After months of delay, the American Medical Association finally released its comprehensive report on physician compensation a week before Christmas. It wasn't the best holiday news for the profession.
The average income for U.S. physicians dipped slightly to $194,400 in 1998 from a record high of $199,600 in 1997, according to the AMA's Physician Socioeconomic Statistics, 2000-2002 Edition. Physicians' median income also dropped to $160,000 in 1998 from $164,000 in 1997.
"This modest change in salary is a reflection of our industry," said David Gans, survey director for the Medical Group Management Association, which publishes its own annual survey on physician compensation. "Physicians are going to have to recognize that they'll continue to earn a good income, but their income may not increase at the rate of the economy because of reimbursement issues -- managed care and federal policy."
The AMA's annual report -- a 240-page tome with a price tag of $495 ($445 for members) -- contains statistics about everything from the average number of office visits to the cost of liability insurance. Information in the report is based on data collected through the AMA's "Socioeconomic Monitoring System."
The latest report includes information from 3,300 physicians, down from the typical response rate of about 4,000 annually.
James Rodgers, M.D., the AMA's vice president for health policy, said the group now tentatively plans to publish the report every other year rather than annually. He attributed the change to the cost of the report and the increasing difficulty in rounding up enough physicians willing to take part in a lengthy telephone survey.
In fact, the AMA was forced to extend the survey period this year because of the lackluster response rate, delaying publication for about four months, Rodgers said.
"It's sort of been a slow, steady decline in the response rate," Rodgers said. "Doing telephone surveys with physicians has become increasingly difficult."
Gans, who surveys about 28,000 group-practice physicians for the MGMA's study, said it is often difficult to prod doctors to respond to questions involving sensitive salary issues.
"You have to educate physicians and practice administrators to participate so they can have the information they need to manage their practices. With the complexities of this industry, you need all the tools you can get," he said.
For now, Rodgers said, the AMA plans to conduct future surveys with a "more limited set of questions." The surveys will still serve as the authoritative voice for the medical profession on a wide range of issues.
He said the AMA has a responsibility to provide this comprehensive information regardless of concerns about the public perception of salary levels and other potentially embarrassing information.
"We are sensitive about doing our best to display this information without getting negative publicity," he said. "But we do have an open survey, and the information is readily available and always reported. People depend on it. We don't have an option of keeping things like this to ourselves."
The survey lists salary levels for 12 specialties and nine geographic regions.
Among the big winners in the salary survey: gastroenterologists, whose average net income jumped 24% to nearly $276,000 in 1998; and urologists, whose average net income climbed 20% to $285,000.
The losers were otolaryngologists, whose average net income fell 10% to $208,000; and orthopedic surgeons, whose average net income dropped 5% to $312,500.
Among the other findings in the survey:
* Physicians spent an average of 56.3 hours per week in professional activities in 1999 compared with 56.6 in 1998.
* In 1999, about 60% of physicians were self-employed, as opposed to 62.3% in 1998; 38.2% were employees (compared with 36.1% in 1998); and 2.9% were independent contractors (compared with 1.6% in 1998).
* The median percentage of physicians' revenue from treating Medicare patients was 25% in 1999 -- the same as in 1998.