Older/Younger Physician Pay Gap Stays at $60K, Survey Shows

Marcia Frellick

September 08, 2020

Physicians under age 40 again this year made about $60,000 less than their older counterparts, according to responses from a Medscape survey.

More than 3200 young physicians responded to the Medscape Young Physician Compensation Report 2020 on questions of pay, debt, expenses, work hours, and job satisfaction.

Responses show that young primary care physicians made on average $198,000 (compared with older PCPs, at $262,000) and young specialists made $302,000 vs $364,000 for those aged 40 and older.

The data for this report were collected before February 11 and do not reflect any COVID-19 changes, which "no doubt" are coming, at least in the short term, Travis Singleton, executive vice president for physician search and recruitment firm Merritt Hawkins/AMN Leadership Solutions, told Medscape.

He said his firm’s research shows that 21% of physicians have experienced furloughs or pay cuts in the pandemic.

Which Work Settings Pay More?

Young physicians who made the most were in office-based, single-specialty group practices, where they made an average $289,000. That was also the highest-paying setting for their older counterparts, who earned $353,000.

For both age groups, the lowest-paying workplace was the outpatient setting, where younger physicians made $199,000 compared with $281,000 for their older counterparts.

The biggest differences in pay satisfaction between young and older physicians came in the specialties of rheumatology (young physicians were 17% more satisfied with pay) and — at the other end of the spectrum — cardiology, where young physicians were 18% less likely to be satisfied with pay.

The age groups also differed in diversity.

Among younger physicians, 42% are female compared with older physicians, where women make up 33%. That follows a trend described by the American Association of Medical Colleges, who reported in 2017 that, for the first time, more women than men were entering medical schools.

Racial diversity is also greater among younger physicians. While 66% of older physicians listed their race as Caucasian/white, 56% of young doctors gave that designation.

The number of Asian physicians is greater in the younger generation. One fourth (25%) of young doctors are Asian vs 16% of those aged 40 and older. The numbers of African American doctors are similar in both younger and older physicians, at 5% and 4%, respectively. The numbers are similar to those in last year's report.

For the 5th straight year, the majority of young physicians are employed. Report authors say that is likely to continue, as the Medscape Residents Salary & Debt Report 2020 reports that only 21% of residents plan to be self-employed. The 82% of the under-40 physicians who are employed contrasts with the 64% of those aged 40 and older who are employed.

"Self-employment has simply become unworkable for many physicians, given what is required to provide care in today's highly complex system, in which payment and delivery models are changing," Singleton said.

Contrasts in Percentages Seeking Promotions

As expected, more young physicians seek promotions than do their more experienced older counterparts, but this survey highlighted a difference when comparing who's seeking promotions by gender.

While young male physicians were more likely to seek promotions than young female physicians (62% vs 56%), the reverse was true for older physicians in that older female physicians were more likely to seek promotions than older male physicians (35% vs 30%).

Survey respondents also answered questions on expenses and debts.

Among the areas where young and older physicians differed was child care (30% of younger physicians vs 11% of older physicians said it was a major expense). And three times as many young physicians as older physicians were paying off a spouse's or significant other's school loans (23% vs 8%).

Young physicians with the largest school loan debt were those in obstetrics/gynecology (67%) and family medicine (66%). The least likely to be paying down student loan debt were those in internal medicine (46%).

Percentages were similar for those paying off a mortgage (61% of younger physicians and 65% of older physicians), and 37%-38% in all ages had car payments.

Work Hours Are Similar

The older and younger physicians spent roughly the same amount of time seeing patients: 93% in both groups saw patients more than 20 hours a week and 4%-5% in both groups saw them 10-19 hours a week. According to the Medscape Physician Compensation Report 2020 , physicians overall spent 37.8 hours a week seeing patients.

They also spent similar amounts of time on paperwork: 37%-38% in both groups spent 20 or more hours on those tasks and 36%-37% spent 10-19 hours a week doing them. The administrative work continues to take a toll, as three fourths of all physicians reported, for the third year in a row in this survey, that they spent at least 10 hours a week on paperwork and administrative tasks.

With the ups and downs, would young physicians choose medicine again? Three fourths said yes, similar to the percentages of their 40- to 69-year-old counterparts.

Young doctors most likely to choose medicine again were those in ophthalmology and oncology, at 84%, and those least likely were those in internal medicine and family medicine, at 73%.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News, and Nurse.com, and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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