Internists' Pay Rises 1%; Ranking Stuck Near Bottom

Marcia Frellick

April 12, 2017

Only about half (49%) of internists are happy with their compensation and a third (33%) of those who are unsatisfied with their current pay say they should make 26% to 50% more than they currently do, according to this year's Medscape Compensation Report

With average pay of $225,000, internists are near the bottom among compensation by specialties, according to the survey data. Only 3 specialties had lower pay: endocrinology ($220,000), family medicine ($209,000), and pediatrics ($202,000).

In addition, internists had one of the smallest salary increases from 2016, at 1%. Only oncologists, cardiologists, and pediatricians has smaller increases (from 0% to −1%)

Conversely, the related Medscape Lifestyle Report showed internists near the top among specialties for rates of burnout. They shared a third-place ranking with family medicine and infectious disease, with 55% of respondents reporting burnout. Only emergency medicine (59%) and obstetrics-gynecology (56%) had higher burnout rates.

In this year's Medscape Compensation Report, physicians who were not satisfied with pay were asked how much more they thought they should make. Almost half of internists (46%) said they should make 11% to 25% more, 33% said they should make 26% to 50% more, 11% said they should make 51% to 100% more, and 5% said their salary should be more than double what it is now.

With respect to the biggest challenge in their work, 30% of internists said it was having so many rules and regulations, followed by dealing with difficult patients (18%) and having to work longer hours for less money (17%). In comparison, among all 19,270 physician respondents across all specialties, the top three challenges were the number of rules and regulations (28%), working more hours for less money (18%), and dealing with difficult patients (15%).

The survey also showed a spike in the number of internists who said they would participate in healthcare exchanges this year (32% vs 20% in 2016). That followed a pattern for all specialties, which showed a jump to 37% from 19% last year.

As for exchanges' effect on income, 44% of internists reported no change, 5% said income had increased, and 12% reported it had decreased.

This year and last, about half of the internists said they had seen an influx in the number of patients because of the Affordable Care Act.

By some indicators, time spent with patients decreased overall among internists: 33% of respondents said they spent more than 45 hours a week with patients, down from 39% in 2016. Most respondents (67%) said they spent between 13 and 24 minutes with each patient.

The survey turned up some signs of regret. Internists were asked whether they would choose medicine again and 75% said yes. Of those, only 64% would choose their specialty again, the lowest percentage among specialties in the survey. Dermatology had the highest percentage of respondents who said they would choose their specialty again, at 96%.

Competing with patient time are increasing administrative duties. Physicians overall, regardless of specialty, spent more time this year on administrative tasks: 52% spent more than 10 hours on the tasks as compared with 35% in 2014. Internists surpassed the all-specialty average, with 62% reporting they spent more than 10 hours on the tasks.

Geographic differences were less pronounced among internists than in some other specialties. The highest pay was found in the south central region ($244,000), and the lowest in the Northeast ($210,000).

Again this year, the gender pay gap persists in internal medicine: Women make 17% less on average ($203,000 vs $238,000.) Women are also more than twice as likely to work part time (24% vs 11% for men).

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