Swipe to advance
1 of 34

Scroll

Medscape Gastroenterologist 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. Gastroenterologists 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.)

2 of 34

Scroll

Medscape Gastroenterologist 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. Gastroenterologists were among the top earners this year, along with plastic surgeons, orthopedists, and cardiologists. This year's lowest-earning specialties were the same as they were 5 years ago in Medscape's 2013 Compensation Report.

3 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Compensation for gastroenterologists increased 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.

4 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists is close to that reported this year by their US-trained peers.

5 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Among gastroenterologists there is a disparity in gender inclusion, with men generally outnumbering women across ethnicities. The gaps between men and women are wide for both Caucasian/white and Asian gastroenterologists. Other racial groups were represented by too low a percentage of respondents to be included in this comparison.

6 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Gastroenterologists 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]

7 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

More gastroenterologists 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]

8 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

This year, as in all previous years, the male gastroenterologists 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 does not account for the difference.

9 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

More male gastroenterologists are employed than are their female peers. This difference, then, does not account for the disparity in income between the two groups.

10 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists, both women and men work part-time at lower rates.

11 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

All gastroenterologists, whether employed or self-employed, were asked about their benefits this year. The majority said they receive liability coverage, employer-subsidized health and dental insurance, retirement plans with employer matches, and paid time off. A greater percentage of gastroenterologists, compared with other physician groups, reported that they receive no benefits.

12 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Gastroenterologists fell below the middle among physicians who believe that they are fairly compensated, despite their higher-than-average compensation. Indeed, specialists' satisfaction does not always coincide with their compensation relative to other physicians. For example, public health physicians reported relatively low compensation but were among the most satisfied with their pay.

13 of 34

Scroll

Medscape Gastroenterologist 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. Slightly over two fifths of gastroenterologists feel that they should be earning 11% to 25% more, and just over one quarter feel that they deserve an increase of 26% to 50%.

14 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Three quarters of gastroenterologists reported that they are paid through an insurance carrier, with less than one half saying they are reimbursed on a fee-for-service basis. Around one quarter 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 very 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]

15 of 34

Scroll

Medscape Gastroenterologist 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. Gastroenterologists reported very high participation in MIPS relative to all physicians surveyed.

16 of 34

Scroll

Medscape Gastroenterologist 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, generally through CMS initiatives. Gastroenterologists reported a very low participation rate compared with others in this payment model, although participation overall is lower in APMs than in MIPS.

17 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

In this year's survey, close to one quarter of gastroenterologists said they would drop insurers that pay poorly. Most of those who reported they would not indicated it is because they need all payers.

18 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

In spite of billing and other administrative challenges, most gastroenterologists surveyed said they will continue to take Medicare and Medicaid patients. Very few indicated that they would stop taking on or drop patients who are Medicare and Medicaid recipients, and a small percentage of gastroenterologists reported that they are undecided.

19 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists. A fair number, however, remain unsure about whether they will participate.

20 of 34

Scroll

Medscape Gastroenterologist 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, and results from this year's survey suggest that 16% of gastroenterologists who participate in an exchange have experienced a decrease.

21 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists reported that they occasionally or regularly have such discussions with their patients.

22 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists, however, reported that they do not charge patients who miss an appointment without providing notification.

23 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Over one half of gastroenterologists reported that they spend 30 to 45 hours each week with patients, and two fifths spend even longer. The latter percentage, however, is lower than in the two prior years' reports.

24 of 34

Scroll

Medscape Gastroenterologist 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 gastroenterologists reported that they spend 17 to 24 minutes.

25 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

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

26 of 34

Scroll

Medscape Gastroenterologist 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 less than one half of employed gastroenterologists reporting this year that they are seeking promotion.

27 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Among gastroenterologists, far more women than men reported this year that they are seeking promotion within their organization. "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."

28 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Gastroenterologists most often named being very good at what they do, making the world a better place, and relationships with and gratitude from patients as the most rewarding aspect of their job. A very small percentage cited teaching.

29 of 34

Scroll

Medscape Gastroenterologist 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 was most often cited as the most challenging part of a gastroenterologist's job. Dealing with difficult patients, working long hours, and managing electronic health records are problems for smaller percentages of gastroenterologists. Very few named concern over being sued.

30 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Despite all of the current challenges, gastroenterologists were near the top among physicians who 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.

31 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

Among gastroenterologists who would choose medicine, they are also near the top among physicians who said they would choose their specialty again if given the opportunity to do so.

32 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

33 of 34

Scroll

Medscape Gastroenterologist Compensation Report 2018

Carol Peckham | April 18, 2018 | Contributor Information

34 of 34

Related Content on Medscape

Start
 

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
All Slideshows
1 26 Next
References + More on Methodology