Neurologists continue to rank near the bottom in terms of annual compensation for all physicians, although their income rose this year compared to last year, and most are happy in their chosen profession, findings from the newly released Medscape Neurologist Compensation Report 2019 show. Neurologists' average annual income this year is $267,000, up from $244,000 in 2018. Neurologists are below the middle earners of all physician specialities. At $267,000 in annual compensation for patient care, neurologists rank 9th from the bottom, just below allergists/immunologists ($275,000), but ahead of psychiatrists ($260,000), rheumatologists ($259,000) and internists ($243,000). Orthopedists are the top earners this year ($482,000 annual pay), followed by plastic surgeons ($471,000), otolaryngologists ($461,000), and cardiologists ($430,000), according to this year's overall Medscape Physician Compensation Report, which covers US physicians as a whole. The survey included nearly 20,000 physicians in over 30 specialties. Pediatricians and public health and preventive medicine specialists continue to earn the least — although they did get a pay bump this year. Pediatricians made $225,000 on average this year compared with $212,000 last year, while preventive medicine specialists' annual income rose to $209,000, up from $199,000 in 2018. Male neurologists earn 24% more than female neurologists ($288,000 vs $232,000). The gender gap in neurologist salary is consistent with that of physicians overall, where men earn 25% more than women. Male neurologists spent 13% more time seeing patients than their female peers, which may be one factor contributing to the gender pay disparity. Professional Pride Fifty percent of neurologists feel they are fairly compensated, down from 60% last year, but up from 39% in 2014. Bureaucratic tasks continue to be a burden for physicians in all specialities. Overall, 38% of physicians report they spent 10 to 19 hours each week on paperwork and administrative tasks, and 36% spend 20 hours or more. Neurologists appear to have more of those burdens than other physicians; 85% are saddled with 10 or more hours per week of paperwork and administrative chores. For neurologists (31%), as for physicians overall (26%), having so many rules and regulations is the most challenging part of their job, followed by difficulties getting fair reimbursement (15%), having to work with an electronic health record systems (15%), having to work long hours (14%), and dealing with difficult patients (12%). Few cited worry about being sued (4%). Despite the challenges, 79% of neurologists said they would choose medicine again and 82% would choose neurology again. What is most rewarding about being a neurologist? Being good at what they do/finding answers or diagnoses (33%) tops the list, followed by making the world a better place (27%); relationships with and gratitude from patients (19%); and making good money at a job they like (8%). Few cited pride in their profession (4%) and teaching (5%). The vast majority (92%) of neurologists are either very satisfied or satisfied with their own job performance. "Doctors take great pride in what they do, even under difficult circumstances, and I would imagine that they all feel we do the best we can in spite of the challenges," said Carol Bernstein, MD, from NYU Langone Medical Center in New York City. Key Findings Other key findings from the latest report regarding neurologists include the following: 40% of neurologists are in fee-for-service arrangements, up from 32% in 2018. There's been no change from last year in the percentage of neurologists in accountable care organizations (ACOs) (21%). Only 5% of neurologists are in cash-only practices; 2% practice concierge neurology. 20% of neurologists work in a hospital; 18% in an office-based, single-specialty group practice; 17% in an office-based, multispecialty group practice; 15% in an academic (nonhospital), research, military, or government setting; 12% in a healthcare organization; 11% in an office-based solo practice; and 3% in an outpatient clinic. 74% of neurologists haven't seen any changes in their benefits packages. More neurologists' benefits have worsened (19%) vs improved (7%). 66% of neurologists say they will continue taking new and current Medicare/Medicaid patients; only 3% won't take new Medicare patients; 1% won't take new Medicaid patients; 26% are undecided. 36% of neurology practices use physician assistants (PAs) and 45% use nurse practitioners (NPs), compared with 36% and 50%, respectively, for other physicians overall; 44% of neurology practices don't use PAs or NPs. 38% of neurologists expect to participate in MIPS (merit-based incentive payment system) and only 4% expect to participate in APMs (alternative payment models). Among all specialists, more than one third (37%) expect to participate in MIPS and 9% plan to take part in APMs. Source
