Despite the trials of the Covid-19 epidemic, physician compensation in 2020 and through early 2021 remained fairly steady compared to the start of 2020, according to Medscape's Physician Compensation Report 2021.

Report details

For the report, Medscape surveyed 17,903 physicians across more than 29 specialties from Oct. 6, 2020, to Feb. 11, 2021. 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. The report included only full-time salaries in its results.

Compensation remains steady

Overall, Medscape found that, despite the Covid-19 epidemic, overall compensation for physicians remained steady. On average, primary care physicians earned $242,000 in early 2021, compared with an average of $243,000 in early 2020. Meanwhile, specialists earned an average of $344,000 in 2021, compared with $346,000 in 2020.

According to Michael Belkin, divisional VP of Merritt Hawkins & Associates, "Many physicians used the Paycheck Protection Program to help keep them afloat; some were able to renegotiate their lease contracts; a large percentage reduced their staff, which reduced their expenses; and those in capitated plans were still getting paid even though they weren't seeing as many patients."

Ready-to-use slides for physician leaders

Belkin added that uptake in the use of telehealth—and its coverage by more insurers—also helped physicians during that time. Additionally, according to Medscape, more than half of both primary care providers (59%) and specialists (55%) have an incentive bonus.

Highest, lowest compensation by specialty

According to Medscape, the highest-paying specialty in early 2021 is plastic surgery, with an average annual compensation of $526,000, a 10% increase over the year prior. Meanwhile, pediatrics was the lowest-paying specialty, with an average annual compensation of $221,000, a 5% decrease compared with the year prior.

Oncologists were the most likely to report feeling fairly compensated in early 2021. However, fewer than half of infectious disease specialists said they felt fairly compensated, a decrease from 51% compared with the year prior.

Medscape also found that the top 10 states for physician compensation in 2021 are:

1. Alabama ($348,000);
2. Kentucky ($340,000);
3. Oklahoma ($338,000);
4. Indiana ($337,000);
5. Missouri ($332,000);
6. South Carolina ($332,000);
7. Florida ($331,000);
8. Georgia ($330,000);
9. Iowa ($330,000); and
10. Tennessee ($329,000).

Gender compensation gap persists

According to Medscape, the gender compensation gap persisted in the latest survey results, with male primary care physicians earning about 27% more than women on average, a difference similar to the 25% compensation gap in the year prior. Among specialists, the pay gap increased slightly, with male specialists earning about 33% more than women in 2021, compared with a 31% gap in 2020 and a 33% gap in 2019.

How Covid-19 impacted physicians

According to Medscape, nearly half of respondents (45%) said the pandemic did not have a negative effect on their finances or practice. However, among physicians who reported a decline in compensation, 92% cited Covid-related issues, such as the loss of a job, reduced hours, or fewer patients. And among respondents overall, 13% said they had multiple months without any income.

Fight burnout by integrating self-care into clinician workflow

More broadly, when asked about the most challenging part of their jobs, just 7% of respondents cited the danger or risk associated with treating Covid-19 patients. A plurality of respondents (23%) cited rules and regulations as their job's biggest challenge.

In addition, Medscape found that while physicians reported working roughly the same number of hours now as they did prior to Covid-19, they saw fewer patients per week on average (71) than they did before the pandemic (76). However, a plurality of respondents (46%) said they did not have a permanent reduction of volume, although about 44% of respondents said they experienced a permanent reduction of volume of between 1% and 25%, Medscape reports.

Halee Fischer-Wright, president and CEO of the Medical Group Management Association, said it's unclear whether those reductions in patient volumes are permanent. "We know that patient volumes have slowly but steadily increased, but we also know that a year out, they are still not back to normal," she said.

However, she added that, as doctors' offices begin to reopen, "we're seeing a massive increase in hiring as medical practices prepare for a steady increase in patient volumes. And we may soon see an increase in patient volumes because of deferred care during the past year" (Kane, Medscape, 4/16).