Physician compensation increased significantly in early 2022 compared with the last two years of the pandemic, according to Medscape's Physician Compensation Report 2022.

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Report details

For the report, Medscape surveyed 13,064 physicians across more than 29 specialties from Oct. 5, 2021, to Jan. 19, 2022. All data was weighted based on age, gender, specialty, and more, based on the distribution of physicians in the American Medical Association database.

In the survey, physicians reported the total compensation they received for providing care. For employed physicians, the figure included their salary, bonus, and income from profit-sharing arrangements, while self-employed physicians reported their earnings before factoring in income taxes but after factoring in business taxes and deductibles. Only full-time salaries were included in the report.

Overall compensation increases

Overall, the report found that physician compensation increased significantly in early 2022 when compared with 2021 and 2020. On average, primary care physicians earned $260,000 in early 2022, compared with $242,000 in 2021 and $243,000 in 2020. Meanwhile, specialists earned an average of $368,000 compared with $344,000 in 2021 and $346,000 in 2020.

"Compensation for most physicians is trending back up as demand for physicians accelerates," said James Taylor, chief operating officer of AMN Healthcare's Leadership Solutions Division. "At the height of the pandemic in 2020, Merritt Hawkins saw a 30% decrease in client physician recruiting engagements year-over-year. But in the fourth quarter of 2021, physician recruitment engagements hit an all-time high. The market for physicians has done a complete 180 over just seven or eight months."

Since 2015, compensation for primary care physician has increased 33%, while compensation for specialists has increased 30%, according to Medscape.

Highest and lowest compensation by specialty

The highest-paying specialty in early 2022 is plastic surgery, with an average annual compensation of $576,000, a 10% increase from the year before. Meanwhile, public health and preventive medicine was the lowest-paying specialty, with an average annual compensation of $243,000, a 3% decrease from the year before.

Among the different specialties, public health and preventive medicine physicians were most likely to report feeling fairly compensated in early 2022. However, fewer than half of OB/GYN, internal medicine, physical medicine and rehabilitation, pediatric, diabetes and endocrinology, and nephrology physicians said they felt fairly compensated for their work.

According to Taylor, it is not only the dollar amount that can contribute to physician satisfaction with their compensation, but also how that compensation is determined. "These can include production bonuses that can penalize physicians for seeing relatively sick patients, or formulas that track quality measures physicians don't believe are relevant or meaningful," he said.

Medscape also identified the top 10 states for physician compensation:

1. Kentucky ($364,000)
2. Tennessee ($364,000)
3. Alabama ($358,000)
4. Missouri ($357,000)
5. Oregon ($352,000)
6. Indiana ($350,000)
7. North Carolina ($348,000)
8. Connecticut ($346,000)
9. Texas ($346,000)
10. Florida ($346,000)

The gender compensation gap persists

According to Medscape, the gender compensation has remained constant even as overall salaries have risen over the past decade. In early 2022, male primary care physicians earned 25% more than female primary care physicians. Among specialists, the gender pay gap has declined slightly over the years from 37% in 2017 to 31% in early 2022.

Ron Holder, COO of the Medical Group Management Association, said the slight decline in the pay gap between male and female specialists may be due to efforts by specialty organizations to address pay inequities.

"A great many of the specialty organizations have efforts underway not just to increase the number of women in specialties but also to address gender pay gaps and bias in evaluations during residency and fellowship," Holder said. "Also, as more women have been able to break down barriers into specialties where they have not been as present before, aspiring female medical students, residents, and fellows now have opportunities for more female mentors in the field of interest. The benefit of that in recruiting women to the specialty can't be overstated."

How the pandemic is affecting physicians

Despite physician compensation rising overall this year, 21% of physicians reported seeing their incomes decline. Among physicians whose income declined, 70% blamed factors related to the Covid-19 pandemic, such as job loss, a reduction in hours, or a reduction in patient volume—down from 92% who said the same last year.

According to Medscape, the pandemic's harshest impacts on physicians seem to have receded this year. Compared with 22% of physicians who reported a reduction in their hours last year, only 10% said they saw reduced hours this year. In addition, only 36% said Covid-19 negatively impacted their job compared with 55% last year.

When asked about the most challenging aspects of their jobs, just 3% cited the dangers or risks associated with treating Covid-19 patients. Instead, a plurality named rules and regulations as the biggest challenge, followed by dealing with difficult patients and having to work long hours. (Gooch, Becker's Hospital Review, 4/15; Kane, Medscape, 4/15)