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Forbes Rates the "Worst Paying Jobs for Doctors"
Forbes magazine counted down the "Worst Paying Jobs for Doctors" this week, and for many physicians in training the numbers are disquieting.
The No. 1 worst-paying doctor job? No surprise here: Family practice, where physicians earned an average of $175,000 last year, according to Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives. Indeed, primary care physicians earn the lowest salary of all doctors.
Pediatricians earned an average of $180,000, while family practitioners (including obstetrics) made $200,000, the Merritt Hawkins data show. Compare that to an orthopedic surgeon ($519,000) or a urologist ($400,000).
Is Physician Income Disparity Fair?
Why the great divide?
The indisputable fact is primary care physicians earn less than specialists because they don't generate the same level of revenue. According to the Merritt Hawkins survey of hospital revenues, specialists generated an average of $225,383 more in revenue per year for hospitals between 2002 and 2010.
Dr. Jeff Brown, who pens Physician's Money Digest's "Take As Needed" blog, addressed the issue of fairness in physician income disparities in a recent post. "Our effort is not equal, our results are not equal, our knowledge is not equal, and society values and incentivizes us differently. Is it "fair"? That's probably unanswerable and we need to realize that and just grow up," he writes.
Fair or not, that enormous disparity in physician income is keeping many young doctors from choosing primary care -- and rising costs and declining reimbursements from health insurers and government programs are driving many of those already in the profession out. The American Medical Association estimates there will be a shortage of 35,000 to 40,000 primary care doctors over the next 15 years.
Debt, Expenses Drive Doctors Out of Primary Care
It's no wonder physician income has become such a lightning rod for controversy in public policy today. A general perception exists among Americans that all doctor's are highly paid -- some would argue overpaid. But despite their six-figure salaries, many doctors today are struggling to pay the bills.
The average medical student graduates with an average of $156,456 in federal and private student loans, according to the AMA. That's just average; some doctors accumulate twice as much debt. With such suffocating debt, young doctors face an often difficult decision: Choose primary care -- a field that brings personal joy and satisfaction , but relatively low pay -- and work long hours while struggling for a decade or more to repay student debt. Or, choose a higher-paying specialty that affords a more flexible work schedule without the worry of being able to make the bills.
Debt isn't the only factor driving doctors out of primary care. This clip from "the Vanishing Oath," a film by Ryan Flesher, MD, illustrates how overhead costs, malpractice insurance and licensing fees slash physician’s take home pay to just $27.72 an hour ... or roughly $58,000 a year.
Top 10 Worst-Paying Jobs for Doctors
Source: Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives.
Solutions to the Primary Care Crisis
Forbes reports that the AMA and the American Academy of Family Physicians are discussing a number of ways to address the increasing shortage of primary care doctors, including an increase in scholarships for students who choose primary care, and expanded loan forgiveness programs for primary care physicians who work in rural and other underserved areas.
Mike Hennessy, Chairman and Chief Executive of MJH & Associates, the publisher of Physician's Money Digest, The American Journal of Managed Care, Pharmacy Times, MDNG and other publications, this month issued a call for action to address the shortage in primary care.
"The Haiti earthquake was a crisis. The Gulf oil spill is a crisis. The Cuban missile crisis was, indeed, a crisis. The Great Depression was a crisis. I’d like to add to that list another crisis that is on a different level, but that will without question -- and sooner rather than later – require an abrupt or decisive change: The primary care crisis. The profession of primary care physician in this country is dying. Fast," he wrote.
Hennessy says the profession needs a leader to develop a stronger national voice and articulate the repercussions of a pronounced shortage in primary care." Otherwise," he said, " needed attention will simply accrue to the next crisis of the times."
The No. 1 worst-paying doctor job? No surprise here: Family practice, where physicians earned an average of $175,000 last year, according to Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives. Indeed, primary care physicians earn the lowest salary of all doctors.
Pediatricians earned an average of $180,000, while family practitioners (including obstetrics) made $200,000, the Merritt Hawkins data show. Compare that to an orthopedic surgeon ($519,000) or a urologist ($400,000).
Is Physician Income Disparity Fair?
Why the great divide?
The indisputable fact is primary care physicians earn less than specialists because they don't generate the same level of revenue. According to the Merritt Hawkins survey of hospital revenues, specialists generated an average of $225,383 more in revenue per year for hospitals between 2002 and 2010.
Dr. Jeff Brown, who pens Physician's Money Digest's "Take As Needed" blog, addressed the issue of fairness in physician income disparities in a recent post. "Our effort is not equal, our results are not equal, our knowledge is not equal, and society values and incentivizes us differently. Is it "fair"? That's probably unanswerable and we need to realize that and just grow up," he writes.
Fair or not, that enormous disparity in physician income is keeping many young doctors from choosing primary care -- and rising costs and declining reimbursements from health insurers and government programs are driving many of those already in the profession out. The American Medical Association estimates there will be a shortage of 35,000 to 40,000 primary care doctors over the next 15 years.
Debt, Expenses Drive Doctors Out of Primary Care
It's no wonder physician income has become such a lightning rod for controversy in public policy today. A general perception exists among Americans that all doctor's are highly paid -- some would argue overpaid. But despite their six-figure salaries, many doctors today are struggling to pay the bills.
The average medical student graduates with an average of $156,456 in federal and private student loans, according to the AMA. That's just average; some doctors accumulate twice as much debt. With such suffocating debt, young doctors face an often difficult decision: Choose primary care -- a field that brings personal joy and satisfaction , but relatively low pay -- and work long hours while struggling for a decade or more to repay student debt. Or, choose a higher-paying specialty that affords a more flexible work schedule without the worry of being able to make the bills.
Debt isn't the only factor driving doctors out of primary care. This clip from "the Vanishing Oath," a film by Ryan Flesher, MD, illustrates how overhead costs, malpractice insurance and licensing fees slash physician’s take home pay to just $27.72 an hour ... or roughly $58,000 a year.
Top 10 Worst-Paying Jobs for Doctors
| Rank | Profession | Salary |
|---|---|---|
| 1. | Family Practice | $175,000 |
| 2. | Pediatrics | $180,000 |
| 3. | Internal Medicine | $191,000 |
| 4. | Family Practice (with Obstretrics) | $200,000 |
| 5. | Hospitalist | $208,000 |
| 6. | Psychiatry | $209,000 |
| 7. | Endocrinologist | $219,000 |
| 8. | Emergency Medicine | $247,000 |
| 9. | Obstretics/Gynecology | $272,000 |
| 10 | Neurologist | $282,000 |
Source: Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives.
Solutions to the Primary Care Crisis
Forbes reports that the AMA and the American Academy of Family Physicians are discussing a number of ways to address the increasing shortage of primary care doctors, including an increase in scholarships for students who choose primary care, and expanded loan forgiveness programs for primary care physicians who work in rural and other underserved areas.
Mike Hennessy, Chairman and Chief Executive of MJH & Associates, the publisher of Physician's Money Digest, The American Journal of Managed Care, Pharmacy Times, MDNG and other publications, this month issued a call for action to address the shortage in primary care.
"The Haiti earthquake was a crisis. The Gulf oil spill is a crisis. The Cuban missile crisis was, indeed, a crisis. The Great Depression was a crisis. I’d like to add to that list another crisis that is on a different level, but that will without question -- and sooner rather than later – require an abrupt or decisive change: The primary care crisis. The profession of primary care physician in this country is dying. Fast," he wrote.
Hennessy says the profession needs a leader to develop a stronger national voice and articulate the repercussions of a pronounced shortage in primary care." Otherwise," he said, " needed attention will simply accrue to the next crisis of the times."
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ECTDOC
The worst paying--and worst overall--jobs for physicians are in academia. Many earn $100k to $125k per year, for a board cert psychiatrist. I did. And the working conditions were awful, with onerous call duties, numerous condescending ignorant administrators on your back, and lousy windowless offices. Sure some of the residents and students were great to work with, but more than a few were abusive and either lazy or mentally dull.
July 20, 2010 - [ 12:47:47 ]
bartrdoc
I take home $9,620.00 per year as a full-time rural family solo practitioner. I just paid off my student loan 21 years after residency ended
July 20, 2010 - [ 13:49:23 ]
neurodoc
The reported average income for neurologists seems very high compared to all the private practice neurologists I talk to around the country. The take-home average I have discussed is around $150,000-200,000. However, this is for neurologists who practice primarily cognitive neurology. It is higher for neurologists who perform many procedures.
My income has been $140,000-150,000 annually for several years and it has been the same for my associates (in California).
The American Academy of Neurology has predicted the end of most private practice neurology by 2015, primarily due to this increasing financial burden..
My income has been $140,000-150,000 annually for several years and it has been the same for my associates (in California).
The American Academy of Neurology has predicted the end of most private practice neurology by 2015, primarily due to this increasing financial burden..
July 20, 2010 - [ 14:04:41 ]
Terri Cullen
ECTDOC, our Financial Health Check Up blogger Ed Rabinowitz talked about the disparity in incomes between academic and private practice this week. (Here's the link: http://bit.ly/azpl0C) With diminishing revenue of private practice, one would think the gap in pay would be narrower than in the past -- but it's not.
July 20, 2010 - [ 14:32:57 ]
Anonymous
I'm struck by the tone of defeat and discouragement in the comments from providers...these times and circumstances are robbing us from the excitement, joy and anticipation of something much different that we probably all had as we entered medical school.
July 20, 2010 - [ 14:33:55 ]
sam
Salary disparity is only in America and spans across all sectors of the American economy. Fancy the disparities in sports for players, e.g., in basketball. In more equitable societies individuals with similar qualifications and expertise enjoy similar remuneration. For example, all first year doctors in Britain are compensated the same irrespective of specialty. That is why this economy may fail one day!
July 20, 2010 - [ 15:54:54 ]
Anonymous
I am a relatively new physician - soon to be in my 3rd year in Family and Geriatric Medicine in my hometown community. I am one of few in my class who was crazy or brave enough to start my own practice, me, myself, and I...it has been stressful, crazy hours, but a joy. The only negative has been the stress of a running a BUSINESS, who gets prepared for that in medical school and residency?
Yes, my pay is lower than the surgeon, but my clinic and call life is different too. Disparity is something that we will not be able to get away from, less disparity would be nice, but not likely to happen. The shame of this situation is that young minds are being told to stay away from these fields because of lack of reimbursement...money talks to someone who is in debt...there is also a stigma attached to those who are in a primary care fields when you are in medical school that is propagated in residency and causes students to shy away from a field they may have otherwise chosen. Perhaps Dr. Hennessy should also propose a champion for the Family physician, and others who are disparaged by their medical colleagues.
Yes, my pay is lower than the surgeon, but my clinic and call life is different too. Disparity is something that we will not be able to get away from, less disparity would be nice, but not likely to happen. The shame of this situation is that young minds are being told to stay away from these fields because of lack of reimbursement...money talks to someone who is in debt...there is also a stigma attached to those who are in a primary care fields when you are in medical school that is propagated in residency and causes students to shy away from a field they may have otherwise chosen. Perhaps Dr. Hennessy should also propose a champion for the Family physician, and others who are disparaged by their medical colleagues.
July 20, 2010 - [ 19:18:23 ]
pauld
hoanm.com
Seems like the obvious would be to develope a system whereby primary care docs who have loans would have them "paid off" to some extent by "another government program" which I know increases our debt. Society can make a decision to say-if you go into primary care we will assist with cost. If you go into plastic surgery no help paying off loans.
Seems like the obvious would be to develope a system whereby primary care docs who have loans would have them "paid off" to some extent by "another government program" which I know increases our debt. Society can make a decision to say-if you go into primary care we will assist with cost. If you go into plastic surgery no help paying off loans.
July 21, 2010 - [ 14:18:26 ]
VPMA-Doc
The great disparity in incomes between primary care providers and specialists began in earnest when Medicare was created in circa.1963. Much more emphasis and reimbursement was associated with procedural services and less with cognitive services. 47 years later, we have a healthcare society largely driven by specialty care in contrast to other developed countries with less per capita healthcare spend--hense our current unsustainable crisis. There will always be some people smarter and more productive thatn others but in what logical system does it make sense to pay a family doc $200 to manage an ICU patient out of DKA(potentially life-saving) and pay a dermatologist $500-$1000 to removed a benign lesion in their office?
July 21, 2010 - [ 16:48:33 ]
drldreeves
I take offense to the attitude of Dr. Jeff Brown who says we have to get over it. It is a proven fact that in countries where primary care is the mainstay of health care, outcomes are better, and health care costs are less. The reason pay has been lower for the group of physicians that are the "10 worst paid positions" is due to the fact that these are not procedure driven specialities. If procedures were all we needed to keep the populace healthy then that would be justified. What we need is to keep people healthy through maintenance of chronic conditions and prevention in healthy individuals. That is the job of primary care. That is what is needed. If we continue to ampute the limb of a diabetic instead of preventing the diabetes then we are doomed as a healthcare state, nation and society.
Leonard Reeves MD FAAFP
President Georgia Academy of Family Physicians
Leonard Reeves MD FAAFP
President Georgia Academy of Family Physicians
July 27, 2010 - [ 13:24:12 ]
annonymous2
Dr. Reeves
August 2, 2010 - [ 11:19:39 ]
DLeongHom726
It isn't just that the pay is low... it is that the hassles are high and getting higher. The amount of time that is spent on uncompensated work is rising and it involves not only work time at the fringe (the most personally costly time) but it is doing something that you really don't want to do at all. The premium cost to both of the latter is generally quite high (think how much you have to pay a Teamster to work on a Holiday night after midnight!).
August 11, 2010 - [ 4:18:19 ]
GYNdoc
I have NO idea where you are getting this data of these high salaries. I have been practicing ON/GYN for 30 years and my salary is too embarrassing to publish. I used to have a very comfortable 6 figure salary, but no longer. The only way my now GYN (only) practice survives and through the cash I get from my medi spa upstairs where we offer liposuction and other cosmetic work.
Many of the physicians in the metropolitan area where I practice get no where the salaries you quote here
Many of the physicians in the metropolitan area where I practice get no where the salaries you quote here
September 4, 2010 - [ 14:43:39 ]
blueshavedice
This is the marketplace speaking. There is a surplus of approximately 40% too many doctors in this country. If one considers the huge amount of ridiculous treatments given (feeding tubes placed into unaware individuals, pneumonia treated in late-stage Alzheimer's, etc) which would not be given except in a socialistic system which has no painful choice of personal expense for family members, when the system collapses in bankruptcy none of this stuff will be done and there will be a painful contraction in the monetary supply available to all doctors. The similarity to the real-estate collapse is inescapable. The government for years has told the people that "we want you to have all the health care you need, for free." The government told doctors and hospitals, home nursing, equipment sellers, everyone, "We want you to provide as much care as you can, and we will pay for it." Now, as the money is running out we are way overbuilt in the health care system, with every little town having a Taj Mahal for a hospital, a dialysis center at every major crossroads, and hundreds of really sickly people in every town who really need an opportunity to meet the Lord. The market will collapse for health care, the only question is "When?" Those whose heart is not in it should exit now, those who are willing to suffer through it should be ready.
September 28, 2010 - [ 16:57:30 ]
Anonymous
I have practiced medicine in three different continents. It is only in the US that there is such a disparity in income between specialities. In many countries, the top rankers from med school, go into specialities like Int Med, Peds and allied medical sub-specialities. While, it is easier to get into specialities like derm, psych, ENT etc.., here in the US, it is just the reverse. I don't mean to say this in a disparaging way, but it is what it is! It is a pity that the person who muddles through 10 different medical problems in an 84 yo pt with 20 different meds, gets paid peanuts, compared to someone who whips off a few benign moles in a few minutes! Having said this, most of us doing primary care, enjoy what we do.
October 8, 2010 - [ 17:42:11 ]
DocSacks
Good for you Dr. Leonard Reeves !! Now if you can just get the ACP, the AMA and the politicians to really HEAR you.
Cut the hassle factor
Cut the hassle factor
November 24, 2010 - [ 19:50:07 ]
PharmD
I really thought that the primary care physician made much more than that. I am a PharmD and make ~130K with no call and $140 in liability insurance each year.
November 27, 2010 - [ 18:54:12 ]
livplepeds
Your numbers need to be broken down to area of the country, independent versus hired physicians, groups on single specialties and multiple specialties etc. to be useful. Pay on the west coast versus the east coast for the same preventative care visit is vastly different. Independent peds in California range from 100K to 140K if they have a low overhead.
January 10, 2011 - [ 18:05:39 ]
FPDOC
In our community we can not find a Gastroentrologist who will consult on a difficult patient, all they will do is scope one end or the other. They are all millionaires, A procedure is a technical skill that anyone can learn, vs using your brain to figure out a complicated case is best done by the Best and Brightest that make it to medical school. Yet the GI's and our town have nimb fingers and lazy brains because they dont need to think.Why not train the midlevels to do the brainless scopes and reserve the brains for making decisions. That way a 20 minute procedure doesnt cost a months worth of an average mans salary. As far as the health care crises, have goverment run hospitals and clinics that are manned by new physicians that provide free care for the uninsured and in exchange forgive some of there debt.
February 18, 2011 - [ 18:03:23 ]
Primarycare
The quoted salaries are based on Merritt Hawkins and associates physician recruiting incentives, which I doubt represents the typical salary. The lower-paying practice recruits with an ad in the back of a journal or with word of mouth in a local residency, there is no way this is representative. As an internist for 14 years in a large health system, the most I've made is 120K and that is relatively typical for my area for outpatient care or for internists who combine outpatient and inpatient medicine (add about 30K for hospitalists). If those numbers are average, then someone is making double my salary to average up.
I'm happy to make less than the cardiologist or orthopedist if it means I can work 5 days a week without only phone call coverage on weekends and not needing to go to the hospital at odd hours. But not 1/3 the salary to manage one problem while I manage 3-15. Give me a break!
I'm happy to make less than the cardiologist or orthopedist if it means I can work 5 days a week without only phone call coverage on weekends and not needing to go to the hospital at odd hours. But not 1/3 the salary to manage one problem while I manage 3-15. Give me a break!
April 6, 2011 - [ 16:45:16 ]
robert goodhope
none
Both my son-family practice and I-general internal medicine feel that mid levels are going to supplant our primary care physicians.
Please could I get you to change my email address to s.goodhope@mchsi.com
I am retiring and will no longer have Robert.Goodhope @va.gov as an address.
Both my son-family practice and I-general internal medicine feel that mid levels are going to supplant our primary care physicians.
Please could I get you to change my email address to s.goodhope@mchsi.com
I am retiring and will no longer have Robert.Goodhope @va.gov as an address.
April 7, 2011 - [ 10:43:59 ]
doctor
most of the Primary care physicians will make an average 140 to 170 if they work about 50-60 hours a week,
June 22, 2011 - [ 7:19:54 ]
moore
Primary Care will soon be dominated by Middlevel providers. The same for Psychiatry. They cost less and they bring almost as much money to the hopsital as physicians.
July 11, 2011 - [ 13:02:43 ]
Mymoneymd@aol.com
There is a solution for doctors who make less. They can make up earnings if they know how to invest their dollars. This requires that doctors appreciate that there is no magic bullet. "Optimism over realism" is not a financial plan. It is simply wishful thinking. Eighty percent of managed mutual funds fail to beat their relevant index in any 1 year. Over time, the results are even worse. Is there any reason to think investment managers do any better? This is the kind of understanding that all physicians need to go forward productively in making the money they have work for them.
August 21, 2011 - [ 7:51:41 ]
FP DOC Midwest
I opened my own family practice clinic out of residency and in less than 3 yrs I'm earning $350,000. Family practice is what you make of it. I do my own joint injections, skin biopsies, vasectomies etc... I have a lab and digital plain film x-ray as well. Basically doing family medicine and urgent care. Why should I send to a specialist for all the things that I was trained to do. I can run labs and do IV antibiotics in office without having to send to the hospital. Practice is what you make of it. My investment will be paid for in 3.5 years and the clinic will be worth $2 million. Plus I haven't dealt with ridiculous administrators, HR morons or accountants telling me I need to work faster to save my job. I love my job ! I only work in my office because you lose money spending time working out of facilities other than your own. I don't do OB or nursing homes either. I have an ARNP, who definitely pays for herself and off sets call. My call is beyond easy. Why would I ever want to be a specialist ? Primary care reimbursement is about to come out on top. Just wait a year or two. I plan on opening more of these and should retire early ! The only physicians that complain about salary are the lazy ones...
November 26, 2011 - [ 18:24:05 ]
Obct Doc
I certainly agree that primary doctors don't get paid equitably for their hard work. Now let's be totally honest folks. The typical IM, FP or peds spent 3 yrs in residency. The typical medical specialist spends an average of 6 yrs in training post med school. The surgical sub specialist spend 7 to 10 years post med school. While these extra 3 to 5 years don't seem to be relevant, remember these are usually the best years of your life ( age 29 to 34). These extra 4 years in training pay off many times over for the rest of ones life. Keep in mind that a person graduating high school will make ~1 million dollars less in earnings over a 30 year career compared to a college graduate. The difference between these two individuals is only 4 more years of school. I am in no way trying to minimize or compare primary care to someone without a college degree. Ultimately life is unfair for all of us. A smart (business wise) dermatologist or plastic surgeon earns twice as much as any fancy surgeon (deals with immediate life and death), so what it doesn't matter. Do the most with what you have and think of your rich business or banking friends that are likely currently unemployed because they were too expansive for their company and were laid off while their companies were restructuring. Who is jealous of whom now!!!
April 29, 2012 - [ 0:39:01 ]
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