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Physician wages across specialties: informing the physician reimbursement debate.

Authors
Leigh-JP; Tancredi-D; Jerant-A; Kravitz-RL
Source
Arch Intern Med 2010 Oct; 170[19]:1728-1734
NIOSHTIC No.
20037772
Abstract
Background: Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. Methods: In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. Results: In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Conclusions: Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.
Keywords
Physicians; Surgeons; Health-care; Health-care-personnel; Medical-care; Medical-personnel; Medical-services; Medical-surveys; Health-services; Health-surveys; Mathematical-models; Demographic-characteristics
Contact
J. Paul Leigh, PhD, Department of Public Health Sciences, University of California Davis School of Medicine, TB 168, Davis, CA 95616-8638
CODEN
AIMDAP
Publication Date
20101025
Document Type
Journal Article
Email Address
pleigh@ucdavis.edu
Funding Type
Grant
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008248
Issue of Publication
19
ISSN
0003-9926
Source Name
Archives of Internal Medicine
State
CA
Performing Organization
University of California - Davis
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