
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Physicians fared better financially this year than in the height of the pandemic but still struggled with tough workloads, long hours, and difficult situations.
More than 13,000 physicians in 29+ specialties told us how their compensation fared, how they supplement their income, and how they feel about being a physician. Employed physicians revealed their 2021 income from patient care services including salary, bonus, and profit-sharing. Self-employed physicians reported their earnings after taxes and deductible business expenses, but before income taxes. We analyzed compensation for full-time physicians only.
Note: Some totals in this report do not equal 100% owing to rounding.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Ophthalmologists' average income rose from our last report ($379K), when COVID-19 took a greater toll on medical practices' finances overall.
"Compensation for most physicians is trending back up as demand for physicians accelerates," says James Taylor, group president and chief operating officer of AMN Healthcare's Physician & Leadership Solutions division. "The market for physicians has done a complete 180 over just 7 or 8 months."
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Ophthalmologists' average compensation rose about 10% from our prior-year report. Ophthalmologists finished above the middle of the 29+ specialties we surveyed, in terms of 2021 income gains. The annual US inflation rate rose to 4.7% last year, which affected physicians' purchasing power.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
While ophthalmologists' income rose overall, not all individuals saw an increase. Those who experienced a decline less often pointed to COVID-19, and more frequently blamed other factors, than they did last year. (Respondents could choose more than one answer.)
About 1 in 5 physicians overall noted that their earnings shrank last year.
"I'm able financially to just make ends meet. Last year we got loans and grants to help, but nothing so far this year."
"The company reduced our pay by 20%."
"My retirement contribution was lowered, and I had a pay cut."
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Overall, 57% of physicians have an incentive bonus arrangement. The average ophthalmologist bonus was higher than in the prior year (when it was about $87K).
A 2021 report showed that incentive bonuses do inspire people to work harder and earn more, sometimes so much so that they opt to spend more time with colleagues than with family.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
This chart applies to physicians overall. As for specialists, while the gender gap has narrowed in recent years, male specialists on average earned 31% more than their female counterparts in 2021. For primary care physicians (PCPs), the gender gap was 25%.
Women physicians gravitating to specialties — particularly higher-paying specialties — have helped close the gender gap somewhat. "A great many of the specialty organizations have efforts underway not just to increase the number of women in specialties but also to address gender pay gaps in evaluations during residency and fellowship," notes Ron Holder, chief operating officer of the Medical Group Management Association (MGMA).
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Ophthalmologists most often pointed to nonphysician practitioners as a source of competition. Physicians overall also cited nonphysician practitioners. (Respondents could choose more than one answer.)
"The Arkansas Legislature made independent practice legal for certified registered nurse anesthetists, so we are no longer needed."
"Our hospital changed groups so they can make more money."
"Hospitals are hiring primary care physicians and forcing referrals to hospital physicians."
"Urgent care clinics are our competition."
Competition may heat up even more in coming years for PCPs, because Walmart, Walgreens, CVS, and Amazon plan to build new or larger retail clinics that will offer many aspects of traditional primary care.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Since 2015, average physician compensation has risen 29% overall, while compensation is up 33% for PCPs and 30% for specialists. Rising salaries help everyone get back on track by covering living costs and keeping up with inflation.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Close to 3 in 10 ophthalmologists are managing to take on extra work, usually by adding responsibilities to their medical workload. Nearly 1 in 10 even have side hustles outside of medicine. (Respondents could choose more than one answer.) Ophthalmologists were somewhat less likely to take on extra work than physicians in general (36%).
"Physicians are fortunate to have a huge array of potential side gigs available to them," says Sylvie Stacy, MD, MPH, author of 50 Nonclinical Careers for Physicians. "Supplemental income that pays well is not difficult to find." She points to interest in early retirement and greater financial independence, and high levels of student debt, as factors.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Getting paid well is one thing; feeling paid well can be another. Ophthalmologists landed toward the middle of all physicians in terms of feeling fairly compensated for their work.
For physicians, the dollar figure may influence job satisfaction less than the methods used to calculate it, says James Taylor of AMN Healthcare. Production bonuses that effectively penalize physicians for seeing relatively sick patients or that track quality measures that don't seem relevant or meaningful can backfire. "That's one reason we are seeing a decline in a salary plus production bonus and an increase in straight salary," Taylor says.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
The challenges of treating COVID patients, working during the pandemic, and the overall changing tone of medicine prompted a number of physicians to leave the profession and disenchanted many others. Still, physicians would be about as likely now to enter a medical career again as in 2011 (73% and 69%, respectively).
A somewhat smaller percentage of ophthalmologists said they would enter medicine again compared with last year's report (87%).
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Many physicians love their specialty; dermatologists and orthopedists are among the top groups in our survey year after year. Ophthalmologists also rank among the top third of physicians overall. At the other end of the scale, this year's report found that family physicians and internists would be less willing than most other physicians to repeat their choice.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
On average, ophthalmologists spend fewer hours each week handling paperwork and administration than nearly all other physicians. This year, the average for physicians overall was about 15.5 hours per week.
For each nonsurgical adult-patient visit, a physician spends on average just over 16 minutes entering data into their EHR, according to a study in Annals of Internal Medicine. That gobbles up a significant chunk of a physician's day.
Note: Numbers in the chart represent hours per week.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Around three quarters of ophthalmologists plan to continue taking Medicare and/or Medicaid patients. However, that rate is smaller than in last year's report (86%). Compared with last year, nearly the same percentage of ophthalmologists said they won't take new Medicaid patients (about 4% vs 3%), while a somewhat larger share are undecided (about 18% vs 10%). Overall, 70% of physicians said they plan to continue taking Medicare and/or Medicaid patients. (Respondents could choose more than one answer.)
Some physicians have opted out of Medicare over low reimbursements, but the issue is even worse with Medicaid. Another reason is that doctors encounter more billing problems under Medicaid, according to one study.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Overall, 17% of physicians in our study said they could or would drop low-paying insurers, while the other 83% said they couldn't do that for business, ethical, or other reasons. But situations differ, and the yes/no splits often varied between ophthalmologists and other physicians.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
Sixty-two percent of ophthalmologists said they plan to participate in MIPS, the same as in last year's report. Four percent said they plan to participate in APMs, compared with 7% last year.
The marketplace has been shifting in recent years. The Healthcare Financial Management Association says in the Medicare program, a sharp increase in physician participation in APMs has been accompanied by a dip in MIPS participation.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
How do the most rewarding aspects of ophthalmologists' jobs (patient relationships, being good at their work, and making the world a better place) compare with those of physicians overall? Patient relationships and being good at their work are highly valued by physicians overall, though in recent years they have increasingly emphasized making the world a better place.
Medscape Ophthalmologist Compensation Report 2022: Incomes Gain, Pay Gaps Remain
For ophthalmologists, difficulties with insurers pose the biggest challenge they face. Physicians overall most often cite the burden of rules and regulations.
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