Despite being below the middle earners for more than 29 physician specialties surveyed in the past several years, nephrologists are among the few medical specialists to see a notable increase in earnings year-over-year, according to the Medscape Nephrologist Compensation Report 2021. Nephrologists averaged earnings of $311,000 in the most recent survey year of 2020 versus $306,000 in 2019 and $305,000 in 2018. However, as with all other medical specialties, nephrologists were not entirely immune to the COVID-19 pandemic’s financial impact.

The most recent Medscape report details some of this financial impact, with the key findings including:

  • A large majority (87%) of nephrologists who saw a drop in income cited COVID-19-related issues, like job loss, reduction in hours, and reduction in patient volume.
  • Nephrologists spent far more time on average this year (19.8 hrs/week vs 16.7 hrs/week) from the previous year, on medical-related work outside of patient visits, including time devoted to paperwork, EHR documentation, administrative and managerial work, participation in professional organizations, and clinical reading. This was the third highest time spent among the specialties surveyed, with the overall average for all physicians by comparison at just 16.3 hours per week on such tasks.
  • Nephrologists averaged 56 work hours per week, which was up slightly from last year’s 54.
  • Of self-employed nephrologists, 49% believe that a drop in patient volume of up to one-quarter is going to be permanent.

The report also detailed some positives, including:

  • Of nephrologists, 26% who suffered financial- or practice-related ill effects due to the pandemic expect their income to return to normal this year, with 59% expecting it to return to normal within the next 2-3 years.
  • Nephrologists are seeing slightly more patients per week on average this year, at 92, versus 89 during the previous year. This contrasts with other medical specialists, like pediatricians, dermatologists, orthopedists, and otolaryngologists, who were seeing 15% to 18% fewer patients than in the previous survey year.

The report also notes that 37% of nephrologists who responded to the survey were planning to participate in the Merit-based Incentive Payment System (MIPS) in 2021, with a near equal percentage having yet to decide. According to a quote from Elizabeth Woodcock, MBA, CPC, president of physician practice consulting firm Woodcock & Associates in Atlanta, the stakes for the Quality Payment program, which incorporates MIPS, are high, with a 9% penalty applied to all Medicare reimbursement for failure to participate.