The Medscape Physician Compensation Report 2015 was recently published, stating, “Last year saw some modest good news for most physicians.” More than 19,500 physicians, across 25 specialties, responded to Medscape’s compensation survey. The report addresses compensation, hours worked, changes in practice associated with healthcare reform, as well as satisfaction with individual circumstances.
There was a time when there wasn’t even a concept of physicians as employees. The percentage of physicians as employees has grown rapidly, however, with employed physicians now outnumbering self-employed physicians. The survey reported that 63 percent of the physicians who responded were employed. Women are more often employed than men: 72 percent, and 59 percent, respectively. Whether employed or self-employed, primary care providers (PCPs) make substantially less than specialists: $258,000 and $329,000, respectively.
To determine the level of general career satisfaction, Medscape averaged the percentage of physicians who would again choose medicine, would choose the same specialty, and those who felt fairly compensated.
In the 2014 Medscape physician survey, employed physicians reported some problematic issues associated with employment, but were still pleased with their choice to practice as employees:
- 53 percent felt they delivered better care as employees
- 49 percent were satisfied with their income
- 46 percent were more satisfied with their income as employees
- 54 percent were satisfied with their work/life balance
- 66 percent said that their work/life balance improved with employment
The 2015 Medscape survey reports that 64 percent of physicians would choose medicine again, down from 69 percent in the 2011 report. Only 45 percent would select the same specialty, down from 61 percent in 2011. In 2015, only 24 percent would choose the same practice setting, down from 50 percent in 2011.
The paperwork load is heavier among self-employed PCPs, with 68 percent reporting greater than 10 hours per week. Among employed peers, 61 percent had greater than 10 hours of paperwork per week.
Although employed physicians don’t miss the business of running a practice, some miss a role in decision-making. The top 10 disadvantages of being employed, from a poll of more than 21,000 employed physicians included:
1) Limited influence in decision-making: 45 percent
2) More limited income potential: 44 percent
3) Too many rules: 34 percent
4) Less control over their work schedule: 32 percent
5) Being “bossed around” by management: 30 percent
6) Lesser or lack of autonomy: 27 percent
7) Too much administrative work: 16 percent
8) Burdensome productivity formula: 14 percent
9) Unpleasant office culture: 11 percent
10) Less interesting work: 5 percent
There were other disadvantages not listed: 6 percent
The respondents’ top ten advantages of being employed included:
1) Not having to deal with the business of running a practice: 58 percent
2) Not dealing with insurance and billing: 45 percent
3) Guaranteed income/cash flow: 42 percent
4) Good benefits package: 28 percent
5) Malpractice insurance coverage: 25 percent
6) More regular hours: 23 percent
7) Limited/no night call: 17 percent
8) Collegiality: 16 percent
9) Staff provided by employer: 15 percent
10) Signing bonus: 2 percent
Other advantages not listed: 4 percent
The movement toward physicians as employees is growing, and the growth is accelerating – it worked for me.
What is not addressed in the report is the influence of the physicians’ attitudes and thoughts on their own situations and practices. In a couple of practice settings in which I worked with several physicians, there was a broad range among the physicians in regard to satisfaction/dissatisfaction, although we all had the same duties, hours, practice settings, and base salaries. As individuals, we could focus on what we saw as advantages and rewarding aspects of our circumstances, or we could focus on what we saw as disadvantages. We could try to come up with creative solutions for what was less than optimal. We could whine – which was never attractive, nor a productive agent of change. Sometimes it’s best to face upheaval and move on. We almost always have choices, starting with our own attitude.
References:
- Becker’s Hospital Review; The Good and the Bad: 20 things Physicians Like and Dislike about Hospital Employment. March 14, 2014.
- Medscape Physician Compensation Report 2015, Carol Peckham April 21, 2015 http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=1.
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