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Leslie Kane, MA | April 11, 2018
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 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. Over 470,000 physicians have used this report to access salary information as well as information on hours worked and the challenges they face in their jobs. This year, more than 20,000 physicians in over 29 specialties responded to the Medscape compensation survey. (Some totals in this presentation do not equal 100% due to rounding.)
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
The average overall physician salary—including primary care and specialties—is $299,000. The profession saw a modest increase in earnings over last year: In 2017, primary care physicians earned $217,000, compared with $223,000 in 2018; specialists earned $316,000 in our 2017 report compared with $329,000 this year. For employed respondents, compensation includes salary, bonus, and profit-sharing contributions. For partners and solo practitioners, it includes earnings after taxes and deductible business expenses but before income taxes.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Physician income overall has been rising steadily over the past 7 years. "One reason is basic supply and demand," says Tommy Bohannon, a vice president at Merritt Hawkins, a physician recruiting firm. "We see this in our recruiting contracts. In our annual report, we show starting salaries, or the amount needed to persuade a physician to move from one setting to another. The 'moving price' is consistently rising."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
The three top-earning specialties from last year are also among the top this year. Plastic surgery has experienced a boom over recent years; more celebrities getting cosmetic procedures has made plastic surgery more accepted and normal among the general public. Among the general population, people are having cosmetic surgery at younger ages, and aging Baby Boomers are getting procedures in record numbers. Regarding the lowest-earning specialties, this year's were the same as those listed 5 years ago in Medscape's 2013 Compensation Report.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Our report aligns with industry data showing an increase for psychiatry. "We have never seen demand for psychiatrists this high in our 30-year history," says Bohannon. "Demand for mental health services has exploded, while the number of psychiatrists has not kept pace. The short version is that aging produces many mental health challenges, including dementia and its associated pathologies, and societal ills such as the opioid crisis are driving the need for more mental health professionals."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 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. Other influencing factors include the median age of that medical school's graduates, as well as their chosen specialties.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
In this year's survey report, as in last year's, Caucasian/white physicians had higher income and African American/black physicians had lower income. Asian and Hispanic/Latino physician income was lower than that of Caucasian/white respondents. Many factors influence these results, including age, choice of specialty, and possible bias.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Racial and ethnic physician groups differ in the percentage of each group's members in specialties versus primary care. African American/black physicians and those who are of mixed race are among the groups with the highest percentage of primary care physicians.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
This year, the North Central and Southeast regions are among those with the highest salaries. Fee-for-service Medicare payments to physicians (and some other clinicians) are adjusted for geographic differences in market conditions and business costs. Competition and physician density are also factors in why earnings vary in different areas.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Only two of the top-earning states (Connecticut and Florida) are on the East Coast. Nevada is among the 10 least populated states in the United States. The need for physicians in rural areas is clear; there are 68 PCPs per 100,000 people in rural areas, compared with 84 per 100,000 in urban areas.[1]
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Many factors contribute to a state's having overall lower physician earnings, including competition, concentration of specialists, and insurance coverage of the patient population.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
As in past years, self-employed physicians earn more than employed physicians. Greg Mertz, managing director of Physician Strategies Group in Virginia Beach, Virginia, says that employed physicians tend to start with higher incomes than self-employed physicians do, but self-employed physicians have the capacity to earn more, owing to such factors as being able to charge for ancillary services.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Employment has been on the upswing and self-employment on the downswing: 26% of respondents said they were self-employed and 69% said they were employed. More male than female physicians are self-employed.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
This year, male doctors earned almost 18% more than females. Last year, male primary care physicians earned about 16% more than women in primary care.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Male specialists earn about 36% more than female specialists. Ob/gyn, pediatrics, public health and preventive medicine, plastic surgery, and family medicine are among the specialties with the highest percentage of women physicians. Specialties with the lowest percentage of women are orthopedics, cardiology, gastroenterology, otolaryngology, and radiology.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Women appear to have decided preferences for certain specialties. For eight specialties, women make up less than 20% of the physician workforce. The specialties with some of the highest percentages of women are ob/gyn and pediatrics.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Women physicians earn less than men, even within the same specialty. "You would think that as we narrow the gap of representation of women in medicine, that would narrow the wage gap, but it's not happening," says Ranit Mishori, MD, professor of family medicine at Georgetown University School of Medicine. "Women still have a hard time asserting themselves and demanding higher salaries. Also, there is so little transparency in salaries, women don't even know what targets to shoot for. They are invisible."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
The percentages of men and women physicians working part-time has been generally stable over the past few years. About 22% of women physicians work part-time (under 30 hours a week), varying by only a couple of percentage points over the years. The percentage of men working part-time—about 12%—also has not varied much.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Malpractice insurance and health insurance are the most frequently provided benefits for physicians. Less than half of physicians receive either short-term or long-term disability, meaning that they have to purchase it themselves or pay for it through a company-sponsored plan. About 66% receive paid time off, which corresponds roughly with the percentage of employed versus self-employed physicians.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Overall, 55% of physicians feel that they're fairly compensated. Emergency physicians, pulmonologists, and dermatologists are among the physicians who feel the most fairly compensated. Some physicians have noted that satisfaction comes from two factors: feeling a sense of importance about and accomplishment in one's work, and the amount of work and frustration they deal with compared with income earned.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Among physicians who feel unfairly compensated, about 45% think they should be earning 11%-25% more than they do; another 32% think they should earn 26%-50% more.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Satisfaction with income by ethnic group is generally correlated with income; ethnic groups earning more were more satisfied.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
While participation in accountable care organizations (ACOs) has increased over recent years, our data align with industry data showing less interest in ACOs. "The model has not yet proven that it can consistently enhance efficiency and improve outcomes while achieving the savings that participating physicians can share in," says Tommy Bohannon of Merritt Hawkins. "There's still work to do when it comes to convincing physicians of the efficacy of the ACO model."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Among the small percentage of physicians who use alternative models of payment, some find a "hybrid" practice to be the most profitable. In a hybrid practice, a portion of patients are concierge patients who have a membership or subscription; the other patients are part of a cash-only model and traditionally pay the physician directly.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Since MACRA (Medicare Access and CHIP Reauthorization Act) was implemented, there have been several changes in MIPS (Merit-based Incentive Payment System), with more anticipated. This has created some confusion and frustration among physicians, and some groups would like it to be significantly reformed, if not replaced. At this time, over a third of specialists and primary care physicians participate in MIPS. Alternative payment models (APMs), the other value-based programs, are generally implemented under large organizations, and so far, fewer physicians participate in them.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
When practices are struggling with financial challenges, many experts will recommend that they review their payers and drop the ones that pay the least. The percentage who reported "No, I need all payers" was 18% last year and is 22% this year.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Many physicians have opted out of Medicare, and particularly Medicaid, due to the low reimbursement rates and the amounts of paperwork and reporting requirements necessary. Most retain their current Medicare patients, but some have decided not to accept new Medicare or Medicaid patients. Their reasoning is that the low reimbursement rates force them to see more patients—and more quickly—in order to keep their practices afloat.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Treatment costs become a major issue particularly when there are options that differ greatly in cost, such as choice of procedures or medications. However, different patients' insurance coverage will vary in what is paid for, and patients' deductibles play a role in what out-of-pocket expenses will be. Physician respondent comments included: "Cost is rarely a consideration that is discussed with patients/families in critical care"; "All of my patients are Workman's Comp"; "I work for a state hospital and don't know the cost."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Charging for no-shows seems to have become a standard practice for about a quarter of physicians in office-based practices. Some practices ask new patients to sign a form to make sure that they are aware of the office's no-show policy. Physicians have said that the no-show policy has helped them eliminate double-booking time slots in order to make sure that all time slots are filled.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Most practices with a no-show policy have an acceptable time parameter during which a patient can cancel without penalty. Other practices have a "two or three strikes and you pay" policy.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Most physicians spend 30-45 hours a week seeing patients. For most, that's just a portion of their work week: Paperwork, returning patient phone calls, reviewing charts, and treatments add to the total number of hours worked per week.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Medscape surveyed the time spent individually with patients, not including the time the patient spends speaking with a PA, nurse, or medical assistant. The largest group of physicians spends from 17 to 24 minutes individually with each patient. (Note: These figures do not include responses from psychiatrists.)
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
The amount of time physicians are spending on paperwork and other administrative tasks has become mind-boggling. Over a third spend 10-19 hours a week on paperwork. In total, almost three fourths (70%) of physicians spend more than 10 hours per week on paperwork and administrative tasks. In 2017, it was 57%.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 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. Not every physician wants that, but a substantial number do.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
A greater percentage of employed female physicians are looking to be promoted, compared with employed male physicians. "It's possible that more male doctors already are in leadership positions and female physicians are anxious to catch up," says Bohannon. "Another factor may be that moving to a full-time or part-time administration role can lead to greater schedule flexibility, less call, and better work-life balance."
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
For the third year in a row, physicians have cited "gratitude/relationships with patients" as being the most rewarding factor in being a physician. Of note, "knowing that I'm making the world a better place" is a greater factor (23%) than it was last year, when only 12% cited it as most rewarding.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
It's not surprising that rules and regulations are the chief factor creating annoyance and frustration for physicians. Between required quality reporting, EHR input, claims denials, and other time-consuming chores, it's no wonder that more than a quarter of physicians cite this as their biggest challenge.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Despite all of the challenges, medicine is still a desirable profession: 77% of physicians overall would choose medicine again. Helping patients and having many of them express appreciation, knowing that one is a good doctor providing competent care, and making a decent-to-excellent living all contribute to most physicians feeling that they would become a physician again if they had to do it all over.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
When it comes to selecting the same specialty, the percentages decline. Only 62% of physicians overall would choose their specialty again. Orthopedists, plastic surgeons, radiologists, and oncologists were among the leaders in "re-choosing" their own specialty. Almost three quarters of primary care physicians (family medicine, internal medicine) would choose their own specialty again.
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
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Medscape Physician Compensation Report 2018
Leslie Kane, MA | April 11, 2018 | Contributor Information
Almost 20,000 physicians in over 30 specialties told us how much they earn, whether they are satisfied with their jobs, and whether their income has gone up or down.Medscape Features Slideshows, April 2019
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Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
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Contributor Information
Leslie Kane, MA
Senior Director
Medscape Business of Medicine
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References + More on Methodology
References
Petterson SM, Phillips RL Jr, Bazemore AW, Koinis GT. Unequal Distribution of the U.S. Primary Care Workforce. Robert Graham Center. June 1, 2013. Article. Accessed March 13, 2018.
More on Methodology
Survey invitations were emailed to Medscape member physicians from November 21, 2017 to February 21, 2018. Respondents were invited to participate in an online study of "Physician Compensation and Net Worth." Members who completed the survey were entered into a sweepstakes that awarded 50 random winners a $150 Amazon.com gift card.
Respondents were required to be physicians currently practicing in the United States. The total sample size was 20,329. The overall margin of sampling error for this survey was ± 0.69% at a 95% confidence level using a point estimate of 50%. Statistical difference from 50% is the most conservative in measuring sample error.
Other factors may also contribute to error in survey estimates, including measurement error, construct and content validity, question wording, and question order. Standard quality-control measures included checking for clear question wording, proper question ordering, and use of appropriate scales and response categories. In addition, during the field period, the survey was checked to make certain that respondents were answering all questions logically and that skip-pattern programming was working properly.
The final data were cleaned to ensure data quality. Full-time respondents were weighted to reflect the American Medical Association's physician distribution by specialty, state, and gender.
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