In its latest physician salary report, Medscape surveyed 13,000 physicians in 29 specialties to detail how physician compensation changed in 2021. The new survey revealed that physician income is back on the rise, after stagnating in 2020 due to impacts from the COVID-19 pandemic.
A look at the headline figures from the past three years illustrates the trend. For primary care physicians, average income was $243,000 in 2019, falling slightly to $242,000 in 2020, then increasing to $260,000 in 2021. Specialists reached an average compensation of $368,000 in 2021, up from $344,000 in 2020, which was a bit down from $346,000 in 2019.
While this is good news overall, Medscape points out that recent increases are just a beginning for physicians, who are still recovering from the salary stagnation of 2020.
Physician compensation by specialty
Virtually all physician specialties saw an income increase in 2021, which Medscape notes is a first since it began tracking physician compensation. Otolaryngology saw the largest increase, at 13%, while critical care physicians — who in many cases faced the brunt of the pandemic in hospitals — logged an increase of just 1%.
The list of highest-paid specialties has remained virtually unchanged since 2017. The top-earning specialty was plastic surgery at $576,000. The next four, in descending order, are orthopedics, cardiology, otolaryngology, and urology.
Physicians’ attitudes about their compensation vary widely among the specialties. The top five specialties in which physicians said they felt fairly compensated include public health and preventive medicine, oncology, plastic surgery, psychiatry, and dermatology. On the other hand, nephrology physicians felt the most unfairly compensated, followed by diabetes and endocrinology, pediatrics, physical medicine and rehabilitation, internal medicine and OB/GYN physicians. In each of those specialties, fewer than 50% of respondents said they felt fairly compensated.
Administrative burdens by specialty
On average, physicians reported spending 15.48 hours per week on administration and paperwork. This type of work contributes to stress and overwork for physicians, and it can cut into billable patient-facing hours. According to the Medscape report, the most paperwork-intensive specialties were infectious diseases (19.8 hours per week), internal medicine (18.7), neurology (17.7), nephrology (17.7), and physical medicine and rehabilitation (17.4).
The least administrative/paperwork-intensive specialties were anesthesiology (10), ophthalmology (10.1), dermatology (11.9), otolaryngology (12.1), emergency medicine (12.8), and plastic surgery (12.8). Of note, some of the highest-paying specialties (otolaryngology, plastic surgery) faced among the lowest administrative and paperwork burdens.
Self-employed physicians and moonlighters
Another point of difference is between self-employed and employed physicians. At an average of $385,000, self-employed physicians (which includes locum tenens physicians) earned 20% more than employed physicians, who earned $320,000 on average.
More than a third of physicians (36%) took on extra work to supplement their income. Some of the sources of this supplemental work include adding hours to their primary work and taking medical or non-medical side jobs. A full 10% of physicians reported medical moonlighting, which would include locum tenens side work.
The gender gap in physician compensation
The gender pay gap between male physicians and female physicians has not improved over the past decade. In fact, the trend shows a slight worsening: in 2012, the gap in primary care between men and women was 23%, while the latest report puts it at 25%. According to the Medscape survey, male primary care physicians earned an average of $285,000 in 2021, while women earned $228,000.
On the other hand, the gender pay gap among specialists has declined — although it’s still greater than the pay gap between male and female primary care physicians. The gap among specialists sits at 31%, which is down from 37% five years ago. Male specialists earned an average of $402,000 in 2021. Female specialists earned $307,000.
Women see their highest representation in pediatrics (58%) and OB/GYN (57%). The only other specialty where they make up more than 50% of physicians is diabetes/endocrinology (52%).
Women face their lowest representation in urology (8%), orthopedics (11%), plastic surgery (16%), and cardiology (16%). Of note, three of these specialties — orthopedics, plastic surgery, and cardiology — are among the top five highest compensated specialties.
Geographic differences in physician salary
The average physician salary can vary notably from state to state. In 2021, Kentucky came out on top with an average physician salary of $364,000. Other states in the top 10 for compensation include (in descending order): Tennessee, Alabama, Missouri, Oregon, Indiana, North Carolina, Connecticut, Texas, and Florida. According to Medscape, southern states have made extra efforts to attract physicians, including increasing salaries and offering sign-on bonuses.
While many physicians are still recovering from the effects of the COVID-19 pandemic, physician earnings have generally rebounded. Overall, Medscape’s 2022 physician salary report suggests that physician compensation will continue to grow.
Chart images from Medscape.com
Article last updated May 19, 2022