Radiologists’ Earnings Down, and Some Expect Long Recovery

Nancy A. Melville

May 18, 2021

The COVID-19 pandemic took a bit of a toll on radiologists' earnings in 2020, with nearly half of radiologists reporting at least some decline in compensation and average annual earnings dropping by about $14,000, according to the Medscape Compensation Report 2021.

The report reflects responses from nearly 18,000 physicians in 29 specialties on compensation, work-related issues, and, importantly, how practices fared during the unprecedented challenges of the COVID-19 pandemic.

Although overall, physicians reported little variation in earnings from 2019 to 2020, radiologists reported that their average earnings dropped by about 3%, from $427,000 in 2019 to $413,000 in 2020.

For most (92%), the decline in earnings was attributed to fallout from the COVID-19 pandemic; however, 19% reported that other factors played a role.

Of note, self-employed radiologists reported incomes 7.5% higher than those who are employees, at an average of $431,000, vs $401,000.

The gap between self-employed physicians and employees was larger among physicians overall, with self-employed physicians earning 17% more — an average of $352,000, vs $300,000 for employed physicians.

Incentive Bonuses Similar to 2019

Radiologists' incentive bonuses remained nearly the same in 2020 as in 2019. The average bonus was about $69,000, which was 17% of their total annual salary. This was down just slightly from last year's 18%.

Eighty percent of radiologists reported earning an incentive bonus that was more than three quarters of their potential full bonus. They earned, on average, about 83% of their potential bonus — a bit higher than the 68% reported by physicians overall.

Fair Compensation?

About 65% of radiologists overall reported that they were fairly compensated, which is near the top of the list of specialties. Oncologists led in this caregory; 79% of oncologists reported feeing that their earnings were fair.

At the bottom of the list are infectious disease physicans, among whom only 44% felt that their compensation was fair.

Radiologists' Workload in 2020

Paperwork and administrative tasks appear to be less of a burden to radiologists compared with other specialists. Radiologists reported spending a relatively low average of 11.6 hours per week on those tasks outside of patient visits, down from the 12.3 hours per week reported in 2019. This placed them third from the bottom of the list. Anesthesiologists were least burdened, at just 10.1 hours per week.

Those with the highest paperwork and administrative burden were, perhaps predictably, infectious disease specialists, who spent an average of 24.2 hours per week on these tasks.

For work hours overall, radiologists reported working an average of 49 hours per week, down just slightly from 50 hours per week in 2019.

The number of patients seen per week dropped by about 7%, from 192 per week in 2019 to 179 in 2020, owing to the fact that patient visits were limited because of the pandemic.

Fifty-one percent of radiologists reported that they expect that 1% to 25% of the reduction in patient volume is likely to be permanent.

Job Satisfaction, Challenges, Legal Worries

In terms of job satisfaction, 43% of radiologists reported that the most rewarding factor of their job was "being good at what I do/finding answers, diagnoses."

Asked about the most challenging aspect of their job, radiologists most frequently responded, "worrying about getting sued"; 21% of radiologists reported having that concern, which was about three times higher than other specialists.

On average, only about 7% of physicians in other specialties listed worrying about being sued as their top challenge.

About three quarters (74%) of radiologists reported that they would pick a career in medicine again if given the chance, which was only slightly lower than the 78% reported by physicians overall.

That rate places them third from the bottom of the list of specialists in terms of choosing a career in medicine again. Physical medicine and rehabilitation was at the bottom of the list, at 67%, and oncology was at the top, at 88%.

Nevertheless, the rate of those who would choose radiology again is significantly higher — 93%, near the top of the list. That rate was unchanged from 2019.

Gender Gap Still a Concern

In commenting on the survey, Howard P. Forman, MD, professor of radiology and biomedical imaging at the Institute for Social and Policy Studies, of Economics, of Management and of Public Health (Health Policy) at Yale University in New Haven, Connecticut, cautioned that "there are always concerns about surveys that rely on individual reporting and a relatively limited sample.

Dr Howard Forman

"The fact that radiology compensation has dropped and also done so relative to other specialties is not surprising, given the enormous impact of the pandemic across the nation,” he told Medscape Medical News.

"The fact that many individuals think that it will take 5 years to recover is a little surprising to me," he said.

Among all physicians in the survey, there were nearly twice as many men (61%) as women (36%). Forman noted that there is, in general, a concern about a gender imbalance in radiology.

"Women continue to be a minority within our field, and this has not caught up at nearly the pace that would otherwise be expected," he noted.

In 2004, Forman and colleagues authored a review in which they assessed why female medical students tended not to choose radiology.

"'[It's been] 17 years since I led this review, and we are not making the progress that we should," he said.

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