With an average annual income of $197,000, psychiatrists rank 6th from the bottom in earnings compared with other specialists, but they are rich in optimism, according to Medscape Psychiatrist Compensation Report 2014.
As in other years, orthopedists are the earning leaders, followed by cardiologists. Urologists and gastroenterologists are tied for third place. The lowest earners are HIV/ID physicians, with primary care physicians and endocrinologists also in the bottom five.
Psychiatrists reported an increase in income of about 6.1% over last year’s income.
With an average income of $209,000, male psychiatrists make considerably more than their female counterparts, who make $178,000, so it is probably not surprising that women feel less satisfied with their income than men (53% vs 62% for men and women, respectively).
Psychiatrists, regardless of sex, are slightly happier with their income compared with all physicians who responded, for which satisfaction rates were 50/50.
The highest earning psychiatrists live in the West ($218,000) and North Central regions ($205,000). The lowest earners among psychiatrists are in the Great Lakes, Northeast, and Southeast ($192,000 for all 3 regions).
The survey results revealed that employed and self-employed psychiatrists made nearly the same amount of money ($196,000 and $194,000, respectively).
The highest earning psychiatrists are those in office-based single-specialty groups ($219,000), following closely by those in healthcare organizations ($217,000).
Psychiatrists who work for office-based solo and multispecialty group practices are the lowest earners (both at $184,000). In any case, physicians in general are increasingly leaving private practice for salaried positions.
The most satisfied physicians were dermatologists (65%), followed by psychiatrists (58%). The least satisfied were plastic surgeons (45%), followed by neurologists and internists (47%).
Nineteen percent of psychiatrists are already in accountable care organizations (ACOs), and 5% plan on joining one this year.
In this year’s Medscape report, 29% of self-employed and 5% of employed psychiatrists report that they are likely to stop taking new Medicare or Medicaid patients, with more employed psychiatrists (59%) than self-employed psychiatrists (25%) likely to continue seeing new and current ones. About a third of each (36% of self-employed and 33% of employed) are still undecided.
Twenty-six percent of psychiatrists report that they will drop insurers who pay poorly, and 25% report they will not, with 10% reporting they need all of their payers.
Three quarters of psychiatrists reported regularly or occasionally discussing the cost of treatment with patients. The remainder either do not discuss the issue or do not see patients.
Sixty-eight percent of psychiatrists report that they spend 40 or fewer hours per week seeing patients, with 31% spending more time. Sixty-one percent of psychiatrists report seeing between 25 and 75 patients per week, and 19% between 76 and 124, with 5% of psychiatrists seeing more than 125 patients per week.
The survey results also showed that 28% of self-employed and 36% of employed psychiatrists spend at least 10 hours per week on paperwork and administrative tasks.
This is very similar to the hours reported by all physicians who responded to this survey, in which 26% of the self-employed and 35% of employed physicians spend at least 10 hours per week on paperwork.
Despite the frustrations, most physicians find their careers deeply rewarding. Psychiatrists report the most rewarding parts of their jobs were relationships with patients (29%), being good at what they do (31%), making the world a better place (16%), making good money (11%), and being proud to be a doctor (6%). Two percent found nothing rewarding, and a small percentage mentioned other rewards.
More than half (51%) of psychiatrists were still not sure whether they would participate in health insurance exchanges, which is the same percentage as that reported by all physicians. Only 17% were certain that they would participate in the exchanges, and 32% were sure that they would not.
When it comes to anticipating decline in income, psychiatrists are the most optimistic. Only 27% expect a decrease in earnings under health insurance exchanges, compared with 43% of all physicians, and 66% do not foresee change in their income.
The full Medscape Psychiatrist Compensation Report 2014 can be viewed online.