Why Is There Such Salary Inequality among Healthcare Professionals?

When most people think of doctors, they think of people who earn lavish incomes and can afford to live fairly luxurious lifestyles when they're not in the office. But what a lot of people don't consider is that not all healthcare professions are created equal. In fact, half of the people working in the healthcare industry, especially wage workers such as home health aides, make less than $40,000 a year. At the other end of the spectrum, you have executives at large hospitals who often reap the rewards of a seven figure paycheck. And then there is a wide range of salaries among the physician population. And the downside of some doctors making $500,000 a year or more is that these rising incomes have translated to skyrocketing costs for patients.

It seems that specialists – and the procedures they perform – are the real culprits here. Not only do many specialists earn many times that of internists and general practitioners, but salary figures for doctors often don't take into account different methods of making money, such as the costs doctors charge for taking blood, performing tests in a lab, or even just to use a facility. Plus, a lot of doctors also invest in the equipment they use and sometimes even own the surgery centers and offices they use. And all of the top earners in medicine are specialists: orthopedists, cardiologists, anesthesiologists, dermatologists, radiologists, plastic surgeons, gastroenterologists, and urologists. The income of some of these doctors has risen by over 50% since 1995, even when adjusted for inflation.

So what gives? In essence, these doctors have become great business people who know how to turn a profit. A dermatologist can freeze off fifteen different skin lesions and bill them all for surgery separately, or come up with a rationalization for using a more expensive procedure than is necessary. Or an oncologist can mark up each dose of chemotherapy he or she delivers privately in the office. And in return, patients are paying thousands of dollars in medical bills, and this nation has $2.7 trillion in healthcare costs. And even though policy makers are attempting to rein in spending, physicians often find other ways to make money – and their salaries are still escalating.

The one exception to this trend is primary care doctors and internists, whose salary has grown much more slowly than other types of physician, and even more slowly than dentists, pharmacists, and registered nurses. In fact, their salary has only grown by about 10% in recent years, and over some time periods has even remained stagnant. Cuts to Medicare payments and tougher bargaining from insurance companies may be contributing to this slow growth. The other factor at play is that more women and minorities are becoming doctors – two demographics who are known to make less than white, male physicians.

This wage inequality isn't motivating many doctors to go into primary care, a troubling fact considering that it's the area where the U.S. has the most shortages. And who can blame them? When there are orthopedists making over $900,000 a year, and internists and pediatricians make less than $250,000, it's not much of a contest. The discrepancy is made even worse when considering that specialists like dermatologists often work less than 40 hours a week and have less stressful jobs than doctors like obstetricians, who work tough hours and deal with a lot of emergencies. It might be time for policy makers and healthcare administrators to start taking action to correct such income inconsistencies and find incentives to get doctors into the fields in which their needed, without sending patient costs spiraling even further.

Sources:

http://www.reuters.com/article/2012/11/27/us-primary-care-doctors-salary-idUSBRE8AQ1A220121127

http://www.nytimes.com/2014/01/19/health/patients-costs-skyrocket-specialists-incomes-soar.html?ref=policy&_r=0

About the Author:
Iris Stone is a freelance writer, editor, and business owner who has written on a range of topics. She has experience covering content on medicine, healthcare, and career training, as well as education. Iris is also interested in science and mathematics and is currently studying to be a physicist. Check out her Google+ Profile.

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