The results of the ‘The Commonwealth Fund survey’ made headlines in 2014, when the US Healthcare system was declared the most expensive and least effective systems among the 11 industrialized and developed countries of the world (such as Germany, Sweden, Switzerland, Norway, Australia, the Netherlands, New Zealand, Canada, France and the United Kingdom).
As crazy as it may sound, the results didn’t come as a surprise for many (especially those who are directly or indirectly a part of the US healthcare industry). For example, average healthcare spending in United States is $8,508 (per person), approximately 3-times higher than in the UK, Sweden, Australia and New Zealand; yet a significant percentage of American population is uninsured or under-insured. So this leaves us with this burning question: Is the condition equally bad for doctors and other healthcare professionals?
Indeed not!
Most doctors in the USA complain about tough schedules, crazy working hours and other hardships of residency and fellowship training. But guess what? Most practicing doctors report a high degree of satisfaction and economic prosperity according to a new report.
Based on the latest Medscape compensation survey, in which more than 19,500 healthcare professionals participated from 25 specialties across the United States, the average annual compensation for physicians who are actively involved in patient care ranges from $195,000 (primary care providers) to $284,000 for specialists. This is definitely a lot higher than what healthcare professionals make in other parts of the world. For example, an average Canadian doctor makes $125,104 per annum, German physicians earn $131,809, and an English physician makes $159,532. In fact, healthcare professionals in countries like France and Australia make even lower annual incomes – $95,585 and $92,844 respectively.
Economic prosperity according to the specialty
Choosing a medical specialty is indeed one of the most difficult decisions of a doctor’s life. Of course a lot of thinking, research and analytics goes into making this vital decision (which may have a huge impact on your economic stability, emotional tranquility and career satisfaction). According to the 2015 Medscape compensation survey, clear winners are physicians who specialize in orthopedics, cardiology and gastroenterology, with annual physician compensation up to $421,000, $376,000 and $370,000, respectively. This trend is different from the findings of 2011 survey in which top earners were orthopedists, radiologists and anesthesiologists. On the other hand, pediatricians, endocrinologists and family physicians make roughly 50% of what these major players earn. This is definitely a point to ponder for physicians who need financial motivation as an incentive.
It is imperative to mention that most physicians can make a decent compensation via non-patient care activities (up to $7,000 if you are a pediatrician to as high as high as $29,000 if you are an orthopedist). This includes physician speaking engagements, product sales, expert witness duties, and other activities. The physician satisfaction scores are also found satisfactory according to the new results. About 50% of specialists and 47% primary care physicians believe that they are compensated fairly, with the highest satisfaction scores in specialties like dermatology, emergency medicine and pathology. The least satisfied of all physicians are ophthalmologists and general surgeons.
Interestingly, with the implementation of the Affordable Care Act, economic changes, and hospital shutdowns, it was initially anticipated that the average compensation of physicians would be negatively affected; yet fortunately, a significant increase has been observed in the compensation of almost all specialties (as high as 22% in specialties like infectious diseases). The only two specialties which have experienced a mild decrease in the annual compensation: urology (1%) and rheumatology (up to 4%).
Employment characteristics:
Unlike most other careers, physicians can work independently; however, it has been observed that most physicians would prefer working in the hospital environment. In fact, physician recruitment by hospitals has increased to 64%, according to latest statistics, from a mere 11% in 2004. Surprisingly, more women prefer hospital employment or working for a salary as compared to male physicians (72% vs. 59% males). It is imperative to mention that the average compensation of self-employed primary care providers ($212,000) is significantly higher when compared to the employed PCPs ($189,000). The same is true for specialists. Employed specialists make $258,000 vs. self-employed specialists, who make $329,000. This trend is expected to change over the course of the coming few years, owing to ACA impact. This will include termination of shared ACO savings contracts, meaningful use penalties, the uprising of competing retail clinics, websites that report payments and compensations, as well as changes in the CPT code.
It is generally believed that male professionals make more money when compared to their female colleagues. It seems like this trend is shrinking in the physician population (from 28% in 2011 to an overall 24% in 2015). For example, self-employed female physicians earn 23% less compensation than self-employed male physicians ($259,000 vs. $324,000 respectively). Likewise, the employed male physicians make 22% higher compensation than females ($249,000 vs. $203,000). It is, however, imperative to mention that lower compensation is not primarily due to gender inequality or political reasons. In fact, various survey and reports suggests that female physicians tend to work less weeks and fewer hours when compared to male physicians (about 24% female physicians work part-time as opposed to only 13% male physicians). In addition, the proportion of females in the high paying specialties is also low. For example, the proportion of female physicians in specialties like obstetrics & gynecology and pediatrics is 50%, whereas the percentage of female physicians in the highest paying specialties is 14%, 12% and 9% for gastroenterology, cardiology and orthopedics, respectively.
Other interesting findings in regards to the physician compensation are:
- Geographical location and competition among physicians can greatly influence compensations. For example, physicians in the South Central and Northwestern region make the most money (an average physician makes $271,000 and $281,000, respectively). In comparison, physicians in the Mid-Atlantic and Northeast have the lowest earnings.
- States offering the highest physician compensation are Alaska ($330,000), North Dakota ($330,000) and Wyoming ($312,000), and the lowest earning states are Maryland, Rhode Island and District of Columbia.
- Most young physicians prefer to work full-time. Only 6% of physicians under 35 years of age and about 12-14% of the physicians between 25 to 64 years work part-time. About one-quarter of the physicians over the age of 65 work part-time.
To conclude, physicians and medical professionals are fairly satisfied and are coping fairly well with all the economic and political changes going on in the United States. For most physicians, the most rewarding element of their career is not money. For approximately 64% of male physicians and 68% female physicians, the most satisfying part of their profession is to be good at what they do and to maintain healthy relationships with their patients. Hopefully, this will also help in improving the patient satisfaction scores, the standard and quality of the services delivered within the US, and the global ranking of US healthcare systems.
References:
- http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
- http://www.staging.medscape.com/features/slideshow/compensation/2015/public/overview
