Primary Care Docs Earn Less Than Specialists, But More Than We Do

Specialists make a lot more than doctors who are generalists, so-called primary care doctors.

But the size of the gap might surprise you: Try more than $100,000 a year.

Before you shed a tear for primary care docs, though, you might want to check out an analysis of doctor income in the current issue of the journal Health Affairs. It shows primary care docs make a lot more than the rest of us, even people with MBAs.

Researchers from Duke University compared career wealth accumulation — basically earnings and interest income minus living expenses — for five different types of workers: Cardiologists, primary care doctors, college grads who earned MBAs, college graduates who went on to become physician assistants, and college graduates who didn’t get graduate degrees.

In their working lives, cardiologists get richest — accumulating wealth the authors estimate at about $5.2 million.That was more than twice as much as the primary care physician; three times as much as the MBA; six times as much as the physician assistant; and a whopping 15 times as much as the run-of-the-mill college graduate.

Now the point the researchers were trying to make was that just making it easier for medical students to pay off their loans or boosting payments for primary care won’t make much of a dent in the problem of medical students generally preferring careers as specialists. Particularly not when you consider that cardiologists aren’t even the best paid specialists. They were only 14th on a list of 68 medical specialties ranked by income.

But while the nation is grappling with a primary care shortage, we might do well to consider just how much primary care doctors DO make, even with all the debt they have to take on to get through medical school. Notes the study, “primary care physicians generated approximately 1.4 times more wealth than MBA graduates, 2.9 times more wealth than physician assistants, and 7.3 times more wealth than college graduates.”

Of course one way to get more medical students to go into primary care would be to pay specialists less. But, as the authors of the study note, “cutting physicians’ salaries would be difficult politically.”

The senior author on the paper, Dr. Kevin Shulman, has hedged his bets. He’s an internist with an MBA who does work at Duke’s medical and business schools.

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