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Internists least likely to choose their specialty again, survey shows


Internists spent an average of 18.5 hours per week on paperwork, according to the Medscape Internist Compensation Report 2020. That number was surpassed only by intensivists, who spent 19.1 hours on such tasks.

Again this year, internists’ income ranked near the bottom of the more than 30 specialties in the survey, with average pay of $251,000. Although that number was up $8,000 from last year, it was still less than half that of the top-earning specialists.

The top four specialties in terms of pay were the same this year as they were last year and ranked in the same order: orthopedists made the most, at $511,000, followed by plastic surgeons ($479,000), otolaryngologists ($455,000), and cardiologists ($438,000).

However, internists ranked in the middle of all physicians as to feeling fairly compensated. Just more than half (52%) reported they were fairly compensated, compared with 67% of oncologists, emergency medicine physicians, and radiologists, who were at the top of the ranking, and 44% of nephrologists, who were on the low end.

Also, just as last year, male internists earned 23% more than their female colleagues, which is a slightly smaller pay gap than the 31% gap seen overall.

COVID-19 reversing income gains

However, the compensation picture is changing for all physicians. This report reflects data gathered between Oct. 4, 2019, and Feb. 10, 2020. Since that time, the COVID-19 crisis has reversed income gains for physicians overall. A study from the Medical Group Management Association (MGMA) indicates that more than half of medical practices reported a drop in revenue by early April of 55% and a drop in patient volume of 60%.

The MGMA noted, “Practices are struggling to stay afloat – and many fear that this is only the beginning.”

Specialty choice may vary

In the Medscape survey, internists were the physicians least likely to say they would choose their specialty again. Only 66% said they would choose it again, compared with the most enthusiastic specialists: orthopedists (97%), oncologists (96%), and ophthalmologists and dermatologists (both at 95%).

However, three-fourths of internists (75%) said they would choose medicine again, which was a larger proportion than that reported by family physicians (74%), neurologists (73%), and plastic surgeons (72%).

This year’s Medscape survey is the first to ask about incentive bonuses. More than half of all physicians (56%) reported receiving one. Bonuses for internists ranked near the bottom, at an average of $27,000. Orthopedists averaged $96,000 bonuses, and family physicians received the least, at an average of $24,000.

Most internists (63%) said their bonus had no effect on the number of hours worked, which was similar to physicians in other specialties.

In good news, internists lost less money on claims that were denied or that required resubmission than most of their colleagues in other specialties. By comparison, internists reported losing 15% on such claims, and plastic surgeons lost almost twice that percentage (28%).

The survey authors noted, “One study found that, on average, 63% of denied claims are recoverable, but healthcare professionals spend about $118 per claim on appeals.”

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