Radiologist Salaries Lag Inflation

A new study in JACR confirms what many radiologists have suspected: salary growth for private-practice radiologists has lagged inflation over the last 10 years. While there were a few bright spots, the study mostly shows that radiologists are working harder for less pay. 

Radiology has long been one of the better-compensated medical specialties, often landing in the top 10 of disciplines with the highest average annual compensation. 

  • But radiology has also been a target for reimbursement cuts by the U.S. government as it tries to shift more Medicare and Medicaid payments to primary care practitioners.

As a result, previous studies have found that payments per Medicare beneficiary in radiology have actually declined. 

  • And another 2.83% cut is on the docket for 2025 unless Congress steps in before the end of the current legislative session to prevent cuts in the 2025 Medicare Physician Fee Schedule.

The new study analyzes radiologist compensation based on MGMA salary survey data from 2014 to 2023. 

  • Researchers compared salaries for both diagnostic and interventional radiologists, and also between private-practice and academic radiologists. 

Based on the data, they found …

  • Diagnostic radiologists saw median total compensation grow over the survey period, but at a faster rate for academic radiologists (32% vs. 18%). 
  • Academic radiologists enjoyed faster annualized salary growth (3.2% vs. 1.9%) and had an edge after adjustment for inflation (+0.3% vs. -1%).
  • Work RVUs (a measure of productivity) also grew but at a slightly higher rate for academic radiologists (21% vs. 20%). 
  • Interventional radiologists saw higher salary growth for both non-academic and academic physicians (41% and 35%). 

The findings indicate that the traditional salary gap between private-practice and academic radiologists may be narrowing.

  • The growth in wRVUs in a time of stagnant or declining salaries after inflation adjustment may confirm the suspicions of both types of radiologists: that they are working harder for less pay. 

The Takeaway

The findings could be a gut punch for private-practice diagnostic radiologists, who are finding that their salary gains aren’t keeping pace with inflation (sound familiar?). They also suggest that academic radiology could offer a refuge from the market and government forces that are reshaping the private sector.

Radiologist Pay Rebounds

Radiologist pay grew 5.6% and radiology moved up one notch on Doximity’s list of highest-paid US medical specialties for 2023. Physician salaries generally rebounded last year after a decline in 2022.

The Doximity survey of 33k doctors found that overall physician pay grew 5.9% last year, a welcome rebound after a decline of 2.4% in 2022. 

  • In other good news, medicine’s gender pay gap narrowed in the new survey, with women making 23% less than men, down from 26% in 2022 and 28% in 2021.

For radiologists, their average annual compensation was $532k, up from $504k a year ago, and radiology jumped ahead of urology on the top 10 list to occupy the ninth spot. 

  • Still, radiology lagged a number of other specialties in terms of salary growth, ranging from hematology (+12.4%) to psychiatry (+7.2%). 

Other findings in the survey include …

  • Some 81% of physicians reported they are overworked, a number that’s actually down from 86% in 2022
  • 88% of respondents said their clinical practice has been affected by the physician shortage
  • 86% of those surveyed said they are concerned about the US healthcare system’s ability to care for its aging population

The Doximity results roughly track recently released salary data from Medscape, which pegged radiologist salaries at $498k in 2023, up 3.1% and ranking sixth on the list of highest-paid specialties. 

The Takeaway

Say what you want about rising workload and burnout in radiology – radiologists are still among the best-compensated physicians in medicine. And the situation in the US is in sharp contrast to Japan, where radiology is one of the lowest-paid specialties (see our article in The Wire section below).

Radiologist Pay Grows 3%

Annual salaries for US radiologists grew 3.1% in 2023 in the most recent physician salary report by Medscape. Although radiologist salaries are nearing the half-million-dollar mark, the increase actually represents a slowdown compared to 11% growth last year

The Medscape report shows that US radiologists had an average annual salary of $498k in 2023, compared to $483k in 2023 and $437k in 2022.

  • Radiologists ranked sixth on a list of 29 medical specialties, with orthopedic physicians topping the charts at $558k and diabetes and endocrinology doctors at the bottom at $256k. 

The report surveyed 7k practicing US physicians from October 2023 to January 2024, finding … 

  • 61% of those surveyed thought physicians overall are underpaid
  • 49% believe that they themselves are fairly paid
  • 83% said that pay was either no factor or only a minor factor in the specialty they chose, with only 14% saying it was the leading factor
  • Male specialists earned 31% more than female specialists, indicating a widening gender gap compared to 27% last year
  • 57% of radiologists were happy with their compensation, sixth among 29 medical specialties

Physician comments submitted to Medscape focused on the significant stress being experienced by many physicians, a phenomenon that’s been linked to burnout in other surveys. 

The Takeaway

Underlying this year’s Medscape data is an inconvenient truth for radiologists: their 3.1% pay gains for the year were not enough to keep pace with the US inflation rate of 3.4%. In that respect, radiologists find themselves in the same situation as most Americans.

Are Doctors Overpaid?

A new study on physician salaries is raising pointed questions about pay for US physicians and whether it contributes to rising healthcare costs – that is, if you believe the numbers are accurate. 

The study was released in July by the National Bureau of Economic Research (NBER), which produces in-depth reports on a variety of topics. 

The current paper is highly technical and may have languished in obscurity were it not for an August 4 article in The Washington Post that examined the findings with the claim that “doctors make more than anyone thought.”

It is indeed true that the NBER’s estimate of physician salaries seems high. The study claims US physicians made an average of $350k in 2017, the year that the researchers focused on by analyzing federal tax records. 

  • The NBER estimate is far higher than $294k in Medscape’s 2017 report on physician compensation – a 19% difference. 

The variation is even greater for diagnostic radiologists. The NBER data claim radiologists had a median annual salary in 2017 of $546k – 38% higher than the $396k average salary listed in Medscape’s 2017 report. 

  • The NBER numbers from six years ago are even higher than 2022/2023 numbers for radiologist salaries in several recent reports, by Medscape ($483k), Doximity ($504k), and Radiology Business ($482k). 

But the NBER researchers claim that by analyzing tax data rather than relying on self-reported earnings, their data are more accurate than previous studies, which they believe underestimate physician salaries by as much as 25%. 

  • They also estimate that physician salaries make up about 9% of total US healthcare costs.

What difference is it how much physicians make? The WaPo story sparked a debate with 6.1k comments so far, with many readers accusing doctors of contributing to runaway healthcare costs in the US.

  • Meanwhile, a thread in the AuntMinnie forums argued whether the NBER numbers were accurate, with some posters warning that the figures could lead to additional cuts in Medicare payments for radiologists. 

The Takeaway

Lost in the debate over the NBER report is its finding that physician pay makes up only 9% of US healthcare costs. In a medical system that’s rife with overutilization, administrative costs, and duplicated effort across fragmented healthcare networks, physician salaries should be the last target for those who actually want to cut healthcare spending. 

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