ID Doctors Have the Most Paperwork, Administrative Demands

Marcia Frellick

May 17, 2021

Infectious disease physicians are among the doctors carrying the largest burdens in the COVID-19 pandemic.

Perhaps not surprisingly, they were the specialty least likely to feel they were fairly compensated in the Medscape Infectious Diseases Physician Compensation Report 2021.

Only 44% said the pay was fair (down from 51% the prior year) compared with those at the high end — 79% in oncology, 69% in psychiatry, and 68% in plastic surgery who answered that way.

Income, which averaged $245,000, varied little from the previous year overall, according to the survey, but nearly one third of ID physicians saw a decline in pay.

Again this year, ID physicians ranked near the bottom on the compensation spectrum. Pediatricians were lowest paid at $221,000. Plastic surgeons topped the chart at $526,000, followed by orthopedists at $511,000.

At the same time, the ID specialty is facing increasing shortages, a gap made even more visible in the pandemic. Medscape reported last year that nearly 80% of US counties have no infectious disease specialists.

Thomas File Jr, MD, last year's president of the Infectious Diseases Society of America, emphasized that COVID-19 is not the only threat that ID specialists have had to deal with or will have. He cited the threats that Zika and SARS posed in past years.

"COVID-19 illustrates the need for more trained ID specialists, because we know we're going to be seeing more outbreaks in the future," he commented to Medscape Medical News at the outset of the pandemic in March 2020.

Longer Hours in Pandemic

ID physicians' hours generally increased during the pandemic, and they remain inflated by 8 hours per week (60 compared with 52 pre-pandemic) as the nation struggles to manage continuing COVID-19 infections. Physicians in critical care and public health and preventive medicine are seeing heavier workloads as well, by an average of 6-7 hours per week.

At the same time, infectious disease physicians spent the most time of physicians in all specialties on paperwork and administrative tasks. Those tasks, which include electronic health record entry and clinical reading, took ID doctors 24.2 hours a week, more the twice the hours spent by those in anesthesiology (10.1); ophthalmology (10.3); and radiology (11.6).

The 24.2 hours was a substantial increase from the last report when ID physicians reported spending 18.5 hours on the tasks.

The survey asked about the most challenging part of the job; ID physicians reported "long hours" as number one followed by "having so many rules and regulations."

Only 4% said the danger or risk associated with treating COVID-19 patients was the most challenging part.

The top two aspects of their work they deemed most rewarding were "being very good at what I do" (chosen by 33%) and "knowing that I'm making the world a better place" (31%).

Patient Volume Up 17%

ID physicians reported seeing 78 patients per week in this report compared with 66 pre-pandemic, a 17% increase. Conversely, pediatricians saw an 18% drop in patient visits, followed by dermatologists, orthopedists and otolaryngologists (all down about 15%).

Despite the challenges and dissatisfaction with pay, the great majority of  infectious disease physicians said they would choose both medicine (83%) and their specialty (89%, up from 85% last year) again.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News and 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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