• What is known about private sector physician salaries?

    I’ve been trying to find out what is known and knowable about private sector physician salaries. The summary of my findings is below and a list of data sources follows. My findings have various limitations and I welcome other leads for this reason.

    Based on what I’ve found, there are three main takeaways: US physician salaries vary significantly by 1) specialty and 2) geography; and 3) US physicians are paid more than physicians in other wealthy countries.

    Variation by specialty

    Salary variation by specialty was not surprising. Generalists (e.g. primary care physicians) make the least. Specialists (e.g. surgeons) make more and specialized specialists (e.g. spine orthopedic surgeons) make the most. The US health care system rewards specialization.

    Variation by geography

    Salary variation by geography was also anticipated but the patterns were unexpected. Noncoastal states/cities have the highest physician salaries. Surprisingly, big medical hubs, even in high cost of living areas like Boston, have some of the lowest. Market saturation may play a significant role in local physician salaries.

    Comparison to other wealthy countries

    An international comparison of physician salaries was not my goal but a few articles addressed it. US physicians make more than physicians in other wealthy nations. One article suggested the US may still devote a smaller percentage of total health care expenditures to physician salaries than most other wealthy countries, but I could not validate that elsewhere.

    Limitations

    The salary range across data sources is expansive, from less than $200,000 to $750,000. At least one source is top-coded (has an upper limit on reported salaries). Certain primary data sources were unavailable; I found review articles and executive summaries but could not gain direct access to the original reports.

    Data sources

    The ideal data source on private sector physician salaries would have the following characteristics: reports mean and median annual salaries by both specialty and geography (state or finer level), is not top-coded, acknowledges cost-of-living variation, and addresses other forms of compensation.

    Below are the sources I found as well as how they compare to the ideal. The data are robust but not comprehensive.

    • Bureau of Labor Statistics maintains national averages for various physician specialties
      • Data are top-coded
      • Data are not geographically specific
    • Merritt Hawkins conducted a survey on revenue per physician based on specialty
      • Data are reported by CFOs based on hospital-wide estimates
      • Data are not geographically specific
      • Data are based on only 74 survey responses
      • Salary patterns seem to loosely follow revenue patterns
    • Merritt Hawkins conducted a survey on recruiting incentives/salaries for physicians
      • Survey does not track actual salaries, only recruiting offers
    • Medscape surveyed 25,000 physicians on salary, satisfactions, quality measures (2012)
      • Data are quite comprehensive but more detailed reports are only available to members
      • 2017 survey results also available
    • MGMA surveyed 65,000+ providers about compensation and productivity
      • Data are not geographically specific
      • More extensive surveys (with geographically specific data) are available to purchase
    • AMGA survey would be a great resource (available to purchase)
      • No direct access, only NEJM review article
    • Federal government publishes national averages of government physicians
      • Data are not specialty specific
      • Data are not geographically specific
      • Data do not represent private sector

    Next steps

    Perhaps further research—and new data sources—will answer some of the following questions.

    1. How do physician salaries impact productivity and retention?
    2. What is the financial footprint of physician salaries on total health care expenditures?
    3. Would the health care system actually save money if we reduce physician salaries?
      • What negative consequences may be associated with reducing physician salaries?

    I welcome your thoughts and leads as they will only add to the conversation (tweet at me: @epearsonbusph). Understanding the current state of private sector physician compensation will certainly advise future policy changes.

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