Neurologist Income Declines, Frustration Grows

Megan Brooks

April 25, 2012

April 25, 2012 — Neurologists practicing in the United States earned $184,000 on average in 2011, a tad less than what they earned in 2010, according to Medscape's 2012 Neurologist Compensation Report.

A total of 24,216 US physicians across 25 specialty areas participated in the overall survey conducted by Medscape during a 2-week period in February 2012.

Neurologists are among the lower-earning physicians — in the bottom half of the 25 specialties. About 1 in 5 neurologists earned $100,000 or less. Only about 22% of neurologists earned $200,000 to $249,000, the same as in last year's survey. About 14% brought in more than $300,000 and just 2% earned more than $500,000.

For employed neurologists, compensation covers salary, bonus, and profit-sharing contributions. For partners, compensation includes earnings after tax-deductible business expenses but before income tax. Compensation does not include non–patient-related activities, such as expert witness services, speaking engagements, and product sales.

About 41% of neurologists surveyed reported almost no change in income between 2011 and 2010, 25% reported earning less in 2011 than in 2010, and 35% said they earned more.

Male neurologists had fatter paychecks in 2011 than female neurologists. Male neurologists reported average compensation of $198,000 compared with $160,000 for women. In the overall survey, male physicians earned 40% more than female physicians. The fact that more female physicians work part-time contributes to their overall lower income.

Neurologists in the Southeast region (Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, South Carolina, and Tennessee) earned the most in 2011, mirroring the 2010 survey results. Their mean income was $209,000. The next-highest breadwinners were in the Great Lakes region, at $201,000. Neurologists in the Southwest made the least in 2011 ($155,000 on average).

Growing Frustration

Neurologists in office-based multispecialty group practices earned the most, at $227,000 on average, which is up somewhat from the previous year. Members of single-specialty groups came in second, earning $224,000 on average, with solo neurologists earning $195,000, down somewhat from 2010. Employees of hospitals and academic/government groups earned the least.

Fifty-seven percent of neurologists responding to the survey said they feel unfairly compensated, up from 51% last year and 8 percentage points more than for physicians overall.

Overall, physician frustration is growing, according to the latest survey, which shows far more dissatisfaction among physicians across all specialties. For example, in 2010, more than two thirds of neurologists surveyed reported that they would still choose a career in medicine if they could do it all over again, but only 50% felt that way in 2011. Less than half of neurologists said they would choose the same specialty; last year, 63% would do the same. Only 25% would choose the same practice in 2012.

Alternative Care Models Slow to Take Hold

The largest percentage of neurologists (25%) spends 30 to 40 hours per week seeing patients, slightly more than in last year's report. Fourteen percent of neurologists spend 41 to 45 hours per week seeing patients, and another 14% spend more than 46 hours per week.

One third of neurologists spend 10 to 14 hours per week on paperwork and administrative tasks, up from 25% in the previous year. Another 23% spent more than 20 hours each week on these tasks.

Despite growing interest in alternative patient care models, only a small percentage of neurologists are involved in one. About 3% of those surveyed participate in an accountable care organization (ACO), but 4% say they plan to do so in the coming year.

An ACO is a type of payment and care delivery model that links provider reimbursement to quality metrics and reduction in the total cost of care for a specific patient population. The majority (53%) of neurologists surveyed believe that ACOs will lead to a large or slight decline in their income, whereas 10% say they will have little or no effect on income. About 37% say it's too early to tell.

Most (72%) of the neurologists who responded to the survey are men and 47% are younger than 45 years. About 87% of all neurologist respondents are board certified.

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