The Medscape 2012 Physician Lifestyle and Compensation Reports show a disconnect in rheumatologists’ feelings their professional and home lives. While expressing increasing dissatisfaction with pay and stating a higher likelihood from the last survey that they would not go into medicine if deciding today, rheumatologists still ranked as the happiest group of physicians in the survey.
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Dissatisfaction with Payment
Frustration among doctors grew between the 2011 and 2012 surveys. Both physicians in general, and rheumatologists in particular, expressed dissatisfaction with their pay. Among those in the subspecialty, 58% said they were not fairly compensated in the newest study, 9% greater than physicians overall. This was an increase from 2011, when 53% of rheumatologists thought they were being paid unfairly. Rheumatologists appear to be less happy with their pay than physicians in general are, because a majority (51%) of all doctors in the 2012 survey thought their remuneration was fair, roughly the same percentage as in the 2011 survey.
Rheumatologists were toward the middle of the pay spectrum, earning a mean compensation of $180,000 compared with $156,000 made by pediatricians and $315,000 for radiologists at the ends of the pay spectrum. There were also variations within the specialty-13% of rheumatologists made $300,000 or more while one in five had incomes of $100,000 or less. Single-specialty practices ranked highest in earnings, while doctors in hospitals or academics made the least.
“Few physicians in cognitive specialties would say they are well compensated,” says Abby Abelson, MD, chair of the department of rheumatologic and immunologic diseases at the Cleveland Clinic. “Our patients are frequently complex and they take a lot of time to treat. As we go through the transitions in healthcare, there should be greater recognition of our value in patient care.”
Career Decisions Might Have Changed
When asked what would happen if they had a “do over” on career decisions, 56% of rheumatologists said they would again choose a career in medicine. This is down from 75% who said they would stick with medicine in 2011. While this response is similar to that seen among all physicians (54% saying they would stay in medicine), there was only a 15-percentage-point year-to-year drop (from 69%) in the larger cohort.
Similar results were seen in decisions on a specialty/subspecialty. The percentage of those still choosing rheumatology was close to that seen among all physicians (42% and 41%, respectively). However, the drop from the 2011 survey was greater among rheumatologists at 24 percentage points (66% vs 42%) when compared with all physicians (decrease of 20 percentage points).
Dr. Abelson, who also chairs the ACR’s Committee on Training and Workforce Issues, thinks this may be related to the unknowns of healthcare’s future.
“I would be more concerned if this continues for five years or more,” she said. “For now, I think this more of a reflection of not knowing what the future holds than with the profession itself.”
Happier After Hours
Despite the apparent concerns in their professional lives, rheumatologists appear to be doing very well outside the office. The Lifestyle survey suggests those treating rheumatologic conditions are among the happiest physicians when the working day is done.
The survey asked physicians to rate their happiness in “civilian” life on a scale of 1 to 5-the higher the score the happier the doctor. Rheumatologists had an average score of 4.09, the highest among all specialties. As a group, physicians’ average score was “on the cheerful side” according to the authors, at 3.96. Three-quarters of the rheumatologists who responded rated themselves either “pretty” or “very happy” with their life after the office closed.
“I think there are a lot of wonderful things about being a rheumatologist,” said Dr. Abelson. “We have the unique privilege of partnering with patients in the care of complex diseases. We have the benefits of newer therapies allowing us to have an impact on patients in a positive way.”
Kurt Ullman is a freelance writer based in Indiana.