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Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Physicians across the country are facing intense challenges in caring for COVID-19 patients while trying to protect their own and their families' health and well-being. Their most critical concerns will always be those involving life and death. Still, while confronting this crisis, salary and income are important to one's career and livelihood.
The data for this Female Physician Compensation Report were collected early in 2020, prior to the onset of the pandemic in the United States. In response to this year's Medscape compensation survey, more than 4500 female physicians told us about their incentive bonuses, income, hours worked, greatest challenges, what gives them satisfaction, and more. Results for all physicians can be seen in Medscape's Physician Compensation Report 2020.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
The health impact of COVID-19 has been grave, and the financial fallout is widespread.
Many physician offices closed at least temporarily or have greatly reduced their hours as patients defer care. Hospitals, clinics, and large groups throughout the nation have cut salaries and laid off staff, though some furloughed workers are being called back as providers resume nonemergency procedures and medical appointments. Specialties that relied upon elective procedures have seen their business fall off dramatically, then resume fitfully as virus hotspots fade or flare. Those include, but are not limited to, orthopedics, plastic surgery, dermatology, cardiology, and ophthalmology.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Survey respondents reported their compensation for patient care. For employed physicians, that includes salary, bonus, and profit-sharing contributions. For self-employed physicians, it includes earnings after taxes and deductible business expenses, before income tax. Only full-time salaries are included in our results.
Overall, prior to the COVID-19 crisis, female physician income continued to rise. In Medscape's Female Physician Compensation Report 2019, female primary care physicians (PCPs) reported earning an average of $207,000, compared with $212,000 this year (a 2.4% increase). Female specialists reported earning an average of $280,000, compared with $286,000 this year (a 2.1% increase).
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Over the years, more women have become specialists. Some specialties that have seen a notable increase in the percentage of female practitioners since 2015 are ob/gyn (58% vs 50% in 2015), pediatrics (58% vs 50%), rheumatology (54% vs 29%), dermatology (49% vs 32%), and family medicine (43% vs 35%). In some of the higher-paid specialties, there's been little change in percentage of women practitioners over the past 5 years: urology (10% vs 8% in 2015), orthopedics (11% vs 9%), cardiology (16% vs 12%), and plastic surgery (16% vs 18%).
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
As in the past 10 years of Medscape Physician Compensation reports, men continue to earn more than women. Among PCPs, men earn about 25% more than women, which is about the same percentage as last year. Still, primary care is the leading choice for female physicians.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Among specialists, men earn 31% more than women; last year, there was a 33% pay gap. This is about the same as the wage gap for physicians overall, where men earn 32% more than women. According to responses to Medscape's physician compensation survey, about a third of specialists are women.
Many physicians expect the gender pay gap to narrow in coming years. "Achieving salary equity in academic medicine is the right thing to do and the smart thing to do," says John Prescott, MD, chief academic officer of the Association of American Medical Colleges. "Yet it is a challenging task, requiring an institutional commitment to transparency, cross-campus collaboration, ongoing communication, dedicated resources, and enlightened leadership."
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Men still earn more than women in every age range, but the differences are smaller than they were last year. For example, men younger than 35 outearned women in that age range by 43% in 2019, compared with 39% this year. Men 55 and older reported the smallest gap again this year: They outearned women in their age group by 30% in 2019, compared with 27% in 2020.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Women working in office-based solo practices reported the highest average compensation again this year ($290,000), a slight increase from last year's report ($285,000). Those in office-based, single-specialty group practices and hospitals were next. Women working in outpatient clinics remain among the lowest paid.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
More than half of physician respondents (56% overall) have an incentive bonus. Slightly lower percentages of female physicians report having bonuses than do male physicians. "Most people agree we are motivated by having something like a carrot; that's what incentivizes extra effort," said Michael Belkin, JD, divisional vice president at Merritt Hawkins, a national physician recruiting firm. "I think it's almost a given that candidates today are looking for some kind of bonus." Belkin says that in his experience, about 75% of hospitals offer an incentive bonus.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Among PCPs who earn an incentive bonus, women's bonuses represent, on average, 9% of their total compensation. Male PCPs' bonuses represent, on average, 12% of their total compensation.
The two major types of incentive bonuses are collections bonus and relative value unit (RVU) bonus, says Belkin. "For the collections bonus, if the physician reaches a benchmark and additionally generates a net profit, he or she has the opportunity to keep part of that profit. The second bucket involves work RVUs, which are a measure of productivity and are tracked through the electronic health records (EHRs)."
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
As with PCPs, female specialists' incentive bonuses represent a lesser percentage of their total compensation than that of their male counterparts. Among specialists who earn an incentive bonus, women's bonuses represent, on average, 11% of their total compensation, while male specialists' bonuses represent, on average, 16% of their total compensation.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Overall, physicians earn about two thirds of their potential bonus. One concern is the Stark Law against self-referral; employers want to build in safe harbor provisions that protect them from possible penalty and so may cap the incentive that a physician can earn.
Among both PCPs and specialists, women earn a lesser percentage of their potential incentive bonus than do men.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Incentive bonuses are tied to performance objectives and are intended to motivate people to work more or be more productive. Among physicians who have an incentive bonus, about a third of PCPs and specialists, both female and male, say the prospect of an incentive bonus has encouraged them to work longer hours.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Physicians overall spend an average of 37.8 hours per week seeing patients. Add this to the average of 15.6 hours per week spent on paperwork, and doctors are on average putting in a 53.4-hour workweek. Women spend an average of about 7% less time seeing patients than do men.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
For the third consecutive year, more than half of both male and female physicians report satisfaction with their compensation, although the percentage of satisfied men increased more (56% in 2019 vs 61% in 2020) than did the percentage of satisfied women (51% in 2019 vs 53% in 2020). Given the disparity in pay, it may not be surprising that more men than women are satisfied with their income.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Compensation disparities exist not only between the sexes but also among various racial and ethnic groups. In all such groups, women physicians earned less than their male counterparts.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
While more than half of male physicians report having a net worth of $1 million or more, only 40% of female physicians report net worth at that level. Net worth is defined as total assets (eg, money in bank accounts, investments, retirement accounts, equity in one's home, value of cars, value of jewelry) minus total liabilities (eg, mortgage, car loans, credit card debt, school loans, home equity loans).
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
As in Medscape's previous reports, mortgages, car loan payments, paying off one's own college loans, and credit card debt are among the major expenses for both male and female physicians. However, an August 2020 extension of the CARES (Coronavirus Aid, Relief, and Economic Security) Act includes a temporary suspension of federal student loan payments and collections until December 31, 2020. For privately held loans, interest will typically continue to accrue.
Again this year, a higher percentage of women than men report a debt due to childcare (20% vs 13%).
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
About 39% of female physicians say they live below their means, a greater share than the 31% who judged their spending that way in 2019. Only 8% say they live above their means, the same percentage we reported last year.
While the annual amount that physicians target to save can vary, Greenwald Wealth Management of St. Louis Park, Minnesota, advises that aiming to save 20% of one's annual gross salary should put one in a good financial position.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Like physicians overall, about two thirds of female physicians have, at the very least, a general idea of how much they should be spending and saving. Still, as some physicians say, actually tracking and monitoring your expenses, either with software or on paper, gives you a better idea of where you can cut back and where you might be spending too much.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Most physicians did not experience significant losses in 2019, the period of time we asked about in our survey. However, in 2020, many physicians expect that COVID-19 will result at least temporarily in lost practice revenue due to sharp decreases in patient volume and staff productivity, and perhaps a loss due to a job furlough or layoff.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
"Typically, one of the spouses in a couple is more adept and interested in managing the family finances than the other," says Ram Kolluri. "This talent is often gender neutral and age agnostic. Thus, he or she is better suited to take up this responsibility.
However, the 'managing partner' of the family finances assumes a 'fiduciary role' to the other spouse and is required to safeguard the family nest egg against large losses. Frequent financial reviews of the family budgets, savings, and investments are essential to prevent any surprises," says Kolluri.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
About a third of female physicians report using physician assistants (PAs) in their practices, while a somewhat higher percentage of male physicians report having help from PAs. About half of all physicians use nurse practitioners (NPs) in their practices.
"Our research and research from others shows that NPs and PAs help with patient access and satisfaction, physician burnout, and revenue and profit," says Halee Fischer-Wright, MD, pediatrician and CEO of the Medical Group Management Association (MGMA).
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Again this year, both female and male physicians found relationships with patients, making the world a better place, and being good at what they do to be the most rewarding parts of their jobs, with some minor variations in percentages.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Female and male physicians feel largely similar about the challenges their jobs entail. Still, a somewhat lesser percentage of women than men consider various rules and regulations challenging.
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
If they could go back in time, the majority of female physicians — in fact, of physicians overall — would choose a career in medicine again. This year, higher percentages of female physiatrists (79%) and gastroenterologists (84%) said they would make that choice again (vs 66% and 76%, respectively, in 2019). (Results are shown only for specialties where sample sizes are sufficient.)
Leslie Kane, MA; Mary Lyn Koval | September 18, 2020 | Contributor Information
Of the female physicians who would go into medicine again, the large majority would also choose the same specialty. This could not be said for endocrinologists, physiatrists, family medicine physicians, and internists, who were least likely to select their current specialty again. (Results are shown only for specialties where sample sizes are sufficient.)
Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
More than 15,000 physicians told us how they feel about burnout and depression. In some cases, their responses differed along generational lines.Medscape Features Slideshow, Jan 2020
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Contributor Information
Leslie Kane, MA
Senior Director, Medscape Business of Medicine
Mary Lyn Koval
Editorial Consultant
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References
Basu S, Phillips RS, Phillips R, Peterson LE, Landon BE. Primary care practice finances in the United States amid the COVID-19 pandemic. Health Affairs. June 25, 2020. Source
Kane L. Medscape US and International Physicians' COVID-19 Experience Report: Risk, Burnout, Loneliness. September 12, 2020. Source
Paavola A. 6 hospitals laying off furloughed workers permanently. Becker's Hospital Review. July 31, 2020. Source
Gooch K. 26 hospitals bringing back furloughed employees. Becker's Hospital Review. August 24, 2020. Source
American Hospital Association. New AHA Report: Losses Deepen for Hospitals & Health Systems. June 30, 2020. Source
Larry Green Center, Primary Care Collaborative, 3rd Conversation. Quick COVID-19 primary care survey. August 24, 2020. Source
Robeznieks A. Telehealth keeps care continuity during COVID-19—that must continue. American Medical Association. July 20, 2020. Source
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