Average physician salaries rose to $313,000 from $299,000 last year according to the Medscape Physician Compensation Report 2019 . The report is the most comprehensive physician salary report in the United States, representing almost 20,000 physicians in more than 30 specialties. Orthopedists' pay ranked highest at $482,000, followed by plastic surgeons' at $471,000 and otolaryngologists' at $461,000. Physicians in public health and preventive medicine made the least at $209,000, though they represent the largest percentage (73%) of physicians who said they were fairly compensated. They were followed by pediatricians at $225,000 and family medicine physicians at $231,000. The specialists who were least likely to say they were fairly compensated were infectious disease physicians and diabetes and endocrinology specialists (both at 42% salary satisfaction). Oklahoma was the top-earning state for all physicians, with an average income of $337,000, followed by Alabama at $330,000 and Nevada at $329,000. Gender Gap Widens A comparison of full-time salaries in primary care shows that male physicians' earning gap widened over their female counterparts' this year to 25% ($258,000 vs $207,000). The gap was 18% last year, 16% in 2017, and 17% in 2016, the report shows. Women often choose to practice in many of the lowest-paying specialties, the report notes. Only 9% of orthopedists are women, for example, whereas 60% of pediatricians are female. "However, the preponderance of women in the lower-paying specialties doesn't explain the pay disparity within each specialty," the report notes. Male specialists earned 33% more than women in this year's report ($372,000 vs $280,000). In 2018, they earned 36% more. In primary care, men work an average of 4 hours more than women, and among specialties, men work 3 hours more, the survey shows. This also does not explain the gender pay gap. A racial gap persists as well. White physicians continued to make the most, on average, at $319,000. Hispanic/Latino and mixed-race physicians were next at $303,000, followed by Asians at $300,000 and African American/black physicians at $281,000. Spike in Paperwork Hours Time spent on paperwork and administrative tasks was up sharply in recent years. The number of physicians who said they perform at least 10 hours of paperwork or administrative tasks rose to 74% this year from 70% last year, and more than a third of physicians (36%) report spending more than 20 hours on such tasks. For comparison, in 2012, 53% of physician said they spent 1 to 4 hours per week on paperwork. Self-employed physicians earned more again this year: $359,000 vs $289,000. That may be tied to age, the report notes, because 64% of self-employed physicians are older than 50. 62% Employ NPs/PAs This year's survey responses showed that 62% of physicians employed physician assistants or nurse practitioners. For NPs, outpatient clinics had the most at 66%, followed by academic (nonhospital) settings (61%) and healthcare organizations (60%). For PAs, healthcare organizations employed the most at 43%, followed by office-based multispecialty groups at 42% and hospitals at 41%. This year, respondents were asked whether PAs and NPs had an effect on their practice's profitability; 47% said they increased profitability, 6% said they decreased it, and 47% said they had no effect. Would You Choose Your Specialty Again? Asked whether they would choose their specialty again, ophthalmologists were most likely to answer yes (96%), followed by orthopedists at 95% and gastroenterologists at 93%. Conversely, about a third of internists and family medicine physicians would choose a different specialty. A majority of physicians would choose medicine again. Those percentages ranged from 62% for physicians in physical medicine and rehabilitation to 84% among infectious disease specialists. Asked what was most rewarding about their job, 29% of all physicians said gratitude/relationships with their patients, followed by "being very good at what I do/finding answers/diagnoses," at 24%. Medicare/Medicaid Acceptance This year's survey also found more uncertainty in physicians' practices regarding accepting Medicare and Medicaid patients. Eighteen percent said they would either not take new Medicaid or Medicare patients or would stop treating current ones; 17% were undecided. For comparison, in the 2017 report, only 8% said they would stop taking new or treating current Medicare/Medicaid patients, and only 7% were undecided. Survey respondents who met inclusion criteria numbered 19,328. Medscape member physicians were invited to participate if they were currently practicing in the United States. The margin of error was +/- 0.70 at a 95% confidence level using a point estimate of 50%. Source
