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

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 CrisisForbes 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."