Cardiologists Still Earning Big Bucks, But Work Frustration Abounds

April 24, 2012

April 24, 2012 (New York, New York)— US cardiologists earned an average of $314 000 in 2011, with the highest earners being cardiologists working in a single-specialty group practice, results from a new physician compensation survey reveal. For these physicians, their average annual salary was $388 000. Despite the numbers, 54% of cardiologists felt they were inadequately compensated, and only 13% considered themselves wealthy. Nearly four in 10 cardiologists said their income is no better than nonphysicians, while 50% said that although their income might qualify them as part of "the 1%," they did not consider themselves rich because of expenses and debt.

In fact, if they had to do it all over again, just 50% said they would choose cardiology as their specialty and only 18% said they would choose the same practice setting. Less than half of respondents said they would choose a career in medicine, a number that is down from the 65% who said they would again choose medicine as a career in 2010.

The numbers, on the whole, are largely unchanged from 2010, although average salaries are slightly down in 2011 and more physicians reported declines in income.  In 2010, one-third of cardiologists reported a decline in income compared with just over 40% in 2011.

The compensation report is based on the responses of 24,216 US physicians across 25 specialty areas and was conducted by Medscape in February 2012. Compensation includes salary, bonuses, and profit-sharing contributions for employed cardiologists and earnings after tax-deductible business expenses but before income tax for partners in a hospital/specialty clinic. Among the 645 cardiologists who responded to the survey, 90% were male and 38% were younger than 45 years of age. Of the cardiologists who responded, 96% are board-certified.

Money in the North-Central US, Less on the Coast

As was seen in last year's survey, cardiologists were among the top earners in the Medscape survey, right behind radiologists and orthopedic surgeons. While 16% of cardiologists earned more than $500 000 in 2011, another 15% reported earning less than $100 000. Only 1% of cardiologists reported earning more than one million dollars. The highest-paid cardiologists are located in the north-central US, including Iowa, Missouri, Kansas, Nebraska, and South and North Dakota (average salary $379 000). In contrast, cardiologists in California and Hawaii earned $270 000 and those in the Northeast earned $271 000 in 2011.

On the whole, female cardiologists earned 32% less than their male counterparts. The average salary men reported was $325 000, which was $79 000 more than the average salary reported by female cardiologists. The discrepancy is largely attributed to females working more part-time hours than male cardiologists.

Looking at salaries based on setting, academic-based cardiologists earned the least of their colleagues in 2011, reporting an annual average salary of $192 000. Individuals working at a hospital, healthcare organization, solo practice, or multispecialty group practice earned $254 000, $325 000, $303 000, and $327 000, respectively. Compared with 2010, 41% of cardiologists report declines in their income in 2011 and another 35% said their income remained the same. One in four cardiologists surveyed saw a bump in compensation between 2010 and 2011.

Overall, cardiologists work long hours, with 40% of doctors spending more than 50 hours per week seeing patients and 11% spending more than 65 hours per week with patients. One in five doctors spend 30 to 40 hours per week seeing patients, and 11% spend less than 30 hours weekly with patients. One-quarter of those surveyed saw between 50 to 75 patients week, a number that is up from 18% of doctors who saw this many patients in 2010. While 30% of cardiologists see less than 50 patients per week, another 25% have between 100 to 174 patient visits weekly.

Accountable-Care Organizations

Very few cardiologists participated in alternative patient-care and payment models, with just 2% currently involved in an accountable-care organization (ACO) and 9% planning to be involved in an ACO in the next year. The ACO is a payment model and healthcare delivery model that reimburses physicians based on quality metrics and reductions in the total cost of care for an assigned patient population. Many cardiologists, 42%, believe that involvement in an ACO will cause a large decline in their income, and 22% said it will result in a slight decline. One in three said it is too soon to tell if participation will lead to a reduction, while 6% felt the ACO will have little or no effect on their salary.

Healthcare reform is also clearly on the minds of the cardiologists, and 43% believe the changes will have a negative effect on patient care. One in five cardiologists surveyed said they will continue to practice defensive medicine and will not reduce testing to contain costs. Another 38% said they also won't reduce testing because the new quality guidelines and cost-containment measures are not in the patient's best interests. One in three said they will reduce testing because the guidelines are valid, while 9% plan to reduce testing to contain costs because it affects their income.

More than half of cardiologists surveyed said they discuss the cost of care if the patient brings up the subject, and 34% said they regularly discuss cost with their patients. Seven percent said they do not discuss cost because they do not know the cost of treatments, and 6% felt that discussing costs in their office was inappropriate.

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