Oncologist Compensation Increase Last Year Among the Top

Nick Mulcahy

April 18, 2018

Oncologists' earnings increased 10% this year over last year, according to the Medscape Oncologist Compensation Report 2018.

That was fourth best among all specialties, outstripped by only physical medicine and rehabilitation (13%), plastic surgery (14%), and psychiatry (16%).

Seven other specialties also saw increases, but six experienced decreases, with general surgery (-9%) and urology (-7%) among the biggest losers in compensation.

The fact that, overall, physician earnings were on the upswing is a matter of simple economics, said an expert.

"The fact remains that the physician workforce is relatively stagnant in terms of growth and that demand for physician services keeps rising. The result, inevitably, is more spending and higher incomes for physicians," Tommy Bohannon, vice president of Merritt Hawkins, a physician recruiting firm, told Medscape Medical News earlier this week.

The new Medscape report was compiled from online survey responses (November 2017 to February 2018) of more than 20,000 physicians who are currently practicing in the United States.

Oncologists were in the top half of all physicians in terms of compensation, reporting an average annual income of $363,000, which was tenth best. Plastic surgery ($501,000), orthopedics ($497,000), and cardiology ($423,000) were the top three. Compensation includes salary, bonus, and profit-sharing. For partners in practices, compensation includes earnings after taxes and deductible business expenses before income tax.

Self-employed oncologists made substantially more money than their employed counterparts ($471,000 vs $330,000). However, this year's Medscape report reveals that only 24% of oncologists are self-employed. This reflects an ongoing national trend toward physician employment, whereby larger entities absorb private practices. Men and women are nearly equally involved as employees (71% vs 73%).

Male oncologists reported higher earnings than their female counterparts ($374,000 vs $332,000). As noted in the Medscape report, this was not owing to part-time work (which women are more likely to have), as the annual report only uses full-time salaries.

In terms of benefits, most oncologists received health insurance (86%), liability/malpractice coverage (79%), paid time off (76%), dental insurance (75%), short-term disability (60%), retirement plan with match (59%), vision insurance (53%), and bonuses (45%). Few oncologists reported no benefits (4%).

Oncologists were among the top doctors in terms of believing that they are fairly compensated (66%). Only five other specialties had a higher percentage.

In terms of payment models, most oncologists (78%) reported being paid through an insurance carrier. Fewer than a third (30%) said they were reimbursed on a fee-for-service basis, such as from Medicare. One quarter reported payment via accountable care organizations.

Oncologists were among the least likely participants in the Merit-based Incentive Payment System (MIPS), one of the Centers for Medicare & Medicaid Services' quality payment programs. Only 29% of oncologists reported participation in MIPS, which was fourth lowest among specialists. Psychiatrists were least likely to participate (8%). Gastroenterologists were the biggest participants (61%).

Most oncologists (65%) will continue to see new and current Medicare and Medicaid patients. However, nearly a quarter (24%) were undecided.

Just more than half (55%) of the oncologists surveyed said that they "occasionally" discuss the costs of treatment with patients, and more than a third (35%) said that they do so "regularly." These conversations take place despite the difficulty in knowing the actual payment or copayment required, as pointed out by an expert at the recent meeting of the National Comprehensive Cancer Network.

In the past year, the most rewarding part of being an oncologist was relationships with patients and their gratitude, with 37% of respondents identifying that dynamic. In terms of other rewards, oncologists also reported "making the world a better place" (25%) and being good at job/finding answers or diagnoses (18%) among the top causes of satisfaction.

This satisfaction with their work presumably accounts for the finding that oncologists were among the top of physicians who said they would choose their specialty again (96%). Only orthopedics, plastic surgery, and radiology had higher rates.

Follow Medscape senior journalist Nick Mulcahy on Twitter: @MulcahyNick

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