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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

The Medscape Physician Compensation Report is the most comprehensive and widely used physician salary survey in the United States for the eighth year in a row. Endocrinologists who responded to this year's survey disclosed not only their compensation but also how many hours they work per week, how many minutes they spend with each patient, what they find most rewarding—and challenging—about their work, and more. (Some totals in this presentation do not equal 100% due to rounding.)

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Survey respondents were asked to provide their annual compensation for patient care. For employed physicians, that includes salary, bonus, and profit-sharing contributions. For partners, it includes earnings after taxes and deductible business expenses before income tax. Endocrinologists' average reported compensation was near the bottom. Plastic surgeons, orthopedists, and cardiologists were among the top earners this year. This year's lowest-earning specialties were the same as they were 5 years ago in Medscape's 2013 Compensation Report.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Compensation for endocrinologists decreased this year. The greatest increases were seen among psychiatrists, plastic surgeons, and physiatrists. Medscape's results align with industry data regarding psychiatry. "We have never seen demand for psychiatrists this high in our 30-year history," says Tommy Bohannon of Merritt Hawkins, a physician recruiting firm. "Demand for mental health services has exploded, while the number of psychiatrists has not kept pace."

Decreases in earnings were evident in only six specialties this year, with general surgery and urology among the hardest hit.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Where a physician attended medical school can be a factor in future earnings. Some graduates of US medical schools are American citizens who studied outside of the United States; others grew up in the country where they went to medical school and moved to the United States to practice. Average compensation for foreign-trained endocrinologists was nearly the same as that reported this year by their US-trained peers.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Among endocrinologists there is a disparity in gender inclusion, with men generally outnumbering women across ethnicities. The gender gap between Caucasian/white male and female endocrinologists is wider than that between their Asian male and female peers. Other racial groups were represented by too low a percentage of respondents to be included in this comparison.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Endocrinologists who are employed earn less than those who are self-employed, presuming they will trade a higher salary for a steadier income and less time focusing on running a business. According to a survey from the Physicians Foundation, however, employment does not necessarily reduce nonclinical workload.[1]

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Far more endocrinologists are now employed rather than self-employed. This reflects a national trend toward physician employment, as hospitals and other entities have consolidated and absorbed private practices, and younger physicians have sought a steadier income stream and more regular hours. There is some indication, however, that the trend has plateaued, as hospitals reach staffing limits.[2]

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

This year, as in all previous years, the male endocrinologists Medscape surveyed reported higher earnings than did their female counterparts. Although women are more likely to work part-time, which would give them a lower average income, this report uses full-time salaries for compensation, so part-time work would not account for the difference.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

More female endocrinologists are employed than are their male peers. This difference may account for some of the disparity in income between the two groups.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Percentages of part-time female and male physicians have varied somewhat over the years, with 22% of women and 12% of men reporting this year that they work fewer than 30 hours per week. There are differences among physician groups, however. Among endocrinologists, about the same percentage of women surveyed work part-time as the average female physician, whereas a smaller percentage of male endocrinologists work part-time compared with the average male physician.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Over three quarters of endocrinologists this year say they receive employer-subsidized liability coverage and health insurance. A large percentage also have paid time off and dental insurance. Very few endocrinologists reported that they receive no benefits. Note that all endocrinologists, whether employed or self-employed, were asked about their benefits.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Less than one half of endocrinologists surveyed believe that they are fairly compensated, and they were toward the bottom of all physicians in this category, which would seem to correspond with their relatively low earnings. Specialists' satisfaction does not always coincide with their compensation relative to other physicians, however. For example, plastic surgeons were among the least satisfied with their compensation despite being among the highest paid. Conversely, public health physicians reported relatively low compensation but were among the most satisfied with their pay.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

This year, the Medscape survey asked physicians who reported that they are not satisfied with their compensation how large an increase they feel they deserve. Similar percentages of endocrinologists feel that they should be earning 11% to 25% or 26% to 50% more.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

The majority of endocrinologists reported that they are paid through an insurance carrier, with just over one third saying they are reimbursed on a fee-for-service basis. One third said they are paid through accountable care organizations (ACOs), which is one of the advanced alternative payment systems under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). A small percentage reported that they have adopted the direct primary care model, which is gaining popularity compared with concierge and cash-only models among physicians whose practices allow direct pay.[3]

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Since MACRA was implemented, there have been numerous changes in the Merit-based Incentive Payment System (MIPS), one of CMS's two Quality Payment Programs (QPPs), and more are anticipated. The changes have created confusion and frustration among physicians, and some would like to see MIPS significantly reformed, if not replaced. Endocrinologists reported lower participation in MIPS relative to most physicians surveyed.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

The other QPP introduced by CMS, Alternative Payment Models (APMs), is generally implemented in large organizations, including demonstration programs, ACOs, and other CMS initiatives. Overall participation is lower with APMs than with MIPS, but endocrinologists reported a low participation rate in this payment model compared with other physicians as well.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

In this year's survey, under a quarter of endocrinologists said they would drop insurers that pay poorly. Most of those who reported they would not drop such insurers had reasons other than needing all payers or because doing so would be inappropriate.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

In spite of billing and other administrative challenges, most endocrinologists surveyed said they will continue to take Medicare and Medicaid patients. Still, nearly one third indicated that they would stop taking on or drop patients who are recipients. About one quarter of endocrinologists reported that they are undecided on this question.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Increases in the number of physicians reporting that they participate in health insurance exchanges have stabilized since their introduction in 2014, and there is almost no change from last year's survey in the percentage of participating endocrinologists. Nor is there a change in those who remain unsure about whether they will.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Anecdotally, physicians have complained about the effect of the Affordable Care Act on their incomes, but results from this year's survey suggest that only a small percentage of endocrinologists who participate in an exchange have experienced a decrease.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Healthcare continues to cause financial worry among Americans, but there is little guidance for physicians about how to discuss costs with their patients. Barriers include unfamiliarity with patients' insurance or financial status and even the cost of the treatments they recommend.[4] Even so, nearly all endocrinologists reported that they occasionally or regularly have such discussions with their patients.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Physicians say that instituting a no-show policy helps them avoid overscheduling in order to ensure that all time slots are filled. Most endocrinologists, however, with the exception of those in solo practices, reported that they do not charge patients who miss an appointment without providing notification.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Whereas about three fifths of endocrinologists reported that they spend 30 to 45 hours each week with patients, 16% spend more than 45 hours. The latter percentage, however, is lower than in the two prior years' reports.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Medscape asked physicians about the time they themselves—not a physician assistant, nurse, or medical assistant—spend with each patient. The majority of endocrinologists reported that they spend 13 to 24 minutes.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Bureaucratic tasks remain the primary cause of burnout among physicians, and nearly three quarters of endocrinologists reported this year that they spend 10 hours or more per week on paperwork and administration.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Getting promoted in a hospital, clinic, or large group setting typically adds administrative and/or management responsibilities to a physician's job. Such factors may play a role in slightly more than one half of employed endocrinologists reporting that they are seeking promotion in this year's survey.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Among endocrinologists, a similar percentage of women and men reported this year that they are seeking promotion within their organization. Among specialties where the gap between men and women seeking promotion is greater, "it's possible that more male doctors already are in leadership positions and female physicians are anxious to catch up," says Tommy Bohannon. "Another factor may be that moving to a full-time or part-time administration role can lead to greater schedule flexibility and better work-life balance."

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Endocrinologists most often named relationships with and gratitude from patients as the most rewarding aspect of their job, followed by being good at what they do and making the world a better place. Very small percentages were cited for teaching, making good money, or pride in their profession.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Given the current upheaval in the healthcare system, it is no surprise that "having so many rules and regulations" and difficulties getting fairly reimbursed were most often cited as the most challenging parts of a endocrinologist's job. Few named having to work long hours or concern over being sued.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Despite all of the current challenges, more than three quarters of endocrinologists said that they would choose medicine again. The rewards of treating patients and having many of them express appreciation, knowing that they are competent in their field, and contributing to a better world appear to make up for the difficulties they face in their jobs.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

More than four fifths of endocrinologists who said they would choose medicine again also reported they would choose their specialty again if given the opportunity to do so. Still, they were below the middle of all physicians in this choice.

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

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Medscape Endocrinologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

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Medscape Physician Compensation Report 2018

More than 20,000 physicians told us how much they earn, how many hours they work, and whether they're satisfied with their compensation.Slideshows, April 2018
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