Saturday, February 4, 2023
Pediatrician 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
Pediatrician Compensation in 2012
Physicians have done well in 2012, and although pediatricians are in the low end of the ranks, they have moved up from last year's lowest position in terms of income. Pediatricians were the second lowest ranked specialty, with a mean income of $173,000. Topping the list were orthopedists, cardiologists, radiologists, gastroenterologists, and urologists.
About 8% of pediatricians earn $300,000 or more; about 14% 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.
Pediatrician Compensation in 2012 vs 2011
Compared with Medscape's 2012 Compensation Report, there has been very little movement in earnings for pediatricians. In 2012, 48% of respondents said that their compensation remained the same from the previous year, compared with 41% in 2011.
Similarly, in 2012, 34% of pediatricians said that they earned more than they earned in 2011, and 18% earned less; in the previous year's report, 40% of pediatricians said that they earned more than in the year before, and about 20% earned less.
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 pediatrics, however, that gap is 22%, 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, 9% of orthopedist survey respondents were women, whereas in some of the specialties with lower income, such as pediatrics, 53% of respondents were women; for family medicine, it was 36%.
Pediatrician Compensation by Geographical Region
Pediatrician compensation varies significantly by region. Doctors in the Great Lakes region earned the most, with a mean compensation of $182,000. Pediatricians in the Northeast earned the least ($165,000). Those in the Northwest earned just slightly more, with a mean income of $166,000.
In 2011, the geographic results were somewhat different. Pediatricians earned the most in the North Central region, and earned the least in the Northeast.
Pediatrician Compensation by Setting
As in Medscape's 2012 Compensation Report, pediatricians in single-specialty group practices are the top earners, with a mean income of $190,000. The other high-earning situation was the multispecialty group practice, with a mean income of $188,000.
Pediatricians who were owners of a solo practice earned more ($174,000) than employed physicians ($160,000), although partners beat them all, earning $212,000. Pediatricians earned more in 2012 in outpatient clinics ($147,000) than in the prior year ($119,000).
Do Pediatricians Feel Fairly Compensated?
More than half of pediatricians feel fairly compensated, which is noteworthy, given that their income is lower than that of most other specialties. This represents a slight increase in positive feelings about earnings fairness from our prior year's compensation report, in which 50% of pediatricians said they were fairly compensated. In 2010, 52% of pediatricians felt fairly compensated, the same percentage as in this year's report. Compared with all physicians, however, pediatricians 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 pediatricians as much as other doctors, the number of pediatricians who would choose medicine again as a career has just slightly declined. Fully 55% would do so in 2012 vs 59% in 2011.
However, among pediatricians who said that they would opt in again, 44% would choose the same specialty in 2012, pretty close to 2011's 46%.
On the other hand, there were ripples of discontent about practice setting. In 2012, only 23% of pediatricians said that they would choose the same practice setting, compared with 27% in 2011.
Pediatrician Participation in Various Payment Models
Clearly there are changes in the way doctors are earning money.
Healthcare reform is having an impact. Pediatricians saw a big uptick in participation in Accountable Care Organizations (ACOs). In last year's Compensation Report, only 8% of pediatricians either participated in an ACO or planned to join one in the coming year. This year saw a huge jump, to 37%.
Also, slightly more pediatricians have opted for cash-only practices in 2012 than in 2011 (5% vs 3%). But the numbers remained the same among pediatricians who are in concierge medical practices (1%).
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 pediatricians, 7% plan to stop taking new Medicare or Medicaid patients, and 2% plan to stop seeing current Medicare or Medicaid patients. Another 25% 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, 66% of pediatricians 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, a fairly small percentage of pediatricians (18%) were planning to take this advice, or perhaps they do it already. But 23% 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.
A minority of pediatricians said yes. Across all specialties, only 19% of doctors said that they had begun to do so. That percentage was even smaller for pediatricians: 15%. By contrast, 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, 29% of pediatricians said that they regularly discuss cost with patients, although another 54% said that they occasionally discuss costs, if a patient brings it up. In 2012, even fewer pediatricians -- 24% -- said that they regularly discussed the cost of care with patients, and fewer -- 44% -- 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 (37%) of pediatricians spends 30-40 hours per week seeing patients. The percentage of doctors who put in that amount of time is identical to last year's figure. In contrast, among all physicians, 30% worked a 30- to 40-hour week in 2012.
In 2012, 27% of pediatricians saw patients for 30 hours a week or less (about the same as in 2011); 14% worked 41-45 hours (the same as in 2011), 11% worked 46-55 hours (similar to last year), and 7% worked 56 or more hours (an increase from last year).
Number of Patients per Week
The sweet spot for pediatricians is 100-124 patient visits per week. In 2012, that accounted for 19% of pediatricians, similar to in 2011. Patient loads in excess of 124 patients per week are not predominant in pediatrics; about 15% of pediatricians saw that many patients in 2012, very similar to in 2011.
Amount of Time Spent With Each Patient
In general, pediatricians spend a meaningful amount of time with each patient. For the largest percentage of pediatricians -- 39% in 2012 -- a 13- to 16-minute patient visit was the norm.
That is a small increase in the number of pediatricians who saw patients for that long in recent years. In 2011, 34% of pediatricians saw patients for 13-16 minutes.
Only about 4% of pediatricians see patients for less than 9 minutes.
Hours Spent Seeing Patients in the Hospital
Pediatricians, because of the nature of their work, spend very little time in the hospital with patients. Close to two thirds (63%) spend 4 hours or less per week seeing patients in the hospital. Another 10% spend 5-9 hours in the hospital seeing patients.
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. Pediatricians spent a considerable amount of time on such tasks.
More than 1 in 5 pediatricians (22%) spent 1-4 hours on paperwork and administration each week; another 26% spent 5-9 hours, and 25% spent 10-14 hours. Only 8% had 25 hours or more of paperwork per week.
Looking at other specialists, 17% of family physicians had 1-4 hours of paperwork a week, and another 17% had 20 hours or more. Oncologists were 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 pediatricians, there are clearly plenty of emotional rewards that still have a strong impact. Gratitude and relationship with patients was the paramount reward for 37%; for physicians overall, that number was similar: 31%.
For 29% of pediatricians, being very good at what they do ranked second to relationships with patients. For physicians overall, that factor was the leading motivation for 34%.
Good compensation ranked fourth in importance, with 7% of pediatricians citing it in 2012 compared with 9% for physicians overall.
When it came to the chief career reward, pediatricians were exactly equal with physicians overall (7%) to note "being proud of being a doctor" as the most rewarding part of their job.
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