Nearly 40% of Internists Would Choose a Different Specialty: Medscape Compensation Report

Robert Fulton

May 31, 2023

Fewer than half of internists consider themselves "fairly paid," according to the Medscape Internist Compensation Report 2023, which puts internal medicine physicians in the bottom three of 29 specialties polled.

In this year's report, internists' average annual income was $273,000, which is in the bottom six of the 29 specialties polled and is a 4% decrease from 2022. However, since 2015, the average annual reported salary of internists has increased approximately 39%.

Physicians in some specialties, including internal medicine, saw their income dip from 2019 to 2020 with the onset of the COVID-19 pandemic.

For employed physicians, compensation figures included salary, bonus, and profit-sharing contributions. For self-employed physicians, figures included earnings after taxes. Only full-time salaries were included in the results.

Internists reported an average annual incentive bonus of $33,000.

Many physicians said they now work harder and longer in order to earn their incentive bonus.

In last year's report, the average pay gap among internists was about 24% higher for men than women. This year, the disparity was about 16%.

In this year's report, 34% of internists pointed to competition from nonphysician practitioners as most affecting their income; 18% cited "minute clinics" and big box stores, and 17% said telemedicine was the leading factor.

Not Satisfied

The survey also found that many internists appear to be deeply dissatisfied with their careers: almost 40% of internal medicine physicians would choose a different specialty if they were granted a do-over, the lowest rate of the 29 specialties in the Medscape survey of more than 10,000 physicians.

In 10 specialties, including plastic surgery, urology, and orthopedics, 90% or more of respondents said they would choose the same specialty.

Physicians in other lower-earning specialties, such as family medicine and public health and preventive medicine, were also less likely to say they would stay in their same specialty given a second chance to choose.

Internists also ranked high in time spent per week on paperwork and administration, at 17.9 hours. Studies have shown that charting into an electronic health record system can add up to 1.5 hours per day to the average physician's workload.

Robert Fulton is a journalist living in California.

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