Telehealth Cited as Key Reason for Increase in Physician Revenue in 2020

F.J. Thomas

Sarasota, FL ( – A new survey from Medical Economics shows that physicians in private practice made around $14,000 less last year than in 2019. HRA, an analytical branch of MJH Life Sciences, conducted the survey via email invitations sent out the first quarter of this year, and asked physicians how their practice had fared this last year in comparison to previous years.

Family medicine and internal medicine made up the bulk of primary field of practice at 19 percent, and 13 percent, respectively. Psychiatry accounted for 7 percent; cardiology and emergency medicine accounted for 3 percent each, surgical specialty totaled 2 percent.

Private practice accounted for the bulk of respondents at 55 percent, with hospital practices accounting for 16 percent. Solo practices made up the majority of practice types at 31 percent, followed by practices of 3 to 10 providers at 24 percent. Large practices of 50 or more physicians accounted for 18 percent of the respondents.

Long-term providers with 21 to 30 years of practice made up the majority of participants at 29 percent. Physicians with 11 to 20 years of practice accounted for 19 percent, followed by 30 to 35 years at 18 percent. Physicians with up to 5 years’ experience accounted for only 1 percent. Older physicians aged 65 and older, and 55 to 64 were the largest age categories at 35 percent each, followed by 45 to 54 at 23 percent. Physicians under the age of 35 accounted for only 1 percent. Overall, 68 percent of respondents were male, and 31 percent were female.

Overall, 72 percent of physicians their income had decreased in 2020. Twenty percent stated that their income had not changed, and 7 percent stated that their income had actually increased. When comparing directly to 2019, 46 percent stated that their income was worse, 43 percent stated it was about the same, and 11 percent stated that their income had increased. In the comparison of 2019 to 2018, only 22 percent stated that their income had declined in the previous year, 55 percent stated it had remained the same, and 23 percent stated their income had increased.

When asked about the reasons for a decline in 2020, the leading reason given was COVID-19. More time spent on uncompensated tasks came in second, followed by lower reimbursement, higher overhead, and increased technology costs.

When asked about time spent on authorizations, 43 percent stated that 1 to 9 hours a week were spent on authorizations. Twenty-three percent stated they spent 10 to 15 hours per week on authorizations, and 15 percent stated they invested 20 hours per week.

When asked about the reasons for an increase in revenue last year, an increase in patient load was the top answer. Increased telehealth came in second, followed by change in practice model, renegotiated payer contracts, and addition of ancillary services.

When asked specifically about telehealth, 64 percent stated that they used telehealth for the first time to treat patients. Nineteen percent stated they increased their use of telehealth, and 16 percent stated there was no change to their telehealth use.

The most popular ancillary services implemented by internal medicine/family medicine physicians in 2020 was labs, with an increase in utilization from the previous year. ECG services came in second, but was a decrease from 2019. Imaging came in third with an increase from the previous year. Nutritional counseling remained the same. Pharmacy and pain management saw an increase over the previous year. Ancillary services accounted for 11 percent of internal and family medicine income.

Although the majority of physicians indicated their income had decreased within the last year, the number of physicians earning an income outside of their practice only increased slightly. In 2020, 33 percent stated they were working a second job compared to 30 percent the previous year. Seventeen percent of physicians working a second job worked in jobs that were non-medical. Consulting ranked as the top second job without any change from the previous year. Non-medical work came in second, followed by expert witness, clinic work, and medical administrator, all with increases from the previous year. Speaking engagements came in 6th, with the expected decline, followed by clinical trials and research which remained steady. Hospital and emergency department work were also cited as top side jobs with an increase over the previous year.

Pediatricians made the most at their second job at an extra $62,000 average pay. Family medicine providers picked up an average $53,000 in their side jobs, followed by internal medicine at $46,000.

The full survey results and June issue of Medical Economics is available for download.

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