Pay disparity between male and female primary care physicians has narrowed, study reveals!

According to the findings of Medscape Physician Compensation Report 2023, intriguing trends have showed up, including a betterment in the gender-based pay gap among primary care doctors; a rising disillusionment with Medicare payments, as more doctors refuse to accept new patients on Medicare; and an overall increase in physician pay. Doctors were invited to participate in a ten-minute online survey. More than 10,000 doctors (sample size 10,011) from more than 29 different disciplines fulfilled the screening criteria, finished the survey, and provided with information on their pay, work ethic, and attitudes towards it. Respondents were US practicing physicians.

The compensation for doctors is still increasing. Five years ago, the total physician compensation in the 2018 study was $299,000; this year, it was $352,000. Given the widespread talk of clinician shortage, which the coronavirus pandemic has aggravated, it is anticipated that clinician income will continue to rise. The number of physicians in practise is falling as more of them retire, cut back on their hours, or look for virtual care or shift work. With the exception of plastic surgery, which started its ascent to the top around the year 2017, the highest-earning specialities have remained largely stable over the past ten years (plastic surgery followed by orthopedics, cardiology, urology, gastroenterology, otolaryngology etc).

Profit-sharing payments, bonuses, and salary are all included in the remuneration estimates for employed clinicians. For medical professionals who work for themselves, they include after-tax revenue and deductible business costs prior to income tax. The findings only encompassed full-time salaries. Oncology, anesthesiology, gastroenterology, radiology, critical care, and urology all illustrated significant improvements in compensation. As the COVID-19 outbreak subsided, the volume of procedures for more complicated specialities have increased. Nevertheless, Medicare cuts and somewhat static reimbursement in comparison to the cost of practise reduced many doctors' incomes.

Reasons for the drop in the income of doctors were no increase in reimbursement, hospital overcrowding, overwhelming burnout, and reduced and delayed payment from insurance carriers. Other reasons that doctors reported for a reduction in their income were pay cut in base salary, not receiving bonuses, practice being acquired by venture capital firms, and decrease in Medicare reimbursement and poor payor. The overall level of physician salaries has been rising. The main influencer is supply and demand. Physicians generally receive attractive offers because employers recognize that finding qualified candidates is not getting any simpler.

More than half (57%) of specialities said that their members receive an incentive bonus (orthopedics $134K, cardiology $88K, radiology $88K etc), and many doctors claim to work for longer hours in order to earn it. Few employers are switching to flat, fixed salaries currently. Although there are many different kinds of incentive plans, the incentive bonus is still considered to be a vital component for doctors. The pay disparity between male and female primary care physicians  appears to have narrowed somewhat. Male primary care physicians earned around 25% more than female primary care physicians in the previous few years, on average. Men earned 19% higher than women this year, which is still a sizable discrepancy but represents the narrowest gap in five years.

Transparency in wage lines may contribute to reduce the pay gap. Specialists who are men earned 27% higher money than specialists who are women, a small decrease from 31% last year and 33% the year before. In comparison with African American/Black physicians ($311,000),  Caucasian/White physicians ($358,000) and Asian American physicians ($351,000) make more in overall income. Compared to Asian American (58%) and African American (36%) doctors, Caucasian/White doctors are more likely to be male (64%). Compared to Asian American (60%) and African American (67%) clinicians, Caucasian/White clinicians are more likely to be forty-five years or older (74%) in age.

In general, 52% of doctors are happy with their pay, which is similar to five years ago, before the coronavirus disease, when 55% of doctors felt they were fairly compensated. Few specialists with lower compensation are content with their pay, nevertheless. The fact that many doctors making substantial salaries work for sizable organisations certainly gives them heartburn because they are aware of how much the organization collects in reimbursements. Four of the top-earning states this year were also on the list from the previous year: (1) Indiana, (2) Connecticut, (3) Missouri, and (4) Florida.  As per the research, the 5 states anticipated to have the highest shortages of physicians by the year 2030 are: (1) California, (2) Florida, (3) Texas, (4) Arizona, and (5) Georgia.

The West does, on average, pay a little bit more when compared to the Northeast. Florida frequently pays well; it exhibits a sizable retired population and respectable Medicare reimbursement, so doctors there earn well. A wide array of doctors undertake part-time jobs to sharpen their skills or find mental reprieve from their jobs, while some do it to make extra money. For supplementing their income, 20% of doctors take other medical-related work, 11% prefer medical moonlightning, 7% reported adding more hours to their primary job as a doctor, 6% of doctors take other non-medical-related work, and 62% do not prefer extra work.

The level of competition seems to be escalating. Only 63% of doctors stated they are no longer impacted by competition (down from 67% last year). The main rivals are those who are not physicians (nonphysician competitors). The majority of the competition, according to one responder, comes from other practices. Owing to diminished Medicare and Medicaid reimbursements, more doctors have started to feel the pressure and are thinking about curtailing their Medicare and Medicaid patient base. The number of doctors who claimed they would continue accepting novel Medicare patients has dropped from 71% five years ago to 65% today, the lowest figure ever observed in the pay reports. Notably, 22% of doctors have not yet decided on dropping Medicare and Medicaid patients.

The proportion of female doctors in higher-paying specialities has somewhat elevated. Plastic surgery had a rise from 16% last year, while urology saw a rise from 8% female doctors. However, primary care illustrated the highest proportion of female doctors. Doctors work 50 hours a week on average, which encompasses time spent seeing patients as well as charting, paperwork, and administrative tasks. Five professions claim to put in 55 hours or higher of work each week. In the US as a whole in 2021, 38.7 hours were the average number of hours worked per week, according to the "Bureau of Labor Statistics".

Most doctors would still pursue medicine despite difficulties with the insurers, payment, baffling patients, and other business-linked issues. Even still, their enthusiasm for the field is less than it was five years ago, when 77% stated they would prefer medicine once more. In 10 specialities, 90% or more of their members would prefer the same speciality as opposed to 8 specialities scoring that high in the previous year.  If given the choice again, those of the lower-paying specialities were less likely to stick with their current field.

Notably, 30% of doctors said that being very good at what they do while 24% stated gratitude/relationships with their patients is the most rewarding part of their job. The most difficult part of their job was too many regulations and rules (21%), working long hours (16%), and handling difficult patients (15%). While many doctors decide to continue practising medicine because they believe these problems can be resolved, others decide to leave the field.  In the year 2021, a total of 117,000 physicians left the workforce due to retirement, burnout, and stressors associated with coronavirus disease.

Overall, self-employed doctors make more money than those who work for others. Facts that more self-employed doctors are often older and more male are some factors that contribute to this.  However, the number of self-employed physicians is tapering down. A clinician's day is being increasingly consumed with paperwork and administrative tasks. According to studies, entering patient data into an electronic health record system can add up to 1.5 hours per day to a doctor's normal workday. The average physician spends 15.5 hours each week on administration and paperwork. Nine of those hours are spent documenting electronic health records.

There has been a steady although slow drop in fee-for-service (a stated goal for a prolonged time). Recent healthcare payments from insurers were connected to value and quality in 59.5% of cases, while fee-for-service models accounted for 40.5% of payments, according to the Alternative Payment Model (APM) measurement effort. Regarding people who don't pay their bills, 55% of doctors continue to treat them and create a payment plan while 14% write off-balance one-time and continue treating them.