April 16, 2014 -- Medicine is going through changes, some for the better and others less so, according to Medscape's "Physician Compensation Report: 2014." Key findings include:
- Compensation has increased slightly in 19 medical specialties.
- The income gap between men and women is narrowing.
- Accountable care organizations (ACOs) are making their impact felt.
- Self-employed doctors earn more than employed ones.
- Cash-only practices, while still a tiny percentage of all practices, are gaining some traction.
The report is based on a survey of more than 24,000 U.S. doctors representing 25 specialties.
Who's on Top?
Orthopedics ($413,000), cardiology ($351,000), urology ($348,000), gastroenterology ($348,000), and radiology ($340,000) are the five top-earning specialties, as they were in last year's survey. Radiology has moved down slightly compared with earlier surveys, and anesthesiology has dropped.
Primary Care Income Has Gone Up Slightly
Compensation for both family doctors and internists is up 1% compared to 2012. While doctors overall have been concerned about income declines due to health care reform, this was not the case in 2013 for 19 specialties that saw modest increases. But inflation in 2013 was 1.5%, so for many, income did not keep up with inflation.
For primary care, some of the increase was probably due to the 10% bonus paid to primary care doctors who see Medicare patients, as included in the Affordable Care Act. Despite the modest increase, family doctors and pediatricians are among the lowest-paid specialists, as they have been in past surveys.
The Income Gap Between Male and Female Doctors Is Narrowing
Among doctors, men earn more than women, as they have in all past surveys. But that picture appears to have improved. In 2010, male doctors earned 40% more than females. In 2013, men earned 30% more. Those percentages vary by specialty. In primary care, the disparity is smaller and hasn't changed much. In 2013, among internists, men earned 13% more than women ($195,000 vs. $173,000). In family medicine, men earned 19% more ($187,000 vs. $157,000).
Although men make more than women in almost every specialty, women tend to be as satisfied as men with their compensation. In some specialties they are more satisfied. For example, female OB/GYNs make $229,000 compared with $256,000 for men, but 47% of women are satisfied with their compensation compared with 38% of men. Female gastroenterologists make less than male ones, but 55% are satisfied with their income vs. 46% of men.
Urology was the only specialty in which women made more than men, and female urologists were also more satisfied with their compensation.
Self-employed Physicians Earn More Than Employed Ones
Among doctors overall, those who are self-employed earned an average of $281,000 compared with employed doctors, who earned $228,000. In primary care, the difference was smaller: self-employed doctors earned $188,000 and employed ones earned $180,000.