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April 25, 2012 — Psychiatrists earn an average of about $170,000 per year, slightly less than many other specialists, but they are among the top in terms of overall job satisfaction, according to new data collected in Medscape's Physician Compensation Report: 2012 .

The report, released this week, collected responses from February 1-17, 2012, from 24,216 US physicians (8% of whom were psychiatrists) across 25 specialties.

According to the survey, physician income declined in general, including for psychiatry, which dropped from $175,000 in last year's survey to $170,000 this year, although the top-earning specialties remained the same as in Medscape's 2011 survey.

In 2012, radiologists and orthopaedic surgeons topped the list at $315,000, followed by cardiologists ($314,000), anesthesiologists ($309,000), and urologists ($309,000). The bottom-earning specialties in the current survey were pediatrics, family medicine, and internal medicine.

About 6% of psychiatrists earned $300,000 or more — a slightly lower percentage than a year ago, whereas 1 in 5 respondents earned $100,000 or less, slightly more than in last year's survey.

Psychiatrists in the North Central region of the United States (Iowa, Kansas, Missouri, Nebraska, and North and South Dakota) earned the highest incomes, with a mean income of $188,000. The next-highest earners were in the Great Lakes region and the West, with a mean income of $182,000. Psychiatrists in the Northwest earned the least, with a mean income of $152,000.

Male psychiatrists reported a mean compensation of $182,000 compared with $151,000 mean earnings for women; however, male physicians across all specialties earned 40% more than their female counterparts vs a 20% difference in psychiatry.

A Satisfied Specialty

The 2012 survey showed a higher level of discontent among doctors across all specialties; just over one half of all physicians (54%) said they would choose medicine again as a career, which is much less than in the previous year (69%). However, psychiatrists nearly topped the list in terms of overall satisfaction (56%), second only to dermatologists (64%), and 59% felt they were fairly compensated.

The most discontented were plastic surgeons, with only 41% saying that they were satisfied overall. Internists (44%) and endocrinologists (45%) also expressed lower levels of satisfaction.

Just over half of psychiatrists reported spending 5 to 14 hours per week on paperwork and other non–patient related activities, about the same as in last year's survey.

The survey also found that about 35% of psychiatrists have 25 to 49 patient visits per week, whereas about 10% of psychiatrists see more than 100 patients per week. Nearly one half reported spending 25 minutes per patient or longer.

Jury Still Out on ACOs

In general, most psychiatrists are undecided or feel negatively about the effect of accountable care organizations (ACOs), a payment and delivery model that ties provider reimbursement to quality metrics and reduction in the total cost of care for an assigned patient population.

About 3 in 10 psychiatrists believe that ACOs will cause a decline in income, whereas 24% say that they will have little or no effect on income. About 46% said it's too soon to tell. Only about 18% of psychiatrists said these measures will lead to better patient care.

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