By Eric Rosenberg, WCI Contributor

There are several pressures facing US healthcare workers today, not the least of which is compensation. Recently released data suggests average pay for doctors decreased by 2.4% in 2022 after increasing an average of 3.8% in 2021. With increases in income being erased and a 2% Medicare payment cut on the horizon, many physicians, including nephrologists, are reassessing their careers.

Nephrologists are close to average when it comes to earnings for doctors. Let’s explore how much they make compared to other medical professionals and their outlook on future earnings. We’ll use data from a 2023 Medscape report, which considered the responses of 10,000 physicians in 29+ specialties to questions about salary, bonuses, and general sentiment about their careers. 

 

Nephrologist Average Salary

Nephrologists diagnose and treat kidney diseases, and they are considered a niche group among internal medicine professionals. Most students in medical school do not consider a career in nephrology, partly because it’s considered more challenging. 

It’s also possible that lower-than-average pay contributes to the limited interest in this field. Medscape’s compensation report for nephrologists found that they earned an average annual salary of $312,000, slightly below average relative to other specialties included in the survey.

 

The two fields with the highest pay in 2023—plastic surgery and orthopedics—reported average annual salaries above $550,000. Meanwhile, the two lowest earning fields from the report—pediatrics and public health/preventive medicine—saw average salaries of about $250,000.

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Financial Independence on a Low Income

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Is Nephrologist Income Rising?

Nephrology income decreased by 5% in 2023, dropping from the previous year’s average of $329,000. In 2022, nephrologists saw their average income increase by 6%, but the Medscape report from that year noted that COVID-19 took a toll on medical practices’ finances in 2021, likely affecting results. 

The 5% decrease places nephrology near the bottom of the 29+ specialties that Medscape surveyed for change in income. Other fields that saw a similar decline in compensation this year included rheumatology and emergency medicine. The Medscape report cited “Medicare cuts and somewhat stagnant reimbursement relative to the cost of practice” as factors reducing some physicians’ income.

It’s also important to remember that high inflation has persisted since peaking in June 2022, chipping away at physicians’ purchasing power.

 

Do Nephrologists Have Incentive Bonuses?

The most recent data for this question from Medscape comes from 2020, when nephrologists earned an average incentive bonus of $50,000. In 2023, specialists in orthopedics and cardiology earned $134,000 and $88,000 in bonuses, respectively. 

Nephrologists and physicians overall cited non-physician practitioners as their most significant source of competition. Also noteworthy: 37% of nephrologists took on other medical or non-medical work to supplement their income in 2023. Sixty-three percent of nephrologists reported they didn’t take on extra work to earn more money, a decrease of 6% from the prior year.

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Do Self-Employed Nephrologists Make More Money?

Self-employed physicians tend to make more money than employed physicians. According to the Medscape report, the average annual salary for self-employed physicians was $374,000, compared to employed physicians’ $344,000. Medscape notes that the number of self-employed physicians is dwindling, with 74% of physicians now saying they’re employed.

The 2023 Medscape report did not specifically provide data on self-employed nephrologists’ compensation. 

nephrologist salary

 

Do Nephrologists Feel Fairly Compensated?

Nephrologists do not feel fairly compensated, falling near the bottom of all physicians surveyed when asked this question. With only 43% of nephrologists feeling they’re paid a fair amount, it’s unsurprising that nephrology has a reputation for being a less popular field. 

Preventive medicine and public health specialists made less on average than nephrologists in 2023, but 65% felt fairly compensated that same year. Pediatrics and internal medicine were other fields that placed low in physician satisfaction with compensation.  

Sixty-nine percent of nephrologists said they would choose a career in medicine again if given the chance, a 2% drop from the previous year’s report. Nephrologists also placed low when asked if they would choose their specialty again—only placing higher than family medicine, internal medicine, and public health and preventive medicine specialists. 

This could, in part, be because nephrologists place relatively high when it comes to how much time they spend doing paperwork and administrative duties. Averaging 18.1 hours per week, nephrologists completed about nine additional hours of paperwork each week than anesthesiologists in 2023. The average time physicians spent doing paperwork overall was 15.5 hours per week.

 

Other Sources

The Medscape survey is not the end-all and be-all of physician salary data. Here are other nephrology salary numbers from reports done around the same time as the recent Medscape survey.

  • MGMA: $384,596
  • AAMC: $284,000
  • AMGA: $310,000

 

Increasing Your Physician Income

One of the most important things you can do to earn more for your work is to negotiate your pay and the terms of your contract. Many doctors wind up with bad contracts that leave them improperly compensated, facing high costs and non-compete agreements that restrict their future opportunities. If you’re negotiating a new contract, WCI has a list of vetted attorneys and law firms to work with to ensure you get a good deal.

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