Nephrologists See Small Earnings Increase in 2020, Despite COVID-19

Nephrologists report that their average earnings in 2020 stayed steady — and even had a small increase. However, nearly half of self-employed nephrologists report a COVID-19–related reduction in patient volume that could be permanent, according to results from the Medscape Nephrologist Compensation Report 2021.

With average earnings of $311,000, nephrologists saw a small increase from the $305,000 reported in 2019, placing them close to the middle of the scale of earnings of medical specialties overall, in the survey of nearly 18,000 physicians in more than 29 specialties.

The leading specialty in terms of earnings is plastic surgery, with an average income of $526,000, and ranking last is public health and preventive medicine, with average annual earnings of $221,000.

Among nephrologists who did report declines in income, 87% cite COVID-19 factors, including job loss, reductions in work hours, and reductions in patient volume. About a third (34%) cite other factors unrelated to the pandemic.

Meanwhile, about a quarter (26%) of nephrologists say they expect income levels to bounce back to pre-pandemic levels within the next year, while 59% expect a return in the next 2 to 3 years.

Of physicians overall, about 45% report making it through the pandemic without experiencing financial or practice-related harms.

While some medical specialties have seen greater COVID-19 pandemic-related declines in patient load in 2020, nephrologists overall report their average number of patients per week in fact inched up a bit, from 89 to 92.

Likewise, physicians’ work hours overall declined during the pandemic, however, nephrologists saw their average number of work hours per week slightly tick up, from 54 hours per week reported in 2019 to 56 in 2020.

Meanwhile, the average amount of time nephrologists report spending on medical-related paperwork and administration, at about 19.8 hours per week, puts them near the top of the list of specialists, ranking third only behind infectious diseases (24.2 hours per week) and public health and preventive medicine (20.7). 

The average is furthermore a sharp increase from the 16.7 hours per week reported by nephrologists in 2019.

Of note, data collection for the survey was between October 6, 2020 to February 11, 2021, reflecting a snapshot of about 4 months in the second wave of the pandemic.

In terms of reimbursement issues, 78% of nephrologists report they will continue to take new and current Medicare/Medicaid patients, while 17% report not taking either new Medicare or Medicaid patients and/or no longer treating patients currently with that coverage.

Over 75% of Nephrologists Would Choose Specialty Again

About 55% of nephrologists say they feel fairly compensated, placing them slightly lower than average of overall specialties, but decidedly higher than the rate of just 44% who report feeling fairly compensated in 2019.

At the top of the list is oncology, with 79% feeling fairly compensated, and infectious diseases, at the bottom, with just 44%.

The most rewarding part of their job, said 28% of nephrologists, is “being very good at what I do/finding answers, diagnoses.” About a quarter of nephrologists say the most rewarding aspects include making the world a better place and having positive relationships with patients.

Conversely, the most challenging aspects of nephrology are “having so many rules and regulations,” cited by 26%, and “having to work long hours,” listed by 17% of nephrologists.

If given the choice, as many as 81% of nephrologists would choose a career in medicine again, slightly more than the 78% reported by all physicians and up a fair amount from the 75% reported by nephrologists in 2019 – despite the multitude of challenges of practicing in 2020.

Those rates are up significantly from the 2013 report, in which only a troubling 51% of physicians said they would choose medicine again.

In addition, 77% of nephrologists say they would choose nephrology again, placing the field fifth from the bottom of the list of specialties, however the rate is a bit of an increase from the 69% reported in 2019.

Topping the list are dermatology, orthopedics, and oncology, all with 96% saying they would choose the same specialty again.

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