Nov 28 Primary care doctors in the United States don't seem to be reaping the rewards of rising health care costs where it counts - in their paychecks, according to a study.
The findings, which appeared in the Journal of the American Medical Association, could have implications for what some predictions say will be a primary care shortage in some parts of the United States in the coming years.
Researchers found that since the late 1980s, the average doctor's earnings have grown more slowly than the salaries of other health professionals, such as pharmacists, dentists and registered nurses.
"It is possible that there are some specialities that have done extremely well in the past 10 or 15 years," said health policy researcher Amitabh Chandra from Harvard University, who worked on the study.
"In terms of the experience of the median doctor, the median doctor is not at the heart of all the cost growth we're seeing in America," he added.
"Median" doctors were the ones in the middle of the salary range.
For their study, Chandra and his colleagues analyzed data from a nationally-representative survey of American's occupations and earnings conducted every year between 1987 and 2010. Each round included people older than 35 from 60,000 different households.
Over the 14-year study, 30,556 health professionals were surveyd, including 6,258 doctors.
Between 1987-1990 and 2006-2010, the median doctor's annual earnings grew from $143,963 to $157,751 - a difference of 9.6 percent. That was after taking into account any salary differences based on gender, age and location.
By contrast, the average pharmacist's earnings increased by 44 percent, from $70,341 to $101,279, and the average dentist's by 23 percent, from $105,511 to $129,795.
Looking closer, the study team found that doctors' salaries grew between 1987-1990 and 1996-2000, but then were stagnant over the next decade, a time when other health professionals continued to get bigger paychecks.
Because the earnings reflect pay for doctors in the middle of the salary pack, Chandra said the slow growth probably represents patterns for primary care doctors rather than specialists - and earnings for some "procedure-driven specialities," such as cardiology, may have grown a lot.
Medicare payment cuts, as well as tougher bargaining by insurance companies, may be partly to blame for the "sluggish" growth in the primary care field, he added.
In addition, more women and minorities are becoming doctors - and research has suggested they make less money than white, male physicians, said Bob Konrad from the University of North Carolina at Chapel Hill, who has studied doctor salaries.
He added that the new findings may also not tell the whole story for primary care doctors. Recently, employers have started offering to pay off more of new doctors' college and medical school debt as a way of luring top candidates - but these benefits would not show up on their paychecks.
Chandra said the study may have implications for parts of the nation that are facing a shortage of primary care doctors.
"If as a country we want more people to go into primary care, this anemic, jaundiced earnings growth is not going to be a motivator," he said. SOURCE: bit.ly/JiFzqx (Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)
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