ACOs, income on the rise, but enthusiasm for medicine waning among MDs

Physician earnings are up, but fewer and fewer said they would go into medicine if they could do it all over again, according to the Physician Compensation Report 2013 from Medscape.

Findings were based on a February survey featuring 21,878 U.S. physicians from 25 specialties.

About one-third of the specialties surveyed each earned a mean of $300,000 annually according to Medscape. The top three specialties in terms of income were orthopedics, cardiology and radiology, which were the usual suspects from last year’s survey, though radiology and orthopedics were previously tied for top overall earners. HIV/infectious disease physicians fell to the lowest spot, replacing the previous lowest-earner pediatrics.

Generally, specialties reported modest to significant income increases, though endocrinologists and oncologists reported a slight decline.

Gaps in income exist based on location and sex, according to the survey results. Physicians in the North Central region of the U.S.—which includes North and South Dakota, Iowa, Nebraska, Missouri and Kansas—earned the most, while those in the Northeast Region earned the least. Men earned 30 percent more than women overall.

Accountable care organizations (ACOs) are making an impact, according to Medscape. A total of 24 percent of respondents to the current survey were either in an ACO or planned to be in one in the coming year, compared with just 8 percent of respondents from the 2012 survey.

Just over half of physicians would choose to become doctors again, down from 54 percent in 2012 and 69 percent in 2011, according to the survey results. Only 42 percent would choose the same specialty, led by dermatology, with 74 percent of that specialty opting to renew in a hypothetical do-over. More than half of radiologists would choose the specialty if they went into medicine again, but just one-third said they would choose medicine as a career.

Overall satisfaction was led by dermatology at 59 percent, followed by HIV/infectious disease and oncology. Plastic surgery, internal medicine and diabetes/endocrinology were the least satisfying specialties at 41, 44 and 45 percent, respectively, according to Medscape.