Monday, January 30, 2023
Radiologist 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
Radiologist Compensation in 2012
Physicians have done well in 2012, and radiologists are near the top of the ranks. Radiologists were the third highest ranked specialty, with a mean income of $349,000. Topping the list were orthopedists, cardiologists, radiologists, gastroenterologists, and urologists.
Historically, radiologists have ranked high among the specialties in Medscape's surveys, although there has been a slight decline. In our 2012 and 2011 reports, radiologists ranked first, tied both years with orthopedists.
About 16% of radiologists earn $500,000 or more; about 8% 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.
Radiologist Compensation in 2012 vs 2011
Compared with Medscape's 2012 Compensation Report, there has been very little movement in earnings for radiologists. In 2012, 43% of respondents said that their compensation remained the same from the previous year, compared with 37% in 2011.
In 2012, 15% of radiologists said that they earned more than they earned in 2011, and 42% earned less -- similar to the earnings situation in 2011 compared with 2010, when the number of radiologists reporting fewer earnings was also 42%. A bit more (21%) said that their income had increased.
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 radiology, however, that gap is 16.5%, 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, 29% of radiology and 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%.
Radiologist Compensation by Geographical Area
Radiologist compensation varies significantly by region. Doctors in the Southwest, with the highest compensation (a mean of $407,000 in 2012), earn 30% more -- $94,000 -- than their colleagues in the North Central region, with the lowest compensation (a mean of $313,000 in 2012).
In 2011, the spread was not as wide. Radiologists earned the most (a mean of $345,000) in the Great Lakes region and earned the least (a mean of $275,000) in the Northwest.
Radiologist Compensation by Setting
Radiologists in single-specialty and multispecialty group practices were the top earners in 2012, each with a mean income of $390,000. While both sets of doctors saw increases over 2011, the rise in income was more dramatic for radiologists in multispecialty groups than in single-specialty groups.
Solo practitioners earned more than employed physicians, although partners beat them all. Radiologists working in hospitals earned a mean of $354,000 in 2012, an increase from 2011. Those working in healthcare organizations and outpatient clinics also did better in 2012 than in 2011. Radiologists in academic settings were at the bottom of the pack in 2012 with $236,000 but saw a large increase from 2011 ($180,000).
Do Radiologists Feel Fairly Compensated?
More radiologists feel fairly compensated (58%) than not (42%), but this represents a gradual erosion in feelings about earnings fairness. In 2010, 63% of radiologists felt fairly compensated. In 2011, that number was 62% -- in keeping with the fact that radiology is one of the highest-paid medical specialties.
Compared with all physicians, radiologists 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 radiologists less so than other doctors, the number of radiologists who would choose medicine again as a career has declined. Only 33% would do so in 2012 vs 44% in 2011.
However, among radiologists who said that they would opt in again, 51% would choose the same specialty in 2012, identical to 2011's response rate.
On the other hand, there were ripples of discontent about practice setting. In 2012, only 17% of radiologists said that they would choose the same practice setting, compared with 22% in 2011.
Radiologist Participation in Various Payment Models
Clearly there are changes in the way doctors are earning money.
Healthcare reform is having an impact. Radiologists saw a big uptick in participation in Accountable Care Organizations (ACOs). In last year's Compensation Report, only 6% of radiologists either participated in an ACO or planned to join one in the coming year. This year saw a large jump, to 20%.
Also, slightly more radiologists have opted for concierge medical practices in 2012 than in 2011 (2% vs <1%). The same is true of radiologists who are in cash-only practices (3% vs 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 radiologists, however, only 4% plan to stop taking new Medicare or Medicaid patients, and 2% plan to stop seeing current Medicare or Medicaid patients. Another 33% are undecided.
That number (will stop taking new Medicare or Medicaid patients) is higher for the primary care specialties of internal medicine (11%) and family medicine (15%). Be that as it may, 61% of radiologists 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, 1 in 5 radiologists (20%) were planning to take this advice, or perhaps they do it already. But 25% were planning to keep all insurers because they felt that even poor payers represent revenue. Another 13% 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 fairly small percentage of radiologists said yes. Across all specialties, only 19% of doctors said that they had begun to do so. That percentage was a touch lower for radiologists: 18%. By contrast, 19% of endocrinologists, 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, only 17% of radiologists said that they regularly discuss cost with patients, although another 57% said that they occasionally discuss costs, if a patient brings it up. In 2012, even fewer radiologists -- 9% -- said that they regularly discussed the cost of care with patients, and far fewer -- 27% -- 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.
In the case of radiologists, it's likely that other personnel, such as the surgeon or hospital billing staff, discuss cost of treatment with patients.
Hours Spent Seeing Patients per Week
The largest percentage of radiologists spends less than 30 hours per week seeing patients. The percentage of radiologists who put in that amount of time has remained constant. In both 2012 and 2011, about 27% worked less than 30 hours per week. In the previous year, just under 25% worked those hours. 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 has changed somewhat from one year to the next. In 2012, 17% of radiologists worked a 30- to 40-hour week (the same as in 2011); 12% worked 41-45 hours (it was 16% in 2011), 17% worked 46-50 hours (vs 15%), 5% worked 51-55 hours (vs 11%), and 10% worked 56 or more hours (in 2011, it was about 14%).
Number of Patients per Week
It's tough to find the sweet spot for radiologists in terms of patient visits per week. They either see lots of patients or very few. For instance, in 2012, fewer than 25 visits per week accounted for 15% of radiologists, vs 25% in 2011 and 30% in 2010. The next largest group -- 14% in 2012, 35% in 2011, and 40% in 2010 -- sees more than 200 patients per week. Another 15% of radiologists in 2012 fall into a more manageable range of 25-75 patients per week, vs roughly 18% in 2011 and 15% in 2010.
Amount of Time Spent With Each Patient
Due to the nature of the specialty, radiologists spend less time with each patient than do many other types of doctors. For the largest percentage of radiologists -- 24% in 2012 -- a mean of less than 9 minutes was the norm per patient visit.
That percentage represents a steep decline in the number of radiologists who saw patients for that long in recent years. In 2011, 48% of radiologists saw patients for less than 9 minutes; in 2010, that number was about 45%.
Hours Spent Seeing Patients in the Hospital
The vast majority of radiologists spend very little of their time in the hospital actually seeing patients. Almost two thirds (65%) spend 4 hours at most per week seeing patients in the hospital. More than half (54%) spend less than an hour.
However, a significant number of radiologists (23%) spend more than 25 hours per week in the hospital. That's on par with some other specialists. Among cardiologists, 24% spent more than 25 hours a week in the hospital; 29% of internists spent that much time; and for critical care physicians it was 72%. By contrast, among family physicians it was only 5%.
Hours Spent per Week on Paperwork and Administrative Activity
Most jobs entail paperwork and cumbersome chores. But radiologists were less bogged down with such tasks than were many other specialists.
More than a third of radiologists (37%) spent 1-4 hours on paperwork and administration each week, and another 29% spent 5-9 hours. Only 8% had 20 hours or more of paperwork per week.
That's in stark contrast to some 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 radiologists, 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 57%; for physicians overall, that number was much lower: 34%.
For 31% of doctors overall, relationships with patients ranked next on the list in 2012. Among radiologists, only 9% felt the same, placing it third as a factor in career satisfaction.
Good compensation ranked second in importance, with 11% of radiologists citing it in 2012 compared with 9% for physicians overall.
As for pride in the profession, radiologists (6%) were slightly less likely than physicians overall (7%) to note "being proud of being a doctor" as the chief reward.
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