Specialist and primary care pay per hour

Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists.

As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make.

I think this is a good approach, since annual salary figures do not account for the number of hours doctors work — and in the case of primary care doctors, this includes uncompensated time doing paperwork and other bureaucratic chores.

Here’s what they found:

… the lowest wages — amounting to $60.48 an hour — [were] paid to primary care physicians.

In other broad categories of practice, surgeons took home the highest average hourly wage of $92. Internal medicine and pediatric docs earned about $85 an hour, the researchers report in the Archives of Internal Medicine.

Looking at salaries among 41 specific subspecialties, however, they found neurologic surgery and radiation oncology to be the most lucrative at $132 and $126 per hour, respectively. These were followed by medical oncologists and plastic surgeons, both making around $114 per hour; immunologists, orthopedic surgeons and dermatologists also took in more than $100 an hour. At the low end of specialist pay, child psychiatrists and infectious disease specialists made around $67 an hour.

Of course, regular readers of the blog know that health care reform will do little to decrease the disparity. The pay raises that will be coming to primary care will be far too little to change the perception that, in the United States, specialists are more valued by far.

Lead researcher J. Paul Leigh is blunt about how to solve the problem — and probably will endure the wrath of specialist physicians nationwide:

Some of the proposed health care reform laws would increase wages for primary care physicians, noted Leigh. But he doesn’t think that is enough. He suggests cutting wages of specialists too.

“Not only are primary care physicians undervalued by society,” Leigh said, “but the specialist is overvalued and overcompensated, while not really adding much bang for the buck as far as public health is concerned.”

Everyone acknowledges that primary care is undervalued in this country. 80% of doctors, in fact, support a pay raise for beleaguered generalists. But when asked if specialists should receive a 3% pay cut to offset the raise, less than 40% supported that idea.

And that’s why primary care will continue to suffer for the foreseeable future.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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