Physician compensation survey: A little more money and a LOT more paperwork

Despite reported cuts in reimbursements, the average physician enjoyed a moderate-to-significant boost in income this year. But that came at a price. Namely, docs are spending way more time on paperwork, thinking more about ACOs and stressing about the future of reimbursement.

According to Medscape’s 2013 Physician Compensation Report, the actual number of patients that physicians are see per day doesn’t appear to be going up. Nor do doctors seem to be spending less time with patients; more than half report spending 13-20 minutes with each patient. But, more of that time likely includes typing data into a computer: In 2012, more than half of physicians said they spent less than five hours per week on paperwork, which includes working with electronic medical records. This year, more than half said they spend 5-14 hours per week.

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The online survey conducted in February reached 21,878 U.S. physicians across 25 specialties and demonstrates some other ways that healthcare reform has impacted physicians’ jobs and attitudes. For example, the influx of hospital M&A seems to be making it harder for independent physicians to compete: In last year’s report, solo physicians earned an average of $220,000 – more than employed physicians. This year, however, their average salary dropped to $216,000, whereas employed physicians’ average salaries rose.

Specialists in orthopedics, cardiology and radiology were the top three earners again this year, all with average salaries well above $300,000. But they also saw more patients — 27 percent of orthopedic specialists said they saw patients for more than 50 hours a week, compared to 18 percent across all respondents.

Some other interesting points from the report:

Career satisfaction rates were steady compared to last year, when a little more than half of doctors said they would choose the same career if they could do it over. But that’s coming off of a huge drop from the 2011 survey, in which two-thirds said they would.
The percentage of physicians who feel they are fairly compensated has slowly dropped over the past two years, from 53 percent in 2011 to 48 percent this year.
Orthopedic surgeons saw the biggest spike in pay, experiencing an average 27 percent increase, potentially due to more elective procedures in aging adults as the economy continues to recover.
Oncologists and endocrinologists were the only specialists whose average salaries dropped.
Last year, less than 10 percent of physicians were involved in an ACO or planned to be within a year. This year, nearly one in four said they were either in an ACO or plan to be in one within the coming year.
Medicare reimbursement is a huge questions mark. Nearly 30 percent of physicians said they haven’t yet decided whether they will continue to accept Medicare patients. Nine percent said they plan to stop taking new Medicare patients, but will continue caring for current ones. Two percent said they won’t even treat current Medicare patients.
On that same note, nearly one in four physician plans to drop lowest-paying insurers
To create more opportunities for income, nearly 1 in 5 respondents has begun offering ancillary services
About two-thirds of physicians said they regularly or occasionally discuss the cost of treatment with patients, compared with 84 percent last year. But that’s not necessarily bad. As physicians become employed, those costs may be discussed by other staff members.