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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021
| Contributor Information
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Physician compensation was atypical last year. Due to COVID-19, many physicians' offices closed temporarily; most physicians saw fewer patients for several months. By year end, the worst business days were over for some physicians, although others are still struggling and the grim emotional toll of COVID remains. Almost 18,000 physicians in over 29 specialties told us about their income, bonuses, hours worked, greatest challenges, and the surprising impact of COVID on their compensation.
Some totals in this presentation do not equal 100% due to rounding.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Despite the hardships that COVID-19 brought, 2020 ended up with overall physician income similar to the prior year's. Michael Belkin, JD, divisional vice president of physician search firm Merritt Hawkins & Associates, in Dallas, Texas, says, "Many physicians used the Paycheck Protection Program to help keep them afloat; some were able to renegotiate their lease contracts; a large percentage reduced their staff, which reduced their expenses; and those in capitated plans were still getting paid even though they weren't seeing as many patients." Additionally, says Belkin, the acceleration of telehealth — and more insurers paying for it —helped physicians during this time.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
COVID-19 affected different specialties in different ways. 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 were included in our results. The five top-earning specialties are the same as last year, with the exception of urology, which moved up.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
While overall physician compensation remained similar to the prior year's, many specialties' incomes shifted. For example, cancer care for those already diagnosed continued generally uninterrupted throughout the year. While some plastic surgeons suffered because elective procedures were halted or bypassed for months, cosmetic surgeons found that patients often had become more critical of their appearance after watching themselves on daily video meetings.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Physicians who saw a drop in income cited COVID-19–related issues such as job loss, fewer hours, and fewer patients. About 13% of physicians overall said they had months of zero income. Still, some pointed to non-COVID-related factors: "voluntary decrease to gain more free time"; "relocation"; "partner left practice"; "maternity leave." (Respondents could choose more than one answer.)
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Incentive bonus is a standard compensation element for more than half of physicians, similar to last year's results. The payment is usually based on productivity but can also be tied to patient satisfaction, clinical processes, or other goals.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Last year, the primary care incentive payment comprised a slightly larger percentage of PCPs' overall pay. The chart shows the average base salary and average incentive among physicians who earn an incentive bonus.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Last year's average incentive bonus (among physicians who received a bonus) was 15% of total salary, about the same as this year's. The same three specialties also topped last year's list. (Results are shown only for specialties with sufficient sample sizes.)
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Thirteen percent of physicians struggled through a temporary period of no earnings; 3 months was the average length of time for having no income. Notably, 45% of physicians said they did not suffer financial or practice-related ill effects due to the pandemic.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Of the 22% of physicians who saw a reduction in their hours — including being required to work part-time instead of full-time — more than half of PCPs and about two thirds of specialists have since had their hours restored.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
More than a third of PCPs and specialists expect their income to return to normal this year. The majority of physicians anticipate a return to pre-COVID income levels within a couple of years or longer.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
In 2020, men in primary care earned 27% more than women, similar to the prior year, which showed men earning 25% more. "Women are often paid less — not just in healthcare but in almost every industry in the United States," says Halee Fischer-Wright, MD, president and CEO of the Medical Group Management Association (MGMA). "On average, women make 81% of what men make, correcting for all the usual factors we trot out, like time and experience. It was true before the pandemic and it will likely be true after it."
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Male specialists earn 33% more, similar to results in both 2020 (31%) and 2019 (33%). "Aside from that simple fact, men also dominate in some specialties that may have seen a smaller drop in patient or procedure volumes (so a smaller effect on pay), such as emergency medicine, infectious diseases, pulmonology, and oncology," says Fischer-Wright.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Overall, fewer women have gone into the higher-paying specialties. In Medscape's Women Physicians 2020: The Issues They Care About report, 64% of women physicians noted that work-life balance was among their top concerns, while 43% said compensation was among their most important issues.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
The percentage of self-employed physicians continues to decline, yet each year, self-employment brings in overall higher income. And self-employment still holds appeal: In Medscape's recent survey of medical residents, 21% said they anticipate becoming a practice owner/partner, while another 20% will consider either employment or self-employment in the future.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Last year, the five top states were Kentucky, Tennessee, Florida, Alabama, and Utah. Two of those states appear again this year.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Physician work hours generally declined for at least some time during the pandemic, and some physicians were even furloughed. Overall, however, physicians are back to working around the same number of hours that they did prior to the pandemic.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Physicians may be working roughly the same number of hours that they did pre-pandemic but are seeing fewer patients per week. Some of the larger declines have occurred in dermatology (141 patients per week before; 119 now) and ophthalmology (132/117). Predictably, critical care saw an increase (56/66), as did infectious diseases (66/78). Belkin notes that medical office safety protocols, social distancing, disinfecting between patients, and answering patient questions translates to fewer patient visits in a typical day.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
"We have no idea if this is a permanent reduction at this point," says Fischer-Wright. "We know that patient volumes have slowly but steadily increased, but we also know that a year out, they are still not back to normal. In the worst early months of the pandemic, tens of thousands of medical practices closed their doors for weeks or longer. Many had to furlough staff and providers. When they began to reopen, they didn't always have the funds to staff up again immediately, and so they couldn't handle the patient volume they once did. Now we're seeing a massive increase in hiring as medical practices prepare for a steady increase in patient volumes. And we may soon see an increase in patient volumes because of deferred care during the past year."
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Personal protective equipment (PPE) was a notable expense in 2020, what with face masks, NIOSH-approved N95 filtering facepiece respirators, face shields or goggles, gloves, hand sanitizer, and more. The increased overhead expense, although tax-deductible, was probably a factor in the decline in income among some physicians. Ninety percent of physicians who are owners or partners spent money on PPE in 2020.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Respondents reported how much time they spent on medical-related work outside of patient visits, including time devoted to paperwork, EHR documentation, administrative and managerial work, participation in professional organizations, and clinical reading. This year's average is similar to last year's (15.6 hours per week).
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
While most physicians will still take Medicare and/or Medicaid, a quarter will not or at least are having second thoughts. This could contribute to the continuing physician shortage, as it's been estimated that there will be 20 million additional Medicare enrollees by 2030.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
More than a third of physicians are participating in the Merit-based Incentive Payment System (MIPS). "The stakes for the Quality Payment Program — the program that incorporates MIPS — are high, with a 9% penalty applied to all Medicare reimbursement for failure to participate," says Elizabeth Woodcock, MBA, CPC, president of physician practice consulting firm Woodcock & Associates in Atlanta, Georgia. "With margins already slim, most physicians can't afford this massive penalty. It makes sense to protect your revenue by complying with — at least — the bare minimum."
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
For close to half of PCPs and a somewhat smaller percentage of specialists, the incentive target changed. Generally, that was done to adapt to the difficult patient care situation imposed by COVID.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Despite problems within the profession, most physicians are still proud of their work and their mission.
"Being proud to be a doctor and serving my people, help them heal, get back on track and function." Internist
"Money, administrative leadership, and making positive changes in my hospital." Cardiologist
"Bringing excellent healthcare to an underserved, poorer clientele." Family physician
"A combination of teaching and patient care and mentoring junior faculty." Neurologist
"Giving neonates a good start in life." Pediatric neonatologist
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Rules and regulations continue to bog down physicians' daily work.
"COVID has changed medicine for me in every facet. I don't like it anymore. The politics have sickened me." Orthopedist
"Virtually all aspects of care are dictated by outside entities including insurance, board regulations, quality improvement, malpractice risks, that prevent you from enjoying taking care of patients." Family physician
"All of the above are combined stressors in the ER, but self-entitled patients are the worst." Emergency physician
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
A greater percentage of oncologists this year (79%) vs last year (67%) feel that they are fairly compensated. Family physicians' and internists' results were about the same as last year's.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Despite the shock, safety issues, stress, and grief wrought by the pandemic, a majority of physicians would choose medicine again. Last year, 77% said they would. In our 2013 Compensation Report, with almost 22,000 physician respondents, only 51% of physicians said they would choose medicine again as their career.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
Year after year, dermatology appears at or near the top of the list. Family medicine and internal medicine are typically toward the bottom; last year, 71% of family physicians and 68% of internists said they'd choose the same specialty.
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
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Medscape Physician Compensation Report 2021: The Recovery Begins
Leslie Kane, MA | April 16, 2021 | Contributor Information
'Death by 1000 Cuts': Medscape National Physician Burnout & Suicide Report 2021
Burnout and depression are still serious problems among physicians, especially amid COVID-19. More than 12,000 physicians told us how burnout has affected their relationships, career, and happiness.Medscape Features Slideshow, Jan 2021
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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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Leslie Kane, MA
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