Physicians experienced extreme income volatility in 2020 due to the COVID-19 pandemic, with some doctors indicating there were months where they had no income at all.
Despite the challenges in 2020, physicians' salaries have rebounded, along with hours working and with only a slight dip in patient volume, according to the "Medscape Physician Compensation Report 2021."
Based on responses from more than 18,000 U.S. physicians across 29 specialties, the survey—conducted Oct. 6, 2020, to Feb. 11, 2021—found that average salaries for primary care physicians held steady at $242,000 from $243,000 the previous year. Similarly, specialists’ average salaries dropped $2,000 to $344,000.
The report only includes physicians' full-time salaries, excluding bonuses and profit-sharing for employed physicians. For self-employed physicians, the salaries report includes earnings after taxes and deductible business expenses, before income tax.
According to a Medscape report, about 44% of physicians reported reductions in patient volume and nearly 1 in 4 saw a decrease in hours.
So what fueled the rebound? A combination of pivoting to telehealth, leveraging government recovery programs and post-lockdown demand for services blunted the impact of the pandemic, according to the salary survey.
Physicians turned to a number of tactics to survive the financial volatility in 2020, such as leveraging government pandemic relief programs, reducing staff to minimize the impact of office closures and restrictions on elective procedures, as well as tapping into reimbursement for telemedicine visits. Capitation plans which continued to pay physicians also helped.
About 45% of doctors said they experienced no loss of income, but 13% reported there were months when they had no income at all.
Nearly one in four doctors reduced their hours during the pandemic, but 58% of primary care physicians and 65% of specialists said income and average hours worked per week are now at pre-pandemic levels, according to the survey..
"Physicians experienced a challenging year on numerous fronts, including weathering the volatile financial impact of lockdowns,” said Leslie Kane, senior director, of Medscape Business of Medicine in a statement. “Our report shows that many were able to pivot to use telemedicine and focus on tactics that would protect their practices. COVID took a terrible emotional toll on physicians and healthcare workers, and many are still struggling financially, but our findings showed that physicians will innovate and change quickly to meet the needs of patients through extremely difficult times."
Who's up, who's down?
While many physicians' salaries held steady in 2020, the pandemic has a surprising impact on some specialists' income.
Plastic surgeons topped the list in earnings this past year ($526,000), experiencing a 10% spike over the previous year, likely driven by what many in the field call the "Zoom boom."
The American Academy of Facial Plastic and Reconstructive Surgery reported that demand for facial plastic surgery skyrocketed in 2020. Seventy percent of AAFPRS surgeons reported an increase in bookings and treatments over the course of the COVID-19 pandemic, with 9 in 10 facial plastic surgeons indicating an increase of more than 10%.
The association refers to the uptick as the "selfie-awareness trend" as more people worked or attended school remotely from home and spent time viewing their faces on-screen in virtual meetings.
The five top-earning specialties are the same as 2019, with the exception of urology, which moved up.
Orthopedists and cardiologists followed as top earners, with compensation at $511,000 and $459,000 respectively.
Following plastic surgeons, oncologists saw the biggest salary increase last year, with compensation rising 7% from $377,000 to $403,000. Cardiologists' salaries increased 5% from $438,000 to $459,000, and rheumatologists also saw a 5% increase in compensation from $262,000 to $276,000.
Otolaryngologists and allergy and immunologists took the biggest hit in salary decreases, with annual pay dropping 9%. Pediatricians and anesthesiologists also saw their compensation drop by 5% last year. Dermatologists reported a 4% drop in salary.
The lowest-earning physicians were those in public health and preventive medicine ($237,000), family medicine ($236,000) and pediatrics ($221,000).
Emergency medicine doctors actually saw their compensation drop by 1% last year from $357,000 to $354,000.