Before America's new coronavirus epidemic emerged, average physician pay had risen for both primary care physicians and specialists in 2020, according to Medscape's Physician Compensation Report 2020—but Medscape predicts average salaries for physicians are likely to decrease as a result of the epidemic.

Report details

For the report, Medscape surveyed 17,461 physicians across more than 30 specialties from Oct. 4, 2019, to Feb. 10, 2020. Medscape then weighted physicians' responses based on the American Medical Association's physician distribution by gender, specialty, and state.

For the report, physicians provided the total amount of compensation they received for providing care. For example, employed clinicians reported their salary, bonus, and income from profit-sharing arrangements, while physician partners and those with solo practices reported their earnings before factoring in income taxes but after factoring in business taxes and deductibles.

Overall increase in compensation

Medscape found that, on average, overall physician compensation rose in 2020, with primary care physicians earning an average of $243,000 this year, compared with an average of $237,000 last year, and specialists earning an average of $346,000 this year, compared with an average of $341,000 last year.

Medscape also found that more than have of physician respondents receive an incentive bonus and the average incentive bonus is 13% of total salary, meaning bonuses vary by specialty.

Highest, lowest compensation by specialty

According to Medscape, the highest-paying specialty in 2020 is orthopedics, with an average compensation of $511,000, while public health and preventive medicine and pediatrics are tied for the lowest-paying specialty, with an average compensation of $232,000.

Medscape also found that the top 10 states for physician compensation in 2020 are:

1. Kentucky ($346,000);
2. Tennessee ($338,000);
3. Florida ($333,000);
4. Alabama ($332,000);
5. Utah ($328,000);
6. Ohio ($326,000);
7. Oklahoma ($326,000);
8. Indiana ($326,000);
9. North Carolina ($325,000); and
10. Georgia ($323,000).

Gender compensation gap persists

According to Medscape, the gender compensation gap persisted in 2020, with male primary care physicians earning about 25% more than women on average—which is roughly the same percentage gap seen in 2019. However, among specialists, the gender compensation gap decreased, with male specialists earning 31% more than women on average, down from a 33% gap last year.

How the new coronavirus epidemic could impact physician compensation

According to Medscape, many experts say America's new coronavirus epidemic likely will have a significant impact on physician compensation going forward—and some providers already have reported decreased revenue and patient volumes. The survey found that physician practices reported a 55% drop in average revenue and a 60% decline in average patient volume since the Covid-19 epidemic began. Medscape notes that many hospitals and physician groups throughout the country "have implemented layoffs, furloughs, and pay cuts."

Travis Singleton, SVP of Merritt Hawkins, told Medscape he's especially worried about the financial outlook for private physician practices. "They don't have a financial cushion, and will start seeing big drops in revenue at the end of May," he said.

As for employed physicians, Singleton said their experiences "are very mixed." He explained, "Some health systems have reduced physicians' pay by 20%, but other systems have been putting off any reductions."

However, care volumes may start slowly returning to normal soon, according to David Gans, senior fellow at the Medical Group Management Association. "From mid-March to mid-April, hospitals and practices were in panic mode," he told Medscape. "They were focusing on the here and now. But from mid-April to mid-May, they could begin looking at the big picture and decide how they will get back into business."

Either way, it's impossible to predict the epidemic's effects, because it impossible to know how the epidemic will change over the next few months, Gary LeRoy, president of the American Academy of Family Physicians, said. "What will the future be like? I don't know the answer. The information we learn in next hours, days, or months will probably change everything" (Kane, Medscape, 5/14; Page, Medscape, 5/13).