Physician Compensation: Doctors Adapting to a New Reality

Disclosures

April 15, 2014

In This Article

Self-employed Physicians Earn More Than Employed Ones

Among physicians overall, self-employed doctors earned an average of $281,000 compared with employed physicians, who earned $228,000. In primary care, the difference was less pronounced; self-employed physicians earned $188,000 and employed physicians earned $180,000.

ACOs Are Clearly Making Their Impact Felt

In 2011, 8% of physicians were either in an Accountable Care Organization (ACO) or were planning to join one that year. In 2013, that percentage had risen to 34%. The growth in ACO participation year-over-year, according to Medscape surveys, has been steady: In 2013, almost a quarter of physicians (24%) who responded were already in ACOs and 10% planned on joining one this year; in our 2012 survey, only 8% of doctors were either in an ACO or were planning to join one.

Cash-Only Practices Seem to Be Becoming More Appealing

While still in the minority, the percentage of physicians involved in cash-only practices rose from 3% of respondents in 2011 to 6% in 2013. This is in line with physicians who are dissatisfied with payments and are looking for ways to practice that don't entail dealing with insurers.

Medicine as a Career Has Lost Some Appeal

Witness the answers to the following questions, comparing Medscape's 2011 report to the 2014 report:

Would you choose medicine again? Yes (2011: 69%; 2014: 58%)

Would you choose the same specialty? Yes (2011: 47%; 2014: 61%)

Would you choose the same practice setting? Yes (2011: 50%; 2014: 26%)

Insurance Is a Huge Issue

When asked whether they were planning to participate in a health insurance exchange, more than a quarter of respondents (27%) said yes, another 20% said no, and more than half (53%) said they were not sure. Their caution probably has to do with fears about income; 43% of physicians said they expected their income to decrease if they participated in health insurances exchanges; 50% said they expected no change, and 7% said they expected their income to increase.

In general, although a majority of doctors will continue taking new and current Medicare and Medicaid patients, about 25% haven't yet decided whether they will or won't, and a very small percentage (3% at most) will stop taking these patients. In regard to private insurance, 25% said they will drop insurers who pay poorly, while 39% will not.

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