In case you missed it earlier this year, over 24,000 physicians in 25 specialties (7% or 1,680 of whom were psychiatrists) responded to this year's Medscape Compensation Report and described their 2013 compensation, number of hours worked, practice changes resulting from healthcare reform, and adaptations to the new healthcare environment.
Here are some highlights:
In Medscape's 2014 Compensation Report, psychiatrists are sixth from the bottom among all physicians, with average earnings of $197,000. As in previous Medscape reports, orthopedists are the earning leaders, followed by cardiologists. Urologists and gastroenterologists are tied for third place. The lowest earners are physicians in HIV/ID, with primary care physicians and endocrinologists also in the bottom five. As in the past, those who perform procedures have the highest incomes compared with those who manage chronic illnesses. Earnings are for full-time work only. They include salary, bonus, and profit-sharing contributions. For partners, these are earnings after taxes and deductible business expenses but before income tax. They do not include non-patient-related earnings.
Nineteen percent of psychiatrists are already in Accountable Care Organizations (ACOs) and 5% plan on joining one this year. While fee-for-service and private practice are the most predominant forms of payment and practice, participation in ACOs is significantly higher than in the other alternative payment models, with concierge practice (also referred to as direct primary care) at 3% and cash-only at 15%, which is a higher percentage than all physicians (6%). ACOs are designed to deliver improved care for patients, and within these settings there are various payment models, including shared savings programs,advanced payment models (mostly for rural providers, and the Pioneer ACO Model, which is for organizations and providers with experience in coordinating patient care.
Despite the frustrations, most physicians find their careers deeply rewarding. When psychiatrists were asked what the most rewarding parts of their jobs were, somewhat unexpectedly, relationships with patients (29%) came in second after being good at what they do (31%). Sixteen percent chose "making the world a better place." Making good money (11%) and being proud to be a doctor (6%) were less compelling factors. A discouraged 2% found nothing rewarding. A small percentage mentioned other rewards