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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023
| Contributor Information
Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In 2022, physicians younger than 40 years, on average, enjoyed a compensation bump that exceeded what older counterparts received. The gender pay gap between younger male and female doctors narrowed as well, meaning raises for women were on a healthy trajectory. Despite these positive developments, younger physicians less often felt fairly compensated than they did 1 year earlier.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Physician compensation is still on the rise. Five years ago, our 2018 report showed overall physician compensation at $299,000 compared with $352,000 in this year's report.
"We expect physician income to continue increasing, as everyone talks about a physician shortage, which the pandemic has exacerbated," says Mike Belkin, JD, divisional vice president at Merritt Hawkins, a physician recruitment firm. "We see more physicians burned out, retiring, reducing their hours, or looking for shift work or virtual care, which further reduces the physician workforce."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
2022 was a good year for the pocketbook of physicians younger than 40 years. Their average total compensation jumped about 11%. The bump was even greater, around 20%, for those who were primary care physicians and nearly 10% for specialists.
Each of those growth rates substantially bested the comparable percentages for physicians generally, meaning that doctors older than 40 years got leaner pay hikes on average.
Demand drives pay, and Merritt Hawkins's 2022 physician salary study found that the firm's most highly paid recruitment searches were for orthopedic surgeons, cardiologists (interventional), and urologists.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In the population of US physicians younger than 40 years, women continued to hold down around half of doctor jobs. In comparison, the ranks of their older colleagues were less diverse, which speaks to the profession's evolution over the past couple of decades.
Overall, women held around 37% of physicians' jobs and about 47% of resident and fellow slots in the United States in 2021, according to the Association of American Medical Colleges.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
The pay advantage was around 26% in favor of male physicians younger than 40 years. In last year's report, it was about 37%.
"Due to efforts by many, some institutions and healthcare organizations have reviewed their salary lines and recognized the discrepancies, not only between the sexes but also between those new hires, which can be offered significantly more than those more senior physicians who have been working there for years and hired under a different pay structure," says Theresa Rohr-Kirchgraber, MD, president of the American Medical Women Association and professor of medicine at AU/UGA Medical Partnership, Athens, Georgia.
"Bringing transparency to salary lines helps to improve the pay disparity."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
If you are a doctor younger than 40 years and practicing on the West Coast, on average, you enjoyed an earnings advantage over your peers in New England among other areas of the country.
"In general, the West does pay a little higher than the Northeast," Belkin notes.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Despite their healthy rise in average compensation, around 1 in 6 young physicians said that their income dipped in 2022 (vs 13% in 2021).
As you might expect with COVID no longer considered a public health emergency in the United States, a smaller share of doctors younger than 40 years whose pay declined blamed the pandemic. In last year's report, 66% of younger physicians pointed to COVID-related factors.
"My compensation was reduced to supplement other physicians," an Iowa surgeon said.
"2022 was better than 2020 or 2021, when my salary was half my usual," one Alabama pediatrician added. "We cut physician salaries to avoid laying off staff."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In last year's report, 87% of young physicians said that they were employed by a healthcare organization, hospital, large group practice, clinic, or other medical group. Sixty-nine percent of doctors older than 40 years reported the same.
"The two reasons that most physicians decide not to go into private practice are to avoid having to be a small business owner and to have a predictable income," says Tommy Bohannon, VP of strategy for AMN Healthcare's physician & leadership solutions division based in Dallas.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
For our third straight report, physicians younger than 40 years told us that they earned the most in a private-office, single-specialty group setting. In last year's report, next came office-based, multispecialty group practices.
But average percentage increases in compensation at healthcare organizations and hospitals for younger doctors were nearly double those at multispecialty group practices in 2022. So the order changed for this year's report.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Despite handsome compensation bumps on average, the share of young physicians who answered this question yes compared with 54% in last year's report. Fifty-two percent of doctors overall told us in the latest survey that they felt fairly compensated.
"Often, physicians with a high salary are part of a large organization, so there's probably some heartburn because they know what reimbursements are, but the organization takes a large part," Belkin says.
"I feel I'm fairly paid vs national norms," a Massachusetts critical care doctor shared. "What is unfair is that Centers for Medicare & Medicaid Services continues to ratchet down the relative value unit conversion factor in the face of [high] inflation."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
If young doctors qualified for a potential incentive bonus at work, the award rose by around 31% from the previous year.
"We're not seeing many employers go to a flat fixed salary," Belkin says. "There can be different types of incentive plans, but we still see the incentive bonus as a pretty important piece to physicians."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Male doctors younger than 40 years more frequently said that they hoped for a promotion or to move up the ranks in their current practice setting than did their female counterparts. Among older physicians, female doctors slightly more often voiced that ambition.
"I lost a job due to outsourcing to a national staffing company, but I found a new job immediately with a private group that has me on a partnership track," shared an Illinois anesthesiologist.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In last year's report, 72% of young physicians said that they had experienced none of the potential cutbacks at work that we suggested, but 14% said that they missed out on a raise.
"I had a reduction in hours due to contract budget restraints," one emergency room physician lamented.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Mortgage debt was a responsibility for young doctors slightly more often than in our last report, wherein 62% of them said that they were paying off a loan on their primary home. Debt for college or postgraduate education, cars, and credit cards continued to demand younger physicians' dollars at about the same frequencies as a year earlier.
"Don't buy a home you can't afford. If you cannot afford a 15-year mortgage, then you cannot afford the home. Pay off debt rapidly!" a Washington State ob/gyn in his 60s counseled.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
We asked doctors younger than 40 years about college and medical school loans. Interestingly, it may be differences in undergraduate costs that drive the gaps shown in this chart. One study found that not only did the amount of medical school debt not drive choice of specialty, but also that the average debt burden did not vary significantly among the specialties.
Among young doctors, family physicians were likelier still paying off college and/or med school loans than were internists.
"My net worth is low because my student loan balance is still huge. I am in my early 40s and unable to buy a home because of this," warned a Hawaii neurologist.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Consistently in recent years, we found that nearly 7 in 10 doctors younger than 40 years felt that they didn't need to take action to bring down big-ticket expenses.
Young physicians slightly less frequently deferred or refinanced mortgage, student, or other loans than in last year's report (19%), possibly because interest rates continue to climb.
"I had to sell a house at a loss to cut expenses," a North Carolina physician told us. "I drive used cars" to keep expenses in check, an Illinois family physician added.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Three in 4 doctors younger than 40 years spent an average of between 1 and 40 hours per week last year seeing patients. About the same was true for physicians aged 40 years or older, meaning time demands with patients did not materially shift as doctors advanced through their careers.
One study that crossed various specialties found that physicians of all ages spent about 67% of their work time on direct patient care (either with or without use of an EHR).
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
When we surveyed doctors younger than 40 years, 56% of them said that, on average, they take 16 minutes or less with each patient vs 62% in last year's report. As for older physicians, 51% of them took 16 minutes or less per patient.
However, the share of young physicians spending at least 25 minutes with each patient rose a bit from 9% in our prior report.
"I have too much additional paperwork to complete, so I'm taking less time with patients," a New Hampshire psychiatrist lamented.
But a Texas physiatrist noted: "I spend time with patients. Luckily, we can now bill for time. It's the only thing that allows me to stay in business."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
A doctor's workweek extends far beyond face time with patients. A chunk of time is also needed for paperwork and EHR documentation, administrative and managerial tasks, clinical reading and research, and attending professional organization meetings and conferences.
Young doctors devoted 1-9 hours weekly to administrative work somewhat more often than did physicians aged 40 years or older. But the latter group needed 15-19 hours per week for paperwork and managerial tasks slightly more frequently than did young physicians.
The picture that emerges is of administrative duties expanding later into your medical career, but not in a major way on average.
One study found that physicians of all ages and specialties on average spent about 21% of their workweek on EHR input, around 8% on administrative tasks, and 5% on other nonpatient activities.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
The profile of a young doctor's priorities that emerges from this question is consistent. For example, the ranking of job features and percentages were nearly identical to last year's report; in our report 5 years ago, patient relationships topped the list at 26%.
"Teaching is quite important but being good at what I do is very high on my list," a California internist said.
"I enjoy finding diagnoses that others have missed," a Maryland infectious disease physician added.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In recent years, doctors younger than 40 years in our survey have regularly pointed to difficult patients, long hours at work, and the rules and regulations placed on physicians as their leading job challenges.
In comparison, rules and regulations were the biggest issue for physicians aged 40 years or older, followed by the long hours.
"Patients are being much more rude to me and our staff than ever before," a New York pediatrician shared.
"Difficult patients are a huge cause of my long hours," an ob/gyn in Maryland told us.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Coming out of the pandemic, the frequency with which young doctors answered yes to this question fell to 68% in last year's report from 76% 1 year earlier. So feelings of pessimism may have leveled off.
Physicians aged 40 years or older were somewhat more positive: 74% of them told us that they would choose medicine again if they had a do-over.
Still, we heard this from a general surgeon in Ohio: "From my current perspective, I would NEVER choose medicine again."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
As in last year's report, doctors younger than 40 years who work in general surgery and orthopedics continued to voice support for their specialty choice by answering yes to a medicine-choice do-over with high frequencies.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Among physicians of all ages and in 10 specialties, 90% or more of doctors told us that they would choose the same specialty again. The likelihood of physicians saying that declined in some lower-earning specialties.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Of note, a greater share (55%) of doctors aged 40 years or older told us that their motivation hasn't waned from when they started their medical career, even though they've worked longer than have their younger counterparts. Twenty-eight percent of those more experienced physicians said that their motivation was somewhat lower than it was when they started in medicine.
Sixteen percent of doctors aged 40 years or older reported that their motivation had greatly decreased, and 1% said that it was never high to begin with.
"What is the motivation to keep working when Medicaid has cut reimbursement below surrounding states and Medicare has never paid adequately," an Arkansas psychiatrist shared with us.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Thirty-seven percent of doctors younger than 40 years opted to work outside of their regular jobs. In last year's report, it was 34%.
Their counterparts aged 40 years or older took on other medical-related work somewhat more often and medical moonlighting somewhat less frequently (21% and 10%, respectively).
"I need to moonlight just to say I'm in private practice," remarked a New Jersey ob/gyn, and a Texas family physician told us that he moonlights in an emergency department for 36-48 hours per month.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
By an even wider margin than in last year's report (38% and 18%, respectively), young doctors used a fee-for-service system rather than a value-based payment model as their primary means of receiving payment.
Across the medical marketplace, there's been a steady although slow decline in fee-for-service, which has been a stated goal for a long time. According to the APM Measurement Effort, most recently, about 60% of healthcare payments from insurers were tied to value and quality, whereas around 41% of payments came from fee-for-service models.
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
In comparison, doctors aged 40 years or older were slightly less inclined (54%) to keep treating these patients under a payment plan and a bit likelier (13%) to drop the patient after several attempts at payment.
Some physicians' comments:
"I continue to treat them. My hospital employer handles the billing."
"We send bills to collection agencies but continue to treat the patient."
"Our practice requires payment in advance or a credit card on file which we bill, so we don't have a large problem with nonpayment."
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
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Medscape Young Physician Compensation Report 2023: Do Rising Salaries Boost Job Satisfaction?
Jon McKenna | September 26, 2023 | Contributor Information
Medical residents weigh in on their compensation and its fairness, work benefits, school debt load, work weeks, and other aspects of their training lives.Medscape Features Slideshows, Sep 2023
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Jon McKenna
Senior Editor, Reports, Medscape Business of Medicine
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