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Karen Mason

Is the theory that specialists make more than a primary care physician still holding true? Is the battle of the sexes continuing in the healthcare field when it comes to what male physicians make versus their female counterparts? Do physicians in different areas of the country make different amounts? Several surveys that looked at physician compensation in the United States seem to indicate the answer is yes to all three questions.

Compensation growth for primary care and specialty care physicians was all over the board in 2010, and it appeared to be determined as much by location as by area of medical expertise, according to a survey from the Medical Group Management Association. The MGMA survey — Physician Compensation and Production Survey: 2011 Report Based on 2010 Data — surveyed nearly 60,000 providers. It is touted by MGMA as the largest and most representative provider population of any physician compensation survey in the United States.

Although some physicians reported an increase in their pay, the majority reported that their income remained flat from 2009 to 2010. Among primary care physicians: internists reported median compensation of $205,379 in 2010, an increase of 4.2 percent since 2009; family practitioners reported a median of $189,402, an increase of 2.9 percent; and pediatricians reported their median compensation was $192,148, an increase of .39 percent. Since 2006, the survey found median compensation has risen 15.5 percent for family practitioners, 13.3 percent for internists and 10.3 percent for pediatricians.

Specialists had an even greater variance. Orthopedic surgeons reported median compensation of $514,659 — the highest median of any specialty in the survey — up 3.7 percent from 2009 and 15.2 percent from 2006. However, urologists reported median compensation of $372,455, a drop of 4.66 percent from 2009 and up 4.15 percent from 2006. Another group, radiology/diagnostic, reported median compensation of $471,253, a drop of 1.6 percent compared to 2009 and up 5.5 percent from 2006.

“Many primary care specialties are not seeing the gain in income that specialties see,” said Karen Mason, senior marketing consultant with Merritt Hawkins, a medical search and consulting firm in Dallas. Merritt Hawkins has conducted an annual review of physician recruiting incentives including physician compensation for the past 18 years. “Internal medicine physicians, who have seen a 7 percent increase in the past year, are the exception,” Mason said. “It comes as no surprise that our 2011 survey reports the specialty that has seen the highest gain in income is urology.”

The medical website Medscape’s 2011 physician compensation report, which was based on 2010 data that utilized more than 15,000 physicians representing 22 specialties across the country, showed that radiology and orthopedic surgeons earned the highest amounts, with a median compensation of $350,ooo. The second highest paid specialists were anesthesiologists and cardiologists who reported median incomes of $325,000. Following these four specialties were, in descending order, urology, general surgery, gastroenterology and dermatology.

For primary care physicians, the income was substantially less; for some nearly $200,000 less. Pediatricians, at $148,000, reported the lowest median income in the Medscape survey. Just slightly ahead of them were internal medicine and family medicine, which had median salaries of $159,000.

The Merritt Hawkins 2011 review indicated that family practitioners and pediatricians earned the lowest pay of all physicians, $178,000 and $183,000 respectively. At the other end were cardiologists at $532,000 and orthopedic surgeons, who have a guaranteed average base salary of $521,000. Urology made the list at number three with an average of $453,000.

“Under our current Relative Value Unit (RVU) System, specialists are being paid more per Physician Work RVU. Because this reimbursement is more, the specialist is usually compensated higher than his or her primary care counterparts,” said Mason. “Recruiting physicians is becoming increasingly difficult due to the shortage of physicians. With our aging population and stagnant residency programs, this shortage will only increase. It is this short supply that is creating the demand and thus driving some physician incomes to increase.”

The Medscape survey also showed that compensation gaps are not just between primary physicians and specialists, but between genders as well. Although women now earn nearly half of all medical degrees, the gender compensation gap has increased in the last decade. Across specialties, female doctors earn a median income roughly $65,000 less than men. Looking at it another way, female doctors earn 71 percent of what a male doctor earns, and in the course of a 35-year career, female physicians will lose a total of $2.3 million on average. The gap in compensation greatly narrowed when it came to primary care where the difference in median income was only $30,000, with men earning $170,000 and women earning $140,000.

Some factors that may explain this disparity include firm size, specialty type and hours worked. Female physicians may compromise salary by choosing smaller clinics and opting for greater flexibility. Doctors in large firms with more than 100 physicians on staff earn $23,000 more per year than those in small private practices, the research found. Women generally spend fewer hours seeing patients than men and are twice as likely to spend less than 30 hours a week on patient care. The Medscape survey also indicated fewer women were represented in the higher income earning specialties, which may have lowered female median income.

“In a lot of specialties, the residents are more than 50 percent female, which is actually contributing to a physician shortage,” said Mason. “That’s because, statistically, women will work less due to their roles at home. This also attributes to why they are earning less.”

Whether you are female or male, being a doctor in West Tennessee seems to be a good thing since the MGMA survey found that median compensation for both primary care physicians and specialists was highest in southern states, with primary care physicians earning a median of $216,170 and specialists earning a median $404,000.

To obtain a copy of Merritt Hawkins’ 2011 Review of Physician Recruiting Incentives, contact Karen Mason via email karen.mason@merritthawkins.com or 1.800.306.1330

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