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Editor's Notes
- • Survey fielded to 455,000 U.S. physicians • Total respondents*: 15,794 U.S. physicians across 22 specialty areas • Fieldwork conducted by Medscape from 2/2/11 to 3/30/11 • Data collected via third-party online survey collection site * Respondents were entered into a sweepstakes to win a $50 American Express gift card - issued to 100 physicians. Demographic/attitudinal weighting not applied to tabulation
- Unless they're specialists, pediatricians, with a median salary of $148,000, earn less than most other specialties. However, pediatric surgeonsreport compensation in excess of $500,000 annually. "Our healthcare system has long valued fixing over preventing," says Amy L. Baxter, MD, Clinical Associate Professor, Medical College of Georgia, Augusta. "Since adults have more problems to fix, it makes sense that the reimbursement for primary care is greater than that of pediatrics, and that both are lower than other specialties dealing with illness rather than health. One factor contributing to these findings is the dramatic increase in required vaccinations over the past decade. Fewer children are dying, but the pediatrician is expected to administer these vaccinations at cost or at a loss." For employed pediatricians, compensation covers salary, bonus, and profit-sharing contributions. For partners, compensation includes earnings after tax-deductible business expenses but before income tax. Compensation excludes non-patient-related activities (eg, expert witness services, speaking engagements, and product sales).
- For more than one quarter (28%) of respondents, 2010 was a more profitable year than 2009. The opposite was true for 22%, whereas the remaining 50% reported little or no change in compensation over one year. Like most physicians, pediatricians earn more as they gain experience. According to career and recruitment experts, pediatricians generally realize their biggest salary increase after about 5 years of practice. Income tends to increase, albeit more gradually, in the ensuing years, and then decrease when the doctors reduce their work hours as they move toward retirement
- Although increasing numbers of women are entering the medical profession, salary continues to vary by gender, with men out-earning women, in part because more women physicians opt to work fewer hours in order to balance family commitments. Among pediatricians, men reported a median compensation of $170,000 as compared with $135,000 median earnings for women
- Pediatricians in more sparsely populated areas -- particularly those in the North Central states (Iowa, Missouri, Kansas, Nebraska, South Dakota, and North Dakota) -- earn higher salaries than pediatricians in locales where competition is keener. "The regional factors are pure supply and demand vis-à-vis location of medical schools," says Amy L. Baxter, MD. "There are many physicians trained in the northeast who want to stay there, hence a relative oversupply. There are fewer training centers in the North Central and Great Lakes areas, hence an undersupply and higher compensation needed to lure practitioners from other areas." Median compensation for pediatricians living in the North Central region was $158,500, about $10,000 greater than the overall median
- The further away from large cities they are, the greater the overall earnings for pediatricians. Respondents who work in rural areas and towns with populations less than 25,000 reported median earnings of $160,000. In contrast, median earnings were $140,000 for pediatricians in major metropolitan areas and $143,500 for pediatricians in midsized cities
- Pediatricians who are partners in private practice and members of multispecialty group practices commonly earn higher incomes than their counterparts. Independent contractors, who had a median salary of $112,000, were among the lowest earners
- Employed pediatricians are more likely than those in private practice to believe that they are being shortchanged financially. Among pediatricians overall, only slightly more than one half (52%) feel that they are compensated fairly. "It's clear that pediatricians don't choose their specialty for the money," says Alan Greene, MD, Clinical Professor, Department of Pediatrics, Stanford University School of Medicine, California. "There's a mismatch between the 11 years of post-high-school training for pediatricians, their responsibility for the life and health of our children, and common pediatric salaries."
- Owing to the need for several examination rooms and enough staff to oversee the details of their typically busy workplaces, almost three quarters of respondents in private practice indicated that they did not reduce office operating expenses in 2010. Of those who did reduce expenses, most did so by less than 10%
- Pediatrics is a high-traffic business, and only about 20% of respondents reported that they spend fewer than 30 hours per week seeing patients. Twice that amount are involved in direct patient care for 30 to 40 hours per week, whereas about 3% of respondents work more than 65 hours per week seeing patients
- Employed pediatricians (24%) are more likely than those in private practice (14%) to spend fewer than 30 hours per week seeing patients. The numbers for the two groups don't vary dramatically, however, when it comes to seeing patients for more than 30 hours weekly. These numbers suggest that pediatricians, on average, see 25-35 patients per day. "Those numbers seem reasonable given that outpatient medicine at present is formulated for volume," says William T. Basco, Jr., MD, MS, Associate Professor, Department of Pediatrics, Medical University of South Carolina, Charleston. "Healthcare reform, if it is successful in implementing aspects of the patient-centered medical home, should result in a reduction of actual office visits to physicians, as they are paid to manage patients without necessarily having as many face-to-face encounters."
- Seeing 76-124 patients per week is typical for pediatricians: Some 44 % do it. Almost 10% see more than 150 patients per week
- About a third of patient visits last from 13 to 16 minutes, and a little over a quarter last from 9 to 12 minutes. Visits less than 9 minutes in duration are atypical, and about 15% of respondents noted that they spend 21 minutes or more with each patient
- Paperwork, participation in professional organizations, clinical reading, supervisory work, administrative/managerial work, and other activities keep pediatricians busy long after the last patient has left the office. Most tackle these tasks in 14 hours or less, but about 23% of respondents devote more than 15 hours a week to office or professional work other than patient care
- Almost three quarters of pediatricians said that if they could go back in time, they would again opt for a career in medicine. A majority -- just over 60% -- would still specialize in pediatrics. However, only 52% would choose the same practice setting. The numbers were similar to those for physicians overall: 70% would choose a medical career again, 60% would select the same specialty, and 50% would choose the same practice setting
- Business, teaching, and law were the top alternative career options for pediatricians, followed by dermatology, education, and finance. Other options included pilot, writer, lawyer, dancer, wedding planner, organic farmer, and artist. One respondent notes, "I think health education (of patients, families, or trainees), or perhaps health journalism, would be satisfying with less liability, exhaustion, and stress."
- As increasing numbers of women join the medical profession, many of them are drawn to pediatrics. According to the American Academy of Pediatrics, although 71% of all physicians practicing in 2008 were male, 55% of pediatricians were women. In line with these statistics, 53% of the pediatricians who responded to Medscape's survey are female. About 20% of respondents are over 60
- Just over 10% of respondents are solo practitioners, and an equal number are part of a 2-physician practice. The largest proportion (22.5%) works in single-specialty group practices, and overall, MDs far outnumber DOs (95% vs 5%). In terms of location, 64% of respondents live in a major metropolitan area or a suburban community. Only 18% live in small cities or rural areas
- The survey's collection timeline spanned from February 2, 2011, through February 17, 2011. Demographic/attitudinal weighting was not applied to tabulation as the survey was sent to physicians with a similar demographic profile. In some cases, small sample size may skew data results. However, the overall number of responses by specialty mirror AMA breakdown. Note that compensation data is represented by the median reported figures