Orthopedic Surgeons: #1 in Pay, #11 in Satisfaction

Since 2010 Medscape, WebMD’s site for healthcare providers, has asked physicians about their compensation, their satisfaction and various other aspects of their work life.

This year’s online survey, the 2015 Physician Compensation Report, received responses from 19, 500 physicians in 25 specialties. As in four of the last five surveys, orthopedic surgeons were the top earners with an average annual compensation of $421, 000.

Since 2010, according to Medscape, the average annual orthopedic surgeon’s pay has risen from $315, 000 to $421, 000. That represents a 10% annual average rate of increase.

Orthopedic surgeons also reported an increase in satisfaction with their work life, rising for the second year in a row. In this year’s survey, 53% of reporting orthopedic surgeons said that they were satisfied overall with their profession. That is higher than last year’s 51% which itself was higher than the 44% reported in the 2013 survey. These satisfaction rates, however, are still well below the 65% reported for 2010.

Pay Details

Interestingly, a different salary survey, this one by salary.com, also found that the average annual rate of compensation for orthopedic surgeons was over $400, 000, specifically $440, 604.

That survey polled thousands of human resource departments at hospitals and private practices of all sizes to compile a range of salaries for people with the job title of orthopedic surgeon.

Unlike the Medscape online survey, the salary.com survey also measured the range of compensation and came up with $347, 824 – $569, 842.

The highest earning orthopedic surgeons, it turns out, were those who are partners in a private practice. Solo practitioners earned approximately 10% less. The second highest annual average orthopedic salaries went to members of single-specialty group practices, whether privately owned or part of an entity such as a hospital system. Orthopedists in multispecialty groups AND those employed by health-care organizations came close to the overall median. Second from the bottom of the pay scale are those orthopedic surgeons who work in hospitals although they also reported average annual earnings of close to $400, 000. At the bottom were orthopedic surgeons who work in academia who made just over $300, 000.

Specialties and Group Practices

Yet another survey, the Medical Group Management Association’s, Physician Compensation and Benchmarking Survey 2011, developed data on orthopedic surgeon compensation by single specialty or multispecialty practices. The highest-paid specialists, according to the survey, were orthopedic surgeons who specialized in the spine and worked in multispecialty practices. On average, they earned about $730, 000 annually. General orthopedic surgeons in multispecialty practices, by contrast, earned an average salary of about $500, 000. Pediatric orthopedic surgeons in a single-specialty practice reported compensation of about $625, 000 and sports medicine surgeons in a single-specialty group earned about $600, 000. Finally, according to the Medical Group Management Association survey, trauma surgeons in single-specialty group practices earned about $630, 000.

This survey reported much higher numbers than did either the salary.com survey or the Medscape survey—so it may have some inherent upward bias to the numbers. But the comparisons between specialties is probably close to reality.

Rise of Accountable Care Organizations

One of the most interesting trends uncovered by the Medscape survey was the rise of the Accountable Care Organization (ACO). About a third of all physicians are now participating in an Accountable Care Organization—which represents a 10-fold jump in four years.

Job Satisfaction

One of the more interesting aspects of the Medscape survey are the questions it asks about day-to-day work flow and overall satisfaction rates among physicians generally and orthopedic surgeons specifically.

It is interesting to note how the overall satisfaction rates for orthopedic surgeons declined from 2011 to 2013 and then have been rising from a low point of 44% overall satisfaction and near the bottom of all physician specialties.

Comparing satisfaction rates to compensation is also interesting as the following chart illustrates.

Eight years ago Orthopedics Today’s Medical Director, Douglas Jackson M.D., wrote: “While physicians remain among the highest trusted professionals on annual surveys of the public, there are large disconnects among some insurers, Medicare reimbursement decisions and other governmental agencies and hospital administrations. Policy bureaucrats are trusting doctors less in their decision making. There is a pervasive mistrust of physicians that we have financial incentives and conflicts of interest that influence the ordering of laboratory and imaging tests, prescribing drugs, selecting devices and supplies.”

The result, Dr. Jackson wrote, was a loss of autonomy across the board and reduced ability to make proper decisions about patient care.

He went on to say: “As an example of the changing trends we have seen in reimbursement, look at Medicare payment rates for joint replacement to surgeons. From 1991 to 2001 when the data was released, the rates declined by 39% for hip replacement and by 36% for knee replacement. Reimbursement has continued to decrease and Medicare has even more scheduled cuts coming. It is one thing to work for less; but in addition to reimbursement being down, my overhead has increased and there has been no significant adjustments made for inflation.”

I think a majority of orthopedic doctors would nod their heads sadly and knowingly at Dr. Jackson’s commentary and between 2001 and 2003, documented the deteriorating overall satisfaction rates among orthopedic surgeons. By 2003, 66% of all orthopedic surgeons surveyed by Medscape were dissatisfied with being a physician.

Dissecting Surgeon Satisfaction Rates in 2015

In the most recent survey, 53% of orthopedic surgeons reported that they were, overall, satisfied with their choice of profession—barely more than half.

Looking into the details of physician life, here is what Medscape found.

• 58% of orthopedic surgeons do not feel that they are fairly compensated. Many orthopedists we talk to say that they are treating more patients, doing more paperwork and dealing with reduced autonomy for the same levels of compensation.
• If they had to choose again, only 50% would choose medicine. The most commonly mentioned alternative professions are law and business.
• If they had to choose again, 67% would choose orthopedics again.

And what is the most rewarding aspects of the job for physicians? The following answers should surprise no one.

Noteworthy is that only 11% of the surveyed physicians mentioned money as a rewarding aspect of their job.

Conclusions

While average pay rates are certainly strong for orthopedic surgeons at over $400k on average and it is encouraging that satisfaction rates appear to have stabilized, the community of orthopedic surgeons is still well below the average of other specialties in terms of satisfaction rates.

The one specialty that posted the highest satisfaction rates was dermatology. Two-thirds of all dermatologists reported that they were satisfied overall with their professional choice and 73% would choose dermatology again. But even this group reported that 45% of their ranks would NOT choose medicine again.

The issue is really, we think, autonomy and the ability to give patients the best care possible. We remain plagued as a community with too many other participants—payers, lawyers, administrators and regulators—in the operating room.