I was not surprised when I read this article highlighting the findings from this Duke University analysis about the large difference in income between a primary care physician and a specialist. Surprise! The specialist makes more money. But, more surprising to me was that the specialist makes about twice as much as the primary care physician over the course of their career in the medical field. According to the US Bureau of Labor Statistics, the annual salary difference between a specialist and a primary care physician exhibited the same disparity. Specialists earn a median annual salary of $339,738 and primary care physicians earn a medial annual salary of $186,044. I knew there was a difference in income, but I had no idea it was that significant.
Money talks and apparently, it is speaking volumes to medical students when they are choosing careers as specialists over careers as primary care physicians in the medical field. This is hindering our chances of reducing the already existing and growing shortage of primary care physicians in the US. Not to mention, the shortage of physicians in rural areas as opposed to urban areas. The US Bureau of Labor and Statistics explains in the occupational outlook handbook that while 75 percent of physician care were in metropolitan areas, only 25 percent were located in rural areas.
My question is what is being done to address this huge and growing concern? Well, according to this article in the Wall Street Journal, there are some actions being taken. For one, the new health care reform bill includes a 10 percent Medicare pay increase for primary care physicians. In addition, more medical schools have opened up around the country and some schools that already exist are raising enrollment totals for first-year students. And one school in Arkansas is working to change the attitude of choosing primary care over specialty, in addition, they are asking students to commit to enter rural medicine practice.
While these are all good steps toward a change, they are very incremental in terms of policy change, just as most of the US government's policies are made. One of my ideas for more significant change includes offering medical students who commit to primary care physician careers before they begin attending medical school either a full waiver or partial waiver of their medical school expenses up front. This could help to eliminate the desire of medical students to go into higher paying specialty careers, simply to eliminate their debt. Another idea would be to offer large discounts or incentives to primary care practice doctors on their liability/malpractice insurance premiums, since this is one of the biggest expenses for physicians. While it is encouraging to see that some small steps are being taken to address this issue, so much more needs to be done.