infectious disease physician compensation - idsa several organizations, such as medscape, mgma, and...

Infectious Diseases Physician Compensation

Assessment

Prepared for: Infectious Diseases Society of America Oct. 2015

Table of Contents

• Background

• Study Details

• Survey Flow

• Executive Summary

• Detailed Findings

• Appendix

Background

• Several organizations, such as MedScape, MGMA, and AAMC, report on annual physician compensation by specialty type; however, these reports have not provided adequate insight into the Infectious Diseases physician’s compensation, partly due to the small sample sizes collected

• As result, the IDSA commissioned research to capture compensation information directly from a broad set of their members

3

Study Details

4

• A self-administered web survey • Included a range of quantitative exercises; such as choice selection,

numeric and open-ended questions • Completion of the web survey took ~ 5 -10 minutes per respondent

• IDSA sent invitations directly to member inviting them to take part in the survey

• Target groups were ID Physicians involved with Patient Care, Research and Public Health

Objectives • Gauge physicians’ total actual compensation • Determine the sources of their compensation • Assess how compensation is structured by group

Method of Data Collection

Sample

• The survey was fielded July 15 through August 22, 2015 Timing

Survey Flow

5

Demographics Income Assessment Future Plan

• Gender • Age • Length of time in practice • Geographic location • Community Type • Employment situation • Full/part time status

• Total Annual Gross Income • % of income by various services • Type of compensation plan • Other metrics tied to

compensation (i.e. quality)

• Anticipated career changes within next 5 years

• Options to expand career

• Best potential to demonstrate value

The following is an outline of the discussion flow, focusing on 3 key areas:

Sample Segmentation & Presentation of Findings

6

Throughout the presentation, financial and other numerical values

will be presented in the following format:

[Average] [Median] [Range]

The entire survey sample was segmented as follows: • Full sample segmented into

Part-time vs Full time Full time respondents

segmented by Primary Responsibility o Patient Care segmented

into Private Practice, Hosp/Clinic Employed, or Academic Medical Center (AMC) Employed Private Practice

segmented into Solo/Owner/ Partner vs Associate

Part-time employment

Full Sample

Full-time employment

Patient Care

Research

Public Health

Private Practice

Hosp/Clinic Employed

AMC Employed

Solo/Owner/ Partner

Associate

Survey questions that relate to findings appearing on the slide will appear towards the bottom of the slide

Executive Summary

Sample Size and Summary Statistics

8

1,878 Physicians Completed the Survey 1,768 are full time employees

Avg. Compensation (full time) [median] [range]

$230,031 [$205,000] [$50K - $1.45M]

Avg. Participant Age [median] [range]

50 years old [48] [24-88]

Avg. Years in Practice [median] [range]

16 years [15] [0-60]

D1. What is your gender? D2. What is your age? D6. How long have you been in your profession since completion of your training program?

41%

24% 22% 13%

0%

10%

20%

30%

40%

50%

< 10 years 11-20 years 21-30 years > 30 years

Respondents by years in practice

Male 60%

Female 40%

Gender Overall Male Avg. Income

$261,415 [$235K] [$50K-$2M]

Overall Female Avg. Income

$193.950 [$180K] [$55K-700K]

Geographic Distribution of Respondents and Community Setting

9 D3. In which state do you practice? D4. How would you describe the area in which you practice?

17% 22%

7%

22%

20%

13%

Urban 71%

Suburban 24%

Rural 5%

Community Type

The Majority of Respondents (64%) Indicate Patient Care as Their Primary Responsibility

10

Private Practice 19%

Hosp/clinic Employed 22%

AMC Employed 26%

Research (Basic, Clinical) 19%

Public Health 4%

Other 10%

By Primary Responsibility Includes full and part time

12% Sole Practitioner, Owner, or Partner

7% Employee/Associate

D5: Please indicate your primary responsibility?

Most of the Respondents in Patient Care Are Male. Most of the Public Health Respondents are Female with an Equal Proportion of Research Respondents

11

66% 61% 55% 50% 45%

34% 39% 45% 50% 55%

0%

10%

20%

30%

40%

50%

60%

70%

Private Practice Hosp/clinic employed AMC employed Research Public Health

Gender by Affiliation % of Respondents

Male Female

D1. What is your gender? D5. Please indicate your primary responsibility. PC1. Which of the following best describes your primary place of employment?

Those Employed by a Hosp/Clinic Are Younger While Those Working in Public Health Are Older

12

21

31 26

22

32 29

22 18

29 32

22 17

25 25 25 25

18

25 25 31

0

5

10

15

20

25

30

35

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age by Affiliation % of Respondents

Private Practice Hosp/clinic employed AMC employed Research Public Health

D2. What is your age? D5. Please indicate your primary responsibility. PC1. Which of the following best describes your primary place of employment?

Segments by full vs. part time status

13

Primary Responsibility Total Number

# who are full time

% Full time

# who are part time

% part time

Patient Care 1,257 1,177 94% 80 6%

Private Practice 350 321 92% 29 8%

Hosp/Clinic Employed 418 396 95% 22 5%

AMC Employed 489 460 94% 29 6%

Research 363 351 97% 12 3%

Public Health 71 60 85% 11 15%

Other 187 180 96% 7 3%

Total 1,878 1,768 94% 110 6%

D5. Please indicate your primary responsibility. D7. Please indicate your working status.

14

Topline Compensation Figures (based on those that reported as working full-time)

Salary Average

[Median] [Range]

25th percentile

75th percentile

90th percentile

Full-time Patient Care (n=1,177)

$231,702 [$210K] [$50K – 1.45M] $170,000 $260,000 $350,000

Private Practice (n=321)

$277,611 [$248K] [$50K - $1.45M] $185,000 $341,250 $431,000

Hosp/clinic employed (n=396)

$241,319 [$230K] [$80-$865K) $200,000 $270,000 $327,500

AMC Employed (n=460)

$191,485 [$179K] [$78-$770K] $150,000 $216,000 $261,400

Full-time Research (n=351)

$199,110 [$175K] [$52-$750K] $135,000 $234,500 $310,000

Full-time Public Health (n=60)

$180,845 [$180K] [$96-$260K] $155,000 $207,250 $229,100

Full-time Other (n=180)

$295,811 [$260K] [$65K - $1M] $205,000 $350,000 $452,300

Comparison of Salary by Gender and Age

15

30-39 year olds 40-49 year olds 50-59 year olds 60+ year olds

Private practice Solo/Partner

Men $320,750

[$300K] [$185-$600K] N=16

$351,140 [$300K] [$85K-$1.45M]

N=45

$326,013 [$300K] [$50K-$1.03M]

N=45

$308,527 [$280K] [$77-$730K]

N=37

Women $210,909

[$180K] [$115-$375K] N=11

$230,391 [$200K] [$150-$400K]

N=21

$283,470 [$255K] [$105-$544K]

N=18

$190,000 [$200K] [$100-$250K]

N=7 Private practice Associate

Men $201,400

[$183K] [$92-$515K] N=22

$267,106 [$250K] [$134-$550K]

N=22

$272,917 [$213K] [$120-$575K]

N=12

$259,147 [$250K] [$90-$500K]

N=17

Women $191,762

[$185K] [$100-$260K] N=21

$247,917 [$205K] [$170-$500K]

N=12

$203,333 [$190K] [$70-$350K]

N=9

$140,000 [$140K] [$120-$160K]

N=2

D2. What is your age? PP3. What is your total annual gross income?


16



Men $228,876

[$223K] [$134-$350K] N=72

$256,470 [$250K] [$92-$537K]

N=67

$278,548 [$250K][$155-$650K]

N=58

$260,012 [$240K] [$130-$865K]

N=55

Women $204,216

[$200K] [$115-$345K] N=51

$221,559 [$210K) ($145-$500K)

N=43

$226,927 [$205K] [$80-$577K]

N=32

$235,545 [$210K] [$160-443K]

N=18

AMC Employed

Men $150,013

[$145K] [$100-265K] N=57

$202,773 [$195K] [$120-$400K]

N=89

$247,310 [$223K] [$120-$770K]

N=54

$242,574 [$220K] [$158-$430K]

N=53

Women $152,124

[$150K] [$88-$240K] N=71

$169,966 [$160K] [$115-$285K]

N=63

$187,717 [$190K] [$78-$275K]

N=48

$194,249 [$180K] [$149-$330K]

N=21

D2. What is your age? EP1/AM3. What is your total annual gross income?


17


Research

Men $133,625

[$131K] [$54-$400K] N=35

$170,280 [$156K] [$65-$340K]

N=62

$251,206 [$220K] [$135-$750K]

N=55

$279,678 [$265K] [$52-$650K]

N=57

Women $120,448

[$123K] [$56-$173K] N=40

$161,132 [$150K] [$100-$320K]

N=51

$233,357 [$197K] [$105-$700K]

N=32

$231,173 [$207K] [$100-$500K]

N=19

Public Health

Men $140,000

[$123K] [$115-$200K] N=4

$167,333 [$167K] [$132-$208K]

N=6

$218,200 [$215K] [$190-250K]

N=10

$212,333 [$213K] [$168-$260K]

N=6

Women $152,444

[$157K] [$96-$190K] N=9

$175,019 [$180K] [$132-$229K]

N=11

$180,750 [$178K] [$165-$200K]

N=6

$178,625 [$165K] [$137-$250K]

N=8

D2. What is your age? R8/PH6. What is your total annual gross income?


18


Other

Men $155,000

[$190K] [$65 - $210K] N=3

$255,178 [$231K] [$111-$480K]

N=21

$324,334 [$300K] [$144 - $991K]

N=48

$367,423 [$325K] [$185K - $1M]

N=49

Women $155,600

[$150K] [$104- $220K] N=9

$212,278 [$210K] [$124 - $350K]

N=18

$243,621 [$214K] [$125-420K]

N=21

$336,300 [$270K] [$145-$700K]

N=10

D2. What is your age? O5. What is your total annual gross income?

The majority plan to remain in their current position

19

% which plan to retire per segment within next 5 years Private Practice Hosp/Clinic

Employed AMC

Employed Research Public Health

< 50 year olds (n=914) 0.2% 2.7% 0.2% 0.0% 0.1%

50-59 year olds (n=380) 2% 3% 2% 2% 0%

60+ year olds (n=312) 9% 3% 12% 9% 5%

Total =1,606 ( who completed question in full) 11.2% 8.7% 14.2% 11% 5.1%

70%

19%

11%

Future plans in next 5 years Avg. % of respondents across all segments

Remain in current position

Change to new position

Retire

PP7/EP5/AM7/R16/PH8. Looking ahead 5 years, which best characterizes your future plan:

Detailed Findings

Detailed Findings Physicians in Patient Care

21

Overall, Private Practice Sole Owners/Partners Who Work Full-time Report the Highest Income

22

FULL TIME (n=1,177) n

Overall Salary Average

[Median] [Range]

Sole owner/ Partner in private practice/ Solo practitioner 203 $305,248 [$272,500] [$50K - $1.45M]

Associate in a private practice 118 $230,302 [$200K] [$70K- $575K]

Hosp/clinic employed 396 $241,319 [$230] [$80K- $865K)

AMC Employed 460 $191,485 [$179K] [$78K-$770K]

Average Salaries of Those Who Work Part-time

23

PART TIME (n=80) n


[Median] [Range]

Sole owner/ Partner in private practice/ Solo practitioner 21 $175,714 [$166K] [$40K - $390K]

Employee/Associate in a private practice 8 $125,000 [$109K] [$48K - $230K]

Hosp/clinic employed 22 $138,344 [$132,500] [$30-$288K]

AMC Employed 29 $125,947 [$120K] [$21-$255K]

Segments by Full vs. Part-time Status

24

Primary Responsibility (n=1,257)

Total Number % Full time % part time

Patient Care 1,257 94% 6%

Sole owner/ Partner in private practice/ Solo practitioner 224 91% 9%

Associate in a private practice 126 94% 6%

Hosp/clinic employed 418 95% 5%

AMC Employed 489 94% 6%

D5. Please indicate your primary responsibility. D7. Please indicate your working status.

Summary of Average Salaries by Area of Focus

25

Primary Responsibility

Pediatrics*

HCV & HIV*

HIV & IC (w/or w/o steward-

ship)*

HIV and Steward-ship*

HIV* IC and

Steward-ship*

IC only*

Steward-ship only*

General ID/Oth

er

Private practice

3% ($237K)

21% ($295K)

17% ($286K)

1% ($236K)

8% ($249K)

8% ($334K)

9% ($299K)

2% ($212K)

30% ($256K)


7% ($208K)

20% ($258K)

14% ($258K)

5% ($216K)

12% ($219K)

8% ($238K)

5% ($238K)

8% ($243K)

20% ($240K)

AMC Employed

19% ($175K)

13% ($190K)

4% ($175K)

3% ($212K)

18% ($188K)

6% ($209K)

8% $198K

5%

($201K)

24% ($202K)

*With or without transplant

61% of private practice, 55% of Hosp/Clinic employed and 51% of AMC selected more than 1 focus area

D10. Please indicate if your work has a particular focus (select all that apply). PP3/EP1/AM3. What is your total annual gross income?

Opportunities to Expand Career

26

6%

13%

50%

10%

30% 31%

21% 21% 18%

35%

26%

36%

10%

21%

0%

10%

20%

30%

40%

50%

60%

Incorporatingclinical

research intopractice

Adoptingtelemedicine

Providingadmin svcs to

hospitals

Offering woundcare

Leadership Teaching Other

Private Practice Employed Academic

Other Services: • Wound care • Teaching • Public Health • Stewardship • Travel medicine

In terms of expanding your career, what options have you identified?

Best Potential to Demonstrate Value

27

72%

18%

9% 2%

Patient care

Antimicrobial stewardship svcs

Infection control and prevention

Other

55% 24%

16% 5%

Patient careAntimicrobial stewardship svcsInfection control and preventionOther

Private Practice Employed

41%

11% 15%

6%

13%

9%

4%

Patient careAntimicrobial stewardshipInfection control and preventionQuality improvement/patient safetyTeachingConducting researchOther

Academic

PP9/EP7/AM9. What area below represents your best potential for demonstrating your value as an ID specialist to your practice?

Detailed Findings Private Practice Physicians

28

The sample includes 321 full time physicians who report their primary place of employment as private practice

29

Private Practice

12%

21% 18% 18%

10%

10%

9%

3%

0%

5%

10%

15%

20%

25%

30%

35%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age

Male Female

Avg. age = 49

D1. What is your gender? D2. What is your age?

Male 68%

Female 32%

Gender

203 are a sole owner/partner or solo practitioner 118 are an employee or associate of the practice

N = 321

N = 321

Overall private practice distribution by age/gender and years in practice

30

41%

24% 23%

12%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


Years in Practice

Private Practice

Avg. YIP = 16

Urban 49%

Suburban 46%

Rural 5%

Community Type

D4. How would you describe the area in which you practice? D6. How long have you been in your profession since completion of your training program?

N = 321 N = 321

Private Practice Associates are Younger, While Solo/Owners/Partners Trend Older

31

8%

21% 20%

14% 14% 11%

6% 6%

0%

5%

10%

15%

20%

25%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Solo/Partner vs. Employee/Associate in Private Practice by Age

Sole Owner/Partner/Solo Employee/Associate

Private Practice

Male 71%

Female 29%

Gender (Sole Owner/Partner)

Male 62%

Female 38%

Gender (Employee/Associate)

D1. What is your gender? PC1. Which of the following best describes your primary place of employment?

N = 203

N = 118

N = 321

Average Income for All Full-time Private Practice Physicians is $277,611

32

Sole owner/Partner in private practice/Solo

practitioner (n=203)

Employee/Associate in a private practice

(n=118)

Age Average

[Median] [Range]

51 [51] [30-75]

46 [42] [24-70]

Years in Practice Average

[Median] [Range]

18 [16] [1-43]

12 [6] [1-43]

Gender 71% male, 29% female 62% male, 38% female

Income Average

[Median] [Range]

$305,248 [$272K] [$50K - $1.45M]

$230,302 [$200K] [$70 - $575K]

Private Practice

Profiles at a Glance by Type

As expected, solo/partners have significantly higher average income than employee/associates

The Majority of Physicians in Private Practice Report Seeing Most of Their Patients in the Inpatient Setting

33

Private Practice

Avg. # of days spent: [range]

Average Income [median] [range]

Inpatient 5 [0-7]

$274,000 [$240K] [$70K-868K]

Physician’s Office

2 [0-7]

$293,560 [$250K] [$50K-$1.4M]

75%

21%

4%

Type of facility see most patients

Inpatient HospitalPhysician's OfficeOther settings

However, treating patients in physician’s offices lends to higher income on average

D9. What type of facility to you see most of your patients? PP3. Approx. how many days per week do you see patients in each of these settings?

N = 321

34

26%

58%

17%

Practice Type

SoloSingle specialty groupMultispecialty group

Average Income

Solo $302,329 [$255K] [$77K-$1.45M]

Single Specialty $272,900 [$240K] [$70K-$1M]

Multispecialty $256,175 [$225K] [$50K-$600K]

Private Practice

Single Specialty Size of Practice: Avg. = 9 physicians

Range = [1-91]

Multispecialty Size of Practice Avg. = 76 physicians

Range = [2-750]

Most Private Practice Physicians who Participated in the Survey are Part of a Single Specialty Group

However, income for those who are in solo practice is higher on average

PP1: What type of private practice is this?

N = 321

Overall Men in Private Practice Report Higher Compensation With Largest Gender Disparity in the 40-49 and 60+ Groups

35

252

324 315 293

198 237 257

179

$0

$50

$100

$150

$200

$250

$300

$350

24-39 age group 40-49 age group 50- 59 age group 60+ age group

Avg. Income by Age and Gender (Shown in thousands)

Male Female

Private Practice

D1: What is your gender? D2. What is your age?

N = 321

Few Private Practice Physicians Have Compensation Tied to Quality Metrics Nor Have Separately Negotiated Hourly On-call Rate

• Only 11% of private practice reported physicians that any part of their patient care compensation is tied to quality metrics such as C-diff, CLABSI or CAUTI infection rate

• No unique commonalities were found versus the overall group among these

• Only 9% reported having a separately negotiated hourly on-call rate, on average $155 ($45-$250)

36

Private Practice

PP5. If you provide a separately negotiated on-call service, what is your hourly rate? PP6. Is any part of your patient care compensation tied to quality metrics?

HIV and Infection Control are Highest Focus Areas For Private Practice Physicians

37

Private Practice

D10: Please indicate if your work has a particular focus [select all that apply].

N = 321

Pediatrics* HCV & HIV*


ship)*

HIV and Steward-

ship* HIV*

IC and Steward-

ship* IC only*

Steward-ship

only*

General ID/Other

3% ($237K)

21% ($295K)

17% ($286K)

1% ($236K)

8% ($249K)

8% ($334K)

9% ($299K)

2% ($212K)

30% ($256K)

% of Income from Various Services

N=321

Service % of Physicians who perform

% of Income this activity represents Average

[Median] [Range]

Patient Care 100% 86% [90%] [10 – 100%]

Epidemiology/Infection Control 44% 9% [7.5%] [1 – 55%]

Antimicrobial Stewardship 32% 7% [5%] [1 – 50%]

Other Sources (Speaking, laboratory oversight, utilization management) 15% 16%

[10%] [1 – 70%]

Hospital P&T or Other Facility/System-Wide Committee 14% 4%

[3%] [1 – 10%]

Expert Witness Testimony/External Consultant 13% 7% [5%] [1 – 40%]

PP4: Approximately, what percentage of your income comes from these services?

Private Practice Patient Care Accounts for Most of Private Practice

Physicians’ Income

37


N=321



[Median] [Range]

Academics/Teaching 13% 7% [5%] [1 – 30%]

Bonus 10% 13% [10%] [2 – 40%]

Patient Safety/ Healthcare Quality Improvement 6% 4% [5%] [1 – 10%]

Employee Health 6% 3% [2%] [1 – 10%]

Program Director 6% 11% [10%] [2 – 30%]

Grant Funding for Clinical/Translational Research 4% 25% [20%] [2 – 50%]

Basic Research 1% 30% [30%] [10 – 50%]

PP4: Approximately, what percentage of your income comes from these services?

Private Practice Other Activities Contribute to the Overall Compensation of

Private Practice Physicians

38

The Vast Majority of Private Practice Physicians Report They Plan to Remain in Their Current Position

40

63%

15% 13% 4% 3% 2% 2%

0%

10%

20%

30%

40%

50%

60%

70%

Remain in currentmodel

Seek emplomentwithin health

system

Retire Other Seek employmentin academia

Seek position inpublic health

Seek position inindustry

Future plans in next 5 years

% of Respondents

Private Practice

PP7. Looking ahead 5 years, which best characterizes your future plan?

N = 309

6% 13%

50%

10% 21%

0%

10%

20%

30%

40%

50%

60%

Incorporating clinresearch into

practice

Adoptingtelemedicine

Providing adminsvcs to hospitals

Offering woundcare

Other

Opportunities to expand career

% of Respondents

Other Services:

• Working in an Infusion center or nursing home

• Independent medical reviews

• Physician Case Mgr.

• Working at state medical hospital

• Travel medicine/international relief work

• Informatics

• Sell practice to healthcare system

Private Practice Private Practice Physicians Report Strong Interest in Providing

Administrative Services to Hospitals to Expand Career

PP8. In terms of expanding your career, what options have you identified? 40

N = 309

Most Private Practice Physicians Reported Patient Care as Their Best Potential to Demonstrate Value

72%

18%

9%

2%

Best potential to demonstrate value

Patient care Antimicrobial stewardship svcs Infection control and prevention Other

Private Practice

PP9. What area below best represents your best potential for demonstrating your value as an D specialist to your practice? 41

N = 309

Detailed Findings Hosp/Clinic Employed

43

Sample Included 396 Full-time Physicians who Report Their Primary Affiliation is a Hospital or Clinic

Male 64%

Female 36%

Gender

18% 17% 14% 13%

13% 11%

8% 4%

0%

5%

10%

15%

20%

25%

30%

35%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age

Male Female


Avg. = 48


43

N = 396

N = 396

Overall Distribution by Community Setting and Years in Practice for Hosp/Clinic Employed Physicians

45

48%

22% 20%

8% 0%

10%

20%

30%

40%

50%

60%


Years in Practice

D4. How would you describe the area in which you practice? D8. Do you work in a clinic that receives Ryan White funding? D6. How long have you been in your profession since completion of your training program?

Avg. YIP = 14

Urban 56%

Suburban 32%

Rural 12%

Community Type

Across all settings, only 29% receive Ryan White funding


N = 396

N = 396

46 D9. What type of facility do you see most of your patients?

Type of facility where see most patients % of Respondents

Salary Average

[Median] [Range]

All full time N=396 $241,319 [$230] [$80-$865K)

Hospital (Inpatient) 67% $242,400 [$244,500K] [$80-650K)

Hospital (Outpatient) 17% $240,000 [$225K] [$120-$865K]

Community based clinic 10% $231,200 [$203K] [$92-$577K]

Other 5% $251,000 [$250K] [$145-$443K]

The majority see patients in an inpatient setting; however, those who earn the highest income on average treat most of their patients in private practice

Hosp/Clinic Employed physicians’ income averaged $241,319 ($80-$865K)


47

229 256

279 260

204 222 227 236

$0

$50

$100

$150

$200

$250

$300

30-39 YO 40-49 YO 50-59 YO 60+ YO


Male Female

Overall, Men Report Higher Compensation with the Largest Gender Disparity in the 50-59 year Group


D1: What is your gender? D2: What is your age? EP1.What is your total annual gross income?

N = 396

49%

5% 3% 12% 30%

0%10%20%30%40%50%60%

wRVU Total Collections Total Billings Don't know Other

Basis for Compensation

% of Respondents

• 34% of physicians report any part of their patient care compensation is tied to quality metrics such as C-diff, CLABSI or CAUTI infection rate

o No unique commonalities were found versus the overall group

• 49% use wRVU as the basis for compensation

o For those who use wRVU, average target or threshold is 4,763

Several unsure of the basis of their compensation

Most here stated they were salaried

Some Physicians Have Compensation Tied to Quality Metrics and About Half Use wRVU as the Basis for Their Compensation

EP3. What is the basis for your compensation related to patient care? EP3a. What is the wRVU for a clinical FTE in your practice? EP4. Is any part of your patient care compensation tied to quality metrics?


47

N = 378

HIV and Stewardship are the Highest Focus Areas for Employed Physicians

49 D10: Please indicate if your work has a particular focus [select all that apply].


Pediatrics* HCV & HIV*


ship)*

HIV and Steward-

ship* HIV*

IC and Steward-

ship* IC only*

Steward-ship

only*

General ID/Other

7% ($208K)

20% ($258K)

14% ($258K)

5% ($216K)

12% ($219K)

8% ($238K)

5% ($238K)

8% ($243K)

20% ($240K)

N = 379


N=379



[Median] [Range]

Patient Care 100% 78% [80%] [10 – 100%]

Epidemiology/Infection Control 39% 16% [10%] [1 – 90%]

Anti-microbial Stewardship 35% 13% [10%] [1 – 70%]

Teaching 25% 12% [10%] [1 – 50%]

Bonus 14% 14% [10%] [1 – 50%]


EP2: Approximately, what percentage of your income comes from these services?

Patient Care Accounts for Most of the Income, with a Mix from Other Services, for Hosp/Clinic Employed Physicians


49


N=379



[Median] [Range]

Hospital P&T or other facility/system wide committee 12% 6% [5%] [1 – 30%]



[10%] [1 – 75%]

Patient Safety / Healthcare Quality Improvement 9% 9% [5%] [1 – 32%]

Employee Health 5% 5% [5%] [1 – 10%]


Basic Research 2% 9% [10%] [5 – 10%]

EP2: Approximately, what percentage of your income comes from these services?

Very few Employed Physicians Engage in Services such as Employee Health or Basic Research


50

The Vast Majority of Employed Physicians Plan to Remain in Their Current Employment

52

72%

11% 7% 4% 3% 3% 0%

10%

20%

30%

40%

50%

60%

70%

80%

Remain in currentmodel

Retire Other Seek employment inacademics

Seek position in PH Seek to start/join aPP


% of Respondents

Other: • Unsure • Adopting telemedicine • Incorporate clinical research into practice • Hospital leadership • Training • Preventative medicine • Change fields completely

EP5. Looking ahead 5 years, which best characterizes your future plan?


N = 378

21% 18%

35%

26%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Incorporating clinresearch into practice

Adopting telemedicine Pursuing position inhospital leadership

Other


% of Respondents

Other Services:

• Wound care

• Teaching

• Public Health

• Stewardship

• Travel medicine

Employed Physicians Look to Pursue Positions in Hospital Leadership or Other Services to Expand Their Careers

EP6. In terms of expanding your career, what options have you identified?


52

N = 378

Most Employed Physicians Reported that Patient Care is Their Best Potential to Demonstrate Value

56% 24%

15% 5%


Patient care Antimicrobial stewardship svcs Infection control and prevention Other

EP7: What area below best represents your best potential for demonstrating your value as an D specialist to your practice?


53

N = 378

Detailed Findings AMC Employed

55

Sample Included 460 full-time Physicians who Report their Primary Affiliation is an Academic Medical Center

Male 55%

Female 45%

Gender

13% 20%

12% 12%

16%

14%

11% 5%

0%

5%

10%

15%

20%

25%

30%

35%

40%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age

Male Female

AMC Employed

D1: What is your gender? D2: What is your age?

Avg. = 48

55

N = 460

N = 460

Overall Private Practice Distribution by Community Setting and Years in Practice

57

47%

25% 17%

11%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


Years in Practice

Avg. YIP = 15

Urban 85%

Suburban

13%

Rural 2%

Type of Setting

D4: How would you describe the area in which you practice? D6. How long have you been in your profession since completion of your training program?

AMC Employed

N = 460

N = 460

58

Type of facility where see most patients

% of Respondents

(n=460)

Salary Average

[Median] [Range]

Hospital (Inpatient) 67% $195,277 [$180K] [$78-$700K]

Hospital (Outpatient) 27% $181,000 [$166K] [$100-$770K]

Other 6% $193,125 [$185K] [$125-$350K]

AM2. Please indicate your compensation plan status. D9: What type of facility do you see most of your patients? [Select one]

Full-time Academic physicians’ income averaged $191,485 ($78k -770K) Across All Facility Types

AMC Employed

40%

17%

42%

1%

Type of Compensation Plan

Not in comp plan (salary only)

Not in comp plan but potential for incentive

In comp plan

Other

N = 448

59

Academic Rank % of Respondents (n=460)

Salary Average

[Median] [Range]

Professor 27% $223,000 [$202K] [$78-$770K]

Assistant Professor 33% $188,500 [$174K] [$99-$430K]

Associate Professor 34% $171,300 [$166,500] [$87-$350K]

Instructor/Lecturer 2% $143,000 [$130K] [$100-$205K]

Other (Program Dir., Course Dir., Division Head, clinical assistant) 4% $195,600

[$190K] [$140-$310K]

AM1: What is your academic rank?

Professors Report the Highest Income, Followed by Other Academic Roles, such as Program Directors, etc.

AMC Employed

AMC Employed Men Report Higher Compensation with the Largest Gender Disparity in the 50-59 year Group

60

150

203

247 243

152 170

188 194

$0

$50

$100

$150

$200

$250

$300

30-39 YO 40-49 YO 50-59 YO 60+ YO


Male Female

AMC Employed

D1. What is your gender? D2. What is your age? AM. What is your total annual gross income?

N = 460

58% 11%

3% 11% 17%

0%

20%

40%

60%

80%

wRVU Total Coll Total Bill Don't know Other

Basis for Compensation

% of Respondents

• 18% of physicians reported any part of their patient care compensation is tied to quality metrics such as C-diff, CLABSI or CAUTI infection rate

o No unique commonalities were found versus the overall group

• Almost 60% used wRVU as the basis for compensation

o For those who use wRVU, average target or threshold is 3,824

Several unsure of the basis of their compensation

Most here stated they were salaried

Some AMC Employed Physicians Have Compensation Tied to Quality Metrics and More Than Half are based on wRVUs

AM5. What is the basis for your compensation related to patient care? AM5a. What is the wRVU for a clinical FTE in your practice? AM6. Is any part of your patient care compensation tied to quality metrics?

AMC Employed

61

N = 446

Pediatrics and HIV are the Highest Focus Areas for AMC Employed Physicians

62 D10. Please indicate if your work has a particular focus [select all that apply].

AMC Employed

Pediatrics HCV & HIV HIV & IC (w/or w/o steward-

ship)

HIV and Steward-

ship* HIV

IC and Steward-

ship* IC only Steward-

ship only

19% ($175K)

13% ($190K)

4% ($175K)

3% ($212K)

18% ($188K)

6% ($209K)

8% $198K

5%

($201K)

N = 449


N=449



[Median] [Range]

Patient Care 100% 61% [60%] [10 – 100%]

Academics/Teaching 51% 16% [10%] [1 – 75%]


Epidemiology/Infection Control 27% 29% [25%] [1 – 80%]


Anti-microbial Stewardship 23% 20% [10%] [1 – 65%]

AM2. Approximately, what percentage of your income comes from these services?

Patient Care Accounts for Most of the Income for AMC Employed Physicians, with a Mix from Other Services

AMC Employed

63


N=449

Service % of Physicians who perform % of Income this activity represents

Average [Median] [Range]


[11%] [1 – 75%]

Bonus 11% 8% [5%] [1 – 28%]

Patient Safety / Healthcare Quality Improvement 7% 16% [10%] [3 – 75%]

Basic Research 6% 19% [10%] [3– 55%]


Hospital P&T or other Facility/System-Wide Committee 6% 11%

[5%] [1 – 25%]

Employee Health 3% 7% [5%] [1 – 20%]

AM2: Approximately, what percentage of your income comes from these services?

Very Few AMC Physicians Engage in Services such as Employee Health, Basic Research or Hospital P&T

AMC Employed

64

The Majority of AMC Employed Physicians Plan to Remain with Their Current Employment

65

74%

9%

17%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Remain in current model Retire Other


% of Respondents

AM7. Looking ahead 5 years, which best characterizes your future plan?

Seek employment in different areas: 5% Other (not sure, change to another field, etc.) 4% In health system 3% In academics 2% In private practice 2% Industry 1% Public Health

AMC Employed

N = 447

36%

10%

30% 31%

21%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Incorporating CR Telemedicine Leadership Teaching Other


% of Respondents

Other Services:

• Wound care

• Travel medicine

• Teaching

• Infection control

• Industry consulting

• Medical journalism

• Quality improvement

• Moonlighting for other primary care

• Disaster preparedness

AMC Employed Physicians See Incorporating Clinical Research and Pursuing Hospital Leadership as Career Opportunities

AM8. In terms of expanding your career, what options have you identified?

AMC Employed

66

N = 447

41%

11% 15%

6%

13%

9% 4%


Patient care Antimicrobial stewardship Infection control and prevention

Quality improvement/patient safety Teaching Conducting research

Other

Most AMC Employed Physicians Reported that Patient Care is Their Best Potential to Demonstrate Value

AM9: What area below best represents your best potential for demonstrating your value as an ID specialist to your practice?

AMC Employed

67

N = 447

Detailed Findings Research Physicians (Basic or Clinical)

68

Sample Included 351 Full Time Physicians Who Report Their Primary Responsibility As Research

Male 60%

Female 40%

Gender

10% 17% 16% 14%

3%

11%

14% 9%

5%

0%

5%

10%

15%

20%

25%

30%

35%

Age

Male Female


Research

Avg. = 50

N = 351

N = 351

70

44

19 25

12

0

5

10

15

20

25

30

35

40

45

50

< 10 years 11-20 years 21-30 years 31-40 years

Years in Practice

97%

3%

Working Status

Full time Part time

R6. Please indicate your working status. R5. How long have you been in your profession since completion of your training program

Almost All Research Physicians Work Full-time and ~ Half Report Being in Practice 10 years or less

Research

Avg. YIP = 16

N = 363 N = 349

Majority of Physicians in Research are in an Urban Area

71

Urban 88%

Suburban 11%

Rural 1%

Community Setting

D4. How would you describe the area in which you practice?

Research

N = 351

Most Researchers Do Not Sit in an Administrative Appointment at Their Facility

72

28%

72%

Perform in academic administrative appointment

(dean, chair, etc.)

Yes

No

Research

R4. Do you have an academic administrative appointment (i.e. dean, chair, division chief, etc.)?

N = 351

Almost 60% report Their Institution Does Not Provide Subsidies and Most Are Not in a Set Compensation Plan

73

45%

12%

35%

9%

Type of Compensation Plan

Not in comp plan (salary only)Not in comp plan but potential for incentiveIn comp planOther

R9. Does your institution provide subsidies for your work such as provision of support staff, technician, free core services, etc.? R7. Please indicate your compensation plan status.

Research

41%

59%

Institutional provision of subsidies for work

Yes, provides subsidies No, does not provide subsidies

Other = Salaried with or without bonus

N = 351

N = 351

Federal Industry Non-Profit Other

Avg. # of research grants 4 [3] [0-15]

Avg. # sponsored 3 [2] [0-14]

1 [0] [0-100]

N/A N/A

Annual Direct funding $1,476,000 [$500K] [$2K-$40M]

$407,000 [$118K] [$4,500-

$12M]

$421,000 [$100K] [$2K-$3M]

$2,900,000 [$100K] [$12K-$80K]

% from sources 81% 7% 6% 6%

R12. How many research grants are you currently receiving support on? ________ R13. How many are: Federally sponsored? __________ Industry Sponsored? __________ R14. What is the annual direct research funding (in dollar amounts) of grants supporting your work and what percentage comes from these sources?

Most Research Grants are Federally Spon Research

75


[Median] [Range]

Full time (n=351)

Part time (n=12)

$199,110 [$175K] [$52-$750K]

$160,772 [$182K] [$50-$240K]

Overall Salary by Gender Full Timers Average

[Median] [Range]

Male (n=209)

Female (142)

$215,274 [$195K] [$52-$750K]

$175,319 [$152,832K] [$56-$700K]

Full-time Research Physicians’ Income Averaged $199,110 with Males Overall Earning a Higher Income

Research

76

134

170

251 280

120

161

233 231

$0

$50

$100

$150

$200

$250

$300

30-39 40-49 50-59 60+


Male Female

Research Overall men report higher compensation, the largest disparity was in the 60+ year old group

D1. What is your gender? D2. What is your age? R. What is your total annual gross income?

N = 351

77 R3. What is your academic rank? R8. What is your total annual gross income?

Research Professors Have Significantly Higher Incomes than Assistant and Associate Professors

Academic Rank % of Respondents Salary


Professor 40% $260,863 [$234,500] [$52-$750K]

Assistant Professor 33% $143,750 [$135K] [$65-$600K]

Associate Professor 17% $180,334 [$173K] [$105-$320K]

Instructor/Lecturer 5% $97,818 [$95K] [$65-$143K]

Other (Senior Directors, clinical faculty) 5% $239,275 [$183,000] [$54-$580K]

N = 351


N=351


% of Time this activity represents

Average

% of Income this activity represents

Average

Patient Care 84% 27% 23% [20%] [1 – 100%]

Teaching 77% 12% 11% [10%] [1 – 70%]

Clinical/Translational Research 80% 76% 61% [65%] [2 – 100%]

Basic Research 40% 52% 58% [60%] [5 – 100%]

Administration 60% 19% 23% [15%] [2 – 10%]

Epidemiology/Infection Control 9% 13% 12% [10%] [1 – 30%]

R11: Approximately, what percentage of your income comes from these services?

Research Accounts for Most of Their Income, with a Mix from Other Services

Research


N=351


% of Time this activity represents

Average

% of Income this activity represents


Other Sources 7% 15% 34% [20%] [1 – 100%]

Antimicrobial Stewardship 7% 9% 19% [10%] [1 – 50%]

Hospital P&T or other facility/system side committee 7% 5% 13%

[5%] [1 – 50%]

Patient Safety/Healthcare Quality Improvement 5% 7% N/A

Expert Witness Testimony/External Consultant 5% 5% 9%

[5%] [1 – 33%]

Employee Health 1% 12% 15% [N/A]

R11: Approximately, what percentage of your income comes from these services?

Very Few Research Physicians Engage in Services such as Employee Health or Patient Safety

Research

The Majority of Research Physicians Plan to Remain in Current Employment

80

76%

5% 9% 10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Remain in my currentemployment model

Seek employment inacademics

Retire Other


% of Respondents

R16. Looking ahead 5 years, which best characterizes your future plan?

Research

Seek employment in different areas

N = 351

76%

13% 3% 8% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Conducting research Patient care Teaching Other


% of Respondents

Most Reported that Conducting Research is Their Best Potential to Demonstrate Value

R17: What area below best represents your best potential for demonstrating your value as an ID specialist to your practice?

Research

Quality improvement Antimicrobial stewardship Infection control

N = 351

Detailed Findings Public Health

82

Male 43%

Female 57%

Gender

6% 7%

14% 17%

12%

17%

12%

14%

0%

5%

10%

15%

20%

25%

30%

35%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age

Male Female

Public Health Sample Included 60 Full-time Physicians who Report

Their Primary Responsibility as Public Health

Avg. = 50

D1: What is your gender? D2: What is your age?

N = 60

N = 60

84

31 26

31

12

0

5

10

15

20

25

30

35

< 10 years 11-20 years 21-30 years 31-40 years

Years in Practice

85%

15%

Working Status

Full time Part time

PH4. Please indicate your working status. PH3. How long have you been in your profession since completion of your training program?

Public Health The Majority of Those in Public Health Work Full-time

Avg. YIP = 17

N = 71

N = 60

85

Urban 88%

Suburban 8%

Rural 4%

Community Setting

D4. How would you describe the area in which you practice?

Public Health Majority of Physicians in Public Health are in an Urban Area

86


[Median] [Range]

Full time (n=60)

Part time (n=11)

$180,845 [$180K] [$96-$260K]

$143,194 [$150K] [$65-$262K]

Overall Salary Full Timers Average

[Median] [Range]

Male (n=26)

Female (34)

$193,077 [$204K] [$115-$260K]

$171,491 [$175K] [$96-$250K]

Full-time Public Health Physicians’ Income Averaged $180,845 with Males Overall Earning a Higher Income

Public Health

87

140

167

218 212

152

175 181 179

$0

$50

$100

$150

$200

$250

30-39 40-49 50-59 60+


Male Female

Public Health Public Health Physicians’ Income Averaged $180,845

D1. What is your gender? D2. What is your age? PH. What is your total annual gross income?

N = 60

Federal Government Employees Command the Highest Income on Average in Public Health

88

Primary Work Location with Mean Income

PH2. Where is your primary site of work? PH6. What is your total annual gross income?

Public Health

Primary Work location % of Respondents (n=60)

Salary Average

[Median] [Range]

Federal government 38% $188,803 [$200K] [$115-$260K]

State 15% $183,801 [$180K] [$132-$239K]

County 25% $181,641 [$180K] [$96-$229K]

Academic 15% $161,600 [$156K] [$132-$210K]

Other (private contractor) 7% $168,750 [$160K] [$140-$215K]

89

TB clinic, 18%

HIV clinic, 39%

STD clinic, 18%

Other, 24%

Type of Public Health Setting

Yes 55%

No 45%

See Patients in a Public Health Setting

(e.g. Indian Hospital or Travel Clinic)

N = 33 N = 60

PH5. Do you see patients in a public health setting? PH5a. In what setting?

Public Health 55% Report Seeing Patients in the PH setting

90

Yes 12%

No 88%

Compensated for Non Clinical Duties

On official time 85%

On own time 9%

Not at all 6%

Type of Time Spent on Infectious Disease Patients

N = 33 N = 33

PH5b. How do you see patients as an infectious disease/HIV specialist? PH5c. If you see patients as an infectious disease/HIV specialist on official job time in your public health

role, do you receive additional or enhanced payment beyond your normal pay for your non-clinical duties?

Public Health Most See Patients on Official time Yet Few Receive

Additional Compensation for Non-clinical Duties

Service % Physicians who Perform Service

N=60

Mean % of Income Received for Service

N=60

Epidemiology/Infection control 65% 50%

Patient care 62% 21%

Teaching 51% 14%

Other Sources 33% 50%

Grant Funding 29% 25%

Patient Safety/Healthcare Quality Improvement 26% 15%

Program Director 23% 40%

Antimicrobial Stewardship 17% 19%

Employee Health 10% 10%

Basic Research 9% 12%

Expert Witness testimony/External Consultant 9% 9%

Hospital P&T or other facility/system-wide committee 7% 9%

PH7. Approximately, what percentage of your income comes from these services

Public Health PH Physicians Perform Mostly Epidemiology and

Infection Control

The Majority of Public Health Physicians Plan to Remain with Current Employment

92

67%

7%

17% 11%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Remain in currentposition

Look for position inindustry

Retire Other


% of Respondents

R16. Looking ahead 5 years, which best characterizes your future plan?

Public Health

Seek employment in different areas

N = 60

22% 15%

27%

37%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Patient care Research Pursuingleadership

Other


% of Respondents

Public Health Physicians Report a Wide Variety of Opportunities To Expand Their Career

PH9. In terms of expanding your career, what options have you identified?

Public Health

• Industry consulting

• International work

• Healthcare policy

• Informatics

93

N = 60

Detailed Findings Other

94

2% 12%

27% 27%

6%

10%

12% 6%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

30-39 YO 40-49 YO 50-59 YO 60+ YO

Age

Male Female

Other 180 Classify Themselves as Full-time “Other” – Very Few Commonalities Exist, Although Most Tend to be Older (50+)

Avg. = 55


Male 67%

Female 33%

Gender

95

N = 180

N = 180

96


[Median] [Range]

Full time (n=180)

Part time (n=7)

$295,200 [$260K] [$65K-$1M]

$564,750 [$92K] [$75-$2M]

Overall Salary Full Timers Average

[Median] [Range]

Male (n=121)

Female (n=59)

$325,583 [$300K] [$65K – $1M]

$234,753 [$210K] [$104-$700K]

Overall salary of those categorized as “Other”

O5: What is your total gross income?

Other

Examples of specific titles of those who select “Other”

• Department chair • Director Stewardship (Antimicrobial) • Division and Fellowship Director • Division Chief (Pediatric ID) • Head of Department of Pediatrics • Director of Marketing • Senior Associate Dean • PD for ID fellowship • Hospital CEO • Department Administration Head • Medical Director • Global Head of Health Practice • VP of Medical Affairs

97 O2: Please describe your responsibilities.

Other

Appendix

Appendix

99

Survey Instrument

infectious disease physician compensation - idsa several organizations, such as medscape, mgma, and...

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