With all eyes and ears on President Obama’s first State of the Union address tonight, I can’t help but wonder what issues he’ll raise with the health care reform debacle. In my mind there is only one, physician work place issues. Sure, insurance and payment is important as is curtailing our out of control malpractice culture but until we find a way to really repair the issues of the health care world itself, we’ll get little yield for doctors and patients.
Dr. Wes this week hit on one of the most major issues of my profession – primary care physician salaries. In his post, he quoted a family doc and noted the following:
“The 35-year-old family practitioner says she earned $120,000 last year on eBay, more than she did practicing medicine.”
Low primary care physician salaries are one huge albatross of the field, especially when expenses and years of experience are factored into one’s overall career. Yes, it does seem like a reasonable salary on paper but what many people don’t realize is that salary is a doctor’s salary basically for his or her entire primary care career.
What happens is we all enter the field with a salary in a low range, $80-90k or around $100k, become board certified, get a bump into the $120-140k range and then stay there regardless of years of experience. Every other profession can expect an annual salary bump in the 3.4-5% range from oil workers to retail…and health care workers not doctors.
The payscale chart above confirms this. While it appears as if a salary increases over time, notice that there is a range and that there is overlap so that whether you are 1-4 years out or 20 years out, you can, and often do, end up in that $120k range.
So, it’s discouraging.
Primary care physicians enter the field to care for people and put in long hours. Over time, a fixed salary translates into less take home pay over time because expense go up: mortgage, kids, cars, college. You get the idea.
It’s time that physician salaries be treated equitable as any other salary in our country with fair and equitable cost of living raises as well as performance raises. Subspecialists often get nice salary bumps due to procedures. The time has come to figure out a way to even the playing field with primary care docs before we end up with the field becoming a true dinosaur. Already residency slots are not filling in what used to be one of the most popular fields of both the adult and pediatric worlds. If board certified primary care docs leaving the field wasn’t enough to be the wake up call…this should be.
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