Doctors' Incomes Are on the Rise -- Is Yours? Medscape Physician Compensation Report 2017

Leigh Page

Disclosures

April 04, 2017

In This Article

Most Physicians Don't Charge for No-Shows

In another practice management finding, charging patients for no-shows is becoming more of a standard practice, particularly in solo practices where a missed appointment clearly represents lost income to the physician. Among solo practices, 34% of physicians charge for no-shows, while among single-specialty group practices, that number is 26%. According to a Medscape article[21]on no-shows, practices typically charge patients $25 and warn them that if they don't show up again, they'll be dismissed from the practice.

Many physicians are adapting to the business realities within a practice and have become less likely to be understanding about no-shows.

La Penna says just having such policies may reduce the no-show rate, but you shouldn't expect the patient to pay the fine, and federal law actually prohibits collecting extra money from Medicare patients. He also doubts that many practices follow through with threats to dismiss no-show patients the second time. "A patient would have to engage in more egregious conduct than that to be dismissed from the practice," he says.

No-shows can be a big problem for psychiatrists, who see one patient at a time, but La Penna says they're less of a problem for a busy practice that double-books patients. When a patient doesn't show up for an appointment, staff only need to walk into the waiting room and announce, "Next," he says.

Doctors Are Happier With Their Jobs

In this year's report, substantially more physicians say they would choose medicine again. That percentage rose from 64% in 2016 to 77% in 2017.

"I'm kind of surprised by this increase because, in a lot of cases, there's still quite of bit of turmoil out there," La Penna says. For example, there have been a lot of mergers of practices and systems in the past 2 or 3 years, he says.

"It could be simply a matter of doctors feeling less sad or angry than they used to feel," he says. "There could be an element of resignation and understanding sinking in."

He also thinks demographics may play a role. "The older doctors tend to be the angriest, and many of them are retiring," he says. "The younger doctors are more comfortable with the way things are because that's all they know."

In Medscape's report, physicians' degree of comfort with their choice of profession varied by specialty. Those most likely to say they would choose medicine again were rheumatologists (83%), psychiatrists (82%), infectious disease specialists (82%), and gastroenterologists (82%).

Those least likely to choose medicine again were neurologists (71%), ob/gyns (72%), otolaryngologists (73%), anesthesiologists (73%), and radiologists (74%). PCPs were somewhere in the middle: internists (75%), family physicians (77%), and pediatricians (78%).

Asking whether respondents would choose the same specialty elicited a totally different list, with markedly higher satisfaction. At the top were some of the high-earning specialties: dermatology (96%), orthopedics (95%), oncology (95%), plastic surgery (94%), and ophthalmology (93%).

In contrast, PCPs were at or near the bottom of the list. Internal medicine was last at 64% and family medicine was next to last at 67%, but pediatrics was higher at 81%.

The survey also asked physicians to indicate what they loved and hated about their work.

From the list of positives, about one third cited gratitude from patients and another third cited being a good clinician. In addition, 13% cited making money at a job they like and 12% cited making the world a better place. But "making money is not really an issue for the medical profession," La Penna observed. "You go into medicine knowing that you will be paid at a certain reimbursement rate."

When asked about the most challenging part of the job, the leading choice was too many rules and regulations (28%), followed by working longer hours for less money (18%), dealing with difficult patients (15%), having to work with EHR systems (12%), dealing with difficulties of fair reimbursement (11%), and worrying about getting sued (8%).

A year or two ago, La Penna says, EHRs might have been higher on the list, but he thinks systems have become more user-friendly. "Also, doctors have gotten more used to the EHR systems," he says. "They are starting to understand that EHRs can make them more efficient. They have suffered through the learning curve."

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