49% would choose the same specialty in 2012, a slight increase from 2011's 47%.
On the other hand, there were ripples of discontent about practice setting. In 2012, only 20% of pathologists said that they would choose the same practice setting, compared with 23% in 2011.
Pathologist Participation in Various Payment Models
Clearly there are changes in the way doctors are earning money.
Slightly more pathologists have opted for concierge medical practices in 2012 than in 2011 (1% vs < 1%). The number of pathologists who are in cash-only practices remained unchanged (2%).
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.
This question was less relevant to pathologists than to numerous other specialties. Many pathologists are salaried and are not as concerned about insurance issues. However, those who are part of a group may note whether or not the group will continue to take Medicare or Medicaid patients.
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, 10% of pathologists were planning to take this advice, or perhaps they do it already. But 21% were planning to keep all insurers because they felt that even poor payers represent revenue. Another 17% 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.
A number of pathologists said yes. Across all specialties, only 19% of doctors said that they had begun to do so. That percentage was slightly higher for pathologists: 23%. By contrast, 22% of dermatologists,19% of endocrinologists, and 29% of plastic surgeons (the second highest percentage) added ancillary services.
Hours Spent Seeing Patients per Week
The largest percentage of pathologists -- 40% in 2012 – said that they did not see patients. Pathologists answering this question referred to "seeing patients" as working on specimens, biopsies, or tests, typically as part of a case or diagnosis. Some pathologists interpreted the question to mean working on "parts of patients." In 2012, 27% of pathologists said that they saw patients for less than 30 hours per week. In both 2011 and 2012, 30-40 hours per week was second in the ranks (20% vs 14%, respectively). In contrast, among all physicians, the greatest percentage (30%) worked a 30- to 40-hour week in 2012.
Amount of Time Spent With Each Patient
Due to the nature of the specialty, pathologists spend less time with each patient than do many other types of doctors. For the largest percentage of pathologists -- 9% in 2012 -- a mean of 25 minutes or longer was the norm per patient for examination and testing. However, that represents a steep decline in the amount of time pathologists spend with patients. In 2011, 21% of pathologists saw patients for that long.
In fact, in every time category, the differences between 2011 and 2012 are dramatic. In 2011, 21% of pathologists spent less than 9 minutes with each patient; in 2012, it was 7%. In 2011, 17% saw patients for 9-12 minutes; in 2012, it was only 6%. In 2011, 13% saw patients for 13-16 minutes. In 2012, it was 2%. The greatest year-to-year difference was in the 17- to 20-minute category: In 2011, 20% of pathologists spent that much time with patients; a year later, none did.
Hours Spent per Week on Paperwork and Administrative Activity
Most jobs entail paperwork and cumbersome chores, and pathologists have their fair share of such tasks, more so than many other specialists.
Nearly a quarter of pathologists (24%) spent more than 25 hours on paperwork and administration each week; 10% spent 20-24 hours, 7% spent 15-19 hours, and 19% spent 10-14 hours. About one-third of pathologists (33%) spent less than 10 hours on paperwork per week.
That's similar to some of other specialists: For family physicians, only 17% had 1-4 hours of paperwork a week, and another 17% had 20 hours or more. 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 pathologists, 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 65%; for physicians overall, that number was considerably lower: 34%.
For 31% of doctors overall, relationships with patients ranked next on the list in 2012. Among pathologists, due to the nature of the specialty, it was not a factor.
Good compensation ranked second in importance, with 12% of pathologists citing it in 2012 compared with 9% of physicians overall.
When it came to being proud of being a physician, the percentage of pathologists in 2012 who considered that the chief reward was similar to the rate for doctors overall: 6% vs 7%.
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