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AMERICAN ACADEMY OF OTOLARYNGOLOGY–HEAD AND NECK SURGERY

Analysis: Income

INCOME This year, we were again able to describe robust and nuanced income data that can benefit our specialty. Looking at the opposite side of resident income expectations, we were able to show the starting base salaries across different practice settings (Figure 9.1). There appears to be a slight disconnect between what residents are expecting and what is offered, at least on a base salary level. More potential for income exists via bonuses, which are widely available in all practice settings (Figure 9.2). These two sets of data might help decrease friction and ease recruitment as residents transition into practice. Notably, clinical income increased, on average, in all practice settings between 2021 and 2022. Private practices saw the largest increases, which may imply that 2021 income was disproportionately affected by COVID-19 in these settings. Given private practice compensation models described in the 2022 report, added marginal revenue likely has a disproportionate effect on private practice. Clinical income appears to peak in one’s 50s, with declines and increased variability thereafter (Figure 9.4). While the clinical income benchmarking across age described here represents the recent state of affairs and does not include ancillary income, it remains notable that resident salary expectations five years into practice are more in line with the peak income decade. Tempered expectations may be warranted.

environments, although still common in other private practice environments (Table 9.2). While the differences in male and female ancillary income receipts may reflect duration of practice (as suggested in our 2022 report), it remains notable that males in Solo Practice and Private Multispecialty Group environments had a much higher likelihood of capturing ancillary income (Table 9.3). Further analysis is warranted, but this may reflect differences in the type of Solo Practice and whether ancillary income is generally available. Ancillary income amounts were similar between 2021 and 2022, both in terms of degree and practice environments, with one notable exception. Nonacademic Hospital physicians both had an increased percentage reporting ancillary income being available (Table 9.2) and also earned substantially more in 2022 when receiving it. Academic physicians also reported an increased availability of ancillary income in 2022. Despite the median comparisons between 2021 and 2022, we saw the largest portion of respondents reporting clinical income increases in the Academic practice environment. Note, this doesn’t speak to quantity – just a directional amount – which could explain the prior income amount change findings. Once again, we saw those in Solo Practice reporting the highest rate (30%) of clinical income declines (Figure 9.5). Advocacy and policy should be crafted around their pain points noted in both the 2022 and 2023 reports in order to ensure a healthcare environment supportive of Solo Practice.

Like our findings in the 2022 report, ancillary income was most common in Private Single-specialty Group

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THE 2023 OTOLARYNGOLOGY WORKFORCE