Thursday, September 28, 2023
Obstetrician/Gynecologist 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
Obstetrician/Gynecologist Compensation in 2012
Physicians have done well in 2012, and obstetricians and gynecologists are no exception. Ob/gyns had a mean income of $242,000, placing them ahead of neurologists but trailing pathologists. Topping the list were orthopedists, cardiologists, radiologists, gastroenterologists, and urologists.
Historically, ob/gyns have ranked toward the middle of the pack among the specialties in Medscape's surveys. In our 2012 report, ob/gyns were sandwiched between pathologists and nephrologists, while in the previous year they were between pulmonologists and nephrologists.
About 25% of ob/gyns earn $300,000 or more; about 10% 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.
Obstetrician/Gynecologist Compensation in 2012 vs 2011
Compared with Medscape's 2012 Compensation Report, there has been very little movement in earnings for ob/gyns. In 2012, 45% of respondents said that their compensation remained the same from the previous year, compared with 39% in 2011.
Similarly, in 2012, 23% of ob/gyns said that they earned more than they earned in 2011, and 31% earned less. In 2011, 26% of ob/gyns said that their earnings increased vs 2010, while 35% said 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 obstetrics/gynecology, however, men earn 14% more than women. That difference is 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 lower-paying specialties, such as pediatrics, 53% of respondents were women; for family medicine, it was 36%, and for obstetrics/gynecology, it was 43%.
Obstetrician/Gynecologist Compensation by Geographical Region
Ob/gyn compensation varies significantly by region. Doctors in the South Central region, with the highest compensation (a mean of $250,000 in 2012), earn much more than their colleagues in the Mid-Atlantic region, who earn the lowest compensation.
In 2011, the spread was not as wide. Ob/gyns earned the most (a mean of $245,000) in the Great Lakes region, while ob/gyns earned the least in the Northeast.
Obstetrician/Gynecologist Compensation by Setting
Ob/gyns who work for healthcare organizations are the top earners, with a mean income of $272,000. This is much higher than last year's figure of $239,000. Ob/gyns in single-specialty and multispecialty groups, who are also among the highest earners, saw similar increases in income.
Employed physicians earned more than those in solo practice, although partners beat them all. Ob/gyns working in hospitals earned a mean of $216,000 in 2012. Ob/gyns who worked in outpatient clinics enjoyed an even bigger jump, however.
Do Obstetrician/Gynecologists Feel Fairly Compensated?
About 43% of ob/gyns feel fairly compensated vs 57% who believe that they are underpaid, which represents a gradual erosion in feelings about earnings fairness. In 2010, about half of all ob/gyns felt fairly compensated. In 2011, that number was 45%, despite the fact that obstetrics/gynecology is one of the lower-paid medical specialties.
Compared with all physicians, ob/gyns 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 ob/gyns who would choose medicine again as a career has declined somewhat. Only 53% would do so in 2012 vs 55% in 2011.
However, among ob/gyns who said that they would opt in again, 37% would choose the same specialty in 2012, identical to their response in 2011.
On the other hand, there was a major note of discontent about practice setting. In 2012, only 18% of ob/gyns said that they would choose the same practice setting, compared with 23% in 2011.
Obstetrician/Gynecologist Participation in Various Payment Models
Clearly there are changes in the way doctors are earning money.
Healthcare reform is having an impact. Ob/gyns saw a big uptick in participation in Accountable Care Organizations (ACOs). In last year's Compensation Report, only 8% of ob/gyns either participated in an ACO or planned to join one in the coming year. This year saw a huge jump, to 25%.
Also, the same small percentage of ob/gyns has opted for concierge medical practices in 2012 vs 2011 (1%). The same is true of ob/gyns who are in cash-only practices (3% for both surveys).
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 ob/gyns, 15% plan to stop taking new Medicare or Medicaid patients, and 3% plan to stop seeing current Medicare or Medicaid patients. Another 28% are undecided.
That number (who will stop taking new Medicare or Medicaid patients) is somewhat lower for the primary care specialty of internal medicine (11%) but the same as for family medicine (15%). Be that as it may, 53% of ob/gyns 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, more than 1 in 4 ob/gyns (26%) were planning to take this advice, or perhaps they do it already. But 29% were planning to keep all insurers because they felt that even poor payers represent revenue. Another 15% 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.
Many ob/gyns said yes. Across all specialties, only 19% of doctors said that they had begun to do so. That percentage was slightly higher for ob/gyns: 21%. By contrast, 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, 41% of ob/gyns said that they regularly discuss cost with patients, and another 48% said that they occasionally discuss costs, if a patient brings it up. In 2012, even fewer ob/gyns -- 35% -- said that they regularly discussed the cost of care with patients, and fewer -- 41% -- discuss costs, if the patient brings 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 ob/gyns spends 30-40 hours per week seeing patients. In 2012,31% worked 30-40 hours per week; in 2011, it was about 34%. In the previous year, approximately 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 were similar from one year to the next. In 2012, 11% of ob/gyns worked a 41- to 45-hour week, 13% worked 46-50 hours, and about 4% worked 51-55 hours. Those percentages are about the same as the ones we reported for 2011, with the exception being the number of ob/gyns who put in 56-60 hours a week (9% in 2012 vs about 6% in 2011). On the other end of the scale, both surveys showed roughly 1 in 5 ob/gyns seeing patients less than 30 hours a week.
Number of Patients per Week
The sweet spot for ob/gyns is 50-75 patient visits per week. In 2012, that accounted for 20% of ob/gyns vs 22% in 2011 and nearly 23% in 2010. The next largest group -- 19% in 2012, 21% in 2011, and slightly more than 23% in 2010 -- sees 76-99 patients per week. The numbers are also more or less the same for ob/gyns seeing 100-124 patients a week. Patient loads in excess of 124 patients per week are rare in obstetrics/gynecology. Only 14% of ob/gyns saw that many patients in 2012, up from 11% in 2011.
Amount of Time Spent With Each Patient
For the largest percentage of ob/gyns -- 30% in 2012 -- a mean of 13-16 minutes was the norm per patient visit.
However, that percentage represents a decline in the number of ob/gyns who saw patients for that long. In 2011, 35% of ob/gyns saw patients for 13-16 minutes or longer.
About 30% of ob/gyns see patients for less than 13 minutes, a percentage that has remained stable over the past 3 years. Consistent, too, has been the number of ob/gyns who see patients for 21 minutes or more: In 2012, it was 17%; in 2011, it was 15%.
Hours Spent Seeing Patients in the Hospital
Ob/gyns spend a significant amount of their time in the hospital with patients. Fully 39% spend 10 or more hours per week seeing patients in the hospital
Other 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. But ob/gyns were less bogged down with such tasks than were many other specialists.
One in 6 ob/gyns (17%) spent 1-4 hours on paperwork and administration each week, and another 30% spent 5-9 hours. Some 14% had 20 hours or more of paperwork per week.
That's pretty close to the load for family physicians: Only 17% had 1-4 hours of paperwork a week, 26% had 5-9 hours, and 17% had 20 hours or more.
The Most Rewarding Part of Your Job
No matter what the public thinks, it's not all about the money. For ob/gyns, there are clearly plenty of emotional rewards that still have a strong impact.
For 42% of ob/gyns, the relationship with patients ranked as their number-one factor in career satisfaction. Among doctors overall, 31% noted that as their most important factor.
Being good at the practice of medicine was the primary reward for 28% of ob/gyns; for physicians overall, that number was 34%.
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