14% of physicians under 40 years old are in private practice: 17 insights

Early-career physicians continue to favor employed opportunities over private practice as declining reimbursements, steep medical school debt and the cost of malpractice insurance premiums remain key factors driving career choices, according to the "Medscape Young Physician Compensation Report 2021."

Almost 2,500 "young physicians" — defined by Medscape as under 40 years old — participated in the survey, published Sept. 24. Data were collected from Oct. 6, 2020, through Feb. 11, 2021.

Here are 17 insights on early-career physician compensation, practice situation, gender pay gap and more:

1. Fourteen percent of physicians under 40 are self-employed, compared to 29 percent of physicians between 40 and 69 years old.

2. On average, specialists in the survey reported earning an annual salary of $304,000, compared to $200,000 for primary care physicians. For physicians overall, specialists earn $344,000 and primary care physicians earn $243,000.

3. On average, male physicians under 35 years old earn $281,000 and women of the same age range earn $197,000. 

4. Among physicians under 40 years old, 46 percent are women, compared to 35 percent among physicians between 40 and 69 years old.

5. The largest income disparity between male and female physicians occurs at 35 to 54 years old, where men earn $346,000 on average compared to $248,000 for women.

6. Early-career physician compensation based on practice situation:

  • Office-based single-specialty group practice: $295,000
  • Hospital: $282,000
  • Office-based multispecialty group practice: $272,000
  • Academic (nonhospital), research, military, government: $268,000
  • Healthcare organization: $266,000
  • Outpatient clinic: $200,000

7. Among survey respondents, emergency medicine (69 percent), psychiatry (68 percent) and radiology (68 percent) specialists were among those most satisfied with their pay.

8. Respondents specializing in gastroenterology (44 percent), orthopedics (47 percent) and otolaryngology (48 percent)  ranked the lowest in terms of compensation satisfaction. 

9. Twenty-one percent of physicians under 40 deferred or refinanced mortgages or student loans in 2020.

10. Percentage of certain ethnicities and races represented in physicians under 40:

  • White: 55 percent
  • Asian: 26 percent
  • Black: 7 percent
  • Other: 6 percent
  • Mixed: 3 percent
  • Prefer not to answer: 8 percent

11. Four percent of physicians under 40 years old reported spending more than 65 hours a week with patients, while 19 percent reported spending less than 30 hours a week.  

12. Ten percent of respondents said that they spend less than five hours a week on administrative work, compared to 36 percent who reported spending more than 20 hours a week.

13. Relationships with patients (26 percent), helping others (26 percent) and finding answers/diagnoses (20 percent) were among the most rewarding parts of early-career physicians' jobs.

14. Dealing with difficult patients (20 percent) and working with many rules and regulations (20 percent) were among the biggest challenges for physicians under 40 years old. Seven percent of respondents cited EHRs as a challenge.

15. If given the choice, 76 percent of respondents said they would choose medicine again.

16. Those in critical care (88 percent), ophthalmology (88 percent) and gastroenterology (87 percent) were most likely to pursue medicine again. Just 56 percent of physical medicine and rehabilitation physicians said that they would pursue medicine again.

17. One-hundred percent of gastroenterologists said that they would choose their specialty again, compared to 73 percent of internal medicine and family medicine specialists.

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