Cardiologists remain among the top earners in medicine, with annual pay of $423,000, up from $410,000 in 2017, according to this year’s Medscape Cardiologist Compensation Report 2018.
About two thirds of cardiologists (65%) feel they are fairly compensated, up from 50% last year. However, about one third of cardiologists feel that they should be earning more.
Still, 88% of cardiologists would choose medicine again and 94% would choose cardiology again.
Cardiologist pay is the third highest of all specialties. Plastic surgeons are the top earners ($501,000 annual pay), followed by orthopedists ($497,000), while pediatricians and public health and preventive medicine specialists continue to earn the least ($212,00 and $199,000, respectively), according to the overall Medscape Physician Compensation Report 2018, covering US physicians as a whole and including more than 20,000 physicians in over 29 specialties.
Cardiologist pay is up only slightly this year, at an increment of 3%. The biggest pay raises were seen among psychiatrists (+16%) and plastic surgeons (+14%) and physiatrists (+13%). Decreases in earnings were evident in only six specialties this year, with general surgery (–9%) and urology (–7%) hardest hit.
Foreign-trained cardiologists make more than US-trained cardiologists (average of $443,000 vs $416,000). Cardiologists who are employed earn less than their peers who are self-employed ($483,000 vs $403,000), presumably trading a higher salary for a steadier income and less time focusing on running a business.
About three quarters of US cardiologists are employed, with only about one quarter self-employed. This reflects a national trend toward physician employment, as hospitals and other entities have consolidated and absorbed private practices and younger physicians have sought a steadier income stream and more regular hours.
While about two fifths of cardiologists say they spend 30 to 45 hours each week seeing patients, half spend more than 45 hours. Thirty-five percent of cardiologists spend at least 13 minutes personally with each patient.
Bureaucratic tasks remain the primary driver of burnout among physicians, and nearly three quarters of cardiologists (74%) report that they spend 10 hours or more on paperwork and administration. Despite billing and other administrative challenges, most cardiologists say they will continue to take Medicare and Medicaid patients (82%).
What is most rewarding about being a cardiologist? Relationships with and gratitude from patients tops the list (37%), followed by being good at what they do (22%) and making the world a better place (18%). Very few cardiologists cited pride in their profession (6%) and teaching (4%).
The most challenging part of being a cardiologist is having so many rules and regulations (34%), following by having to work with an electronic health record system (18%), having to work long hours (17%), and trouble getting fair reimbursement (10%). Few named dealing with difficult patients (5%) or concern over being sued (5%).
Following are other key findings for cardiologists:
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Most are paid through an insurance carrier (70%), with just under half reimbursed on a fee-for-service basis (45%). More than one quarter (27%) are paid through accountable care organizations. A small percentage have adopted the direct primary care model (7%), which is gaining popularity compared with concierge and cash-only models.
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Cardiologists report high participation in the Merit-based Incentive Payment System (MIPS) relative to all physicians surveyed. More than half (56%) said they expect to participate in MIPS; 16% expect to participate in Alternative Payment Models (APMs).
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A minority of cardiologists said they would drop insurers who pay poorly (22%). About one quarter said they need all payers (24%).
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Increases in the number of physicians reporting that they participate in health insurance exchanges have stabilized since their introduction in 2014, and there is almost no change from last year’s survey in the percentage of participating cardiologists (36%). A fair number, however, remain unsure about whether they will participate (42%).
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