July 19, 2013

The top-earning doctors: Why salary trends are changing

Daily Briefing

Orthopedic surgeons and cardiologists earned the highest starting salaries of all U.S. physicians last year, according to Forbes' sneak peek at an upcoming report from physician recruitment firm Merritt Hawkins & Associates.

For the report, Merritt Hawkins researchers analyzed data on offered starting salaries for physicians in the 20 most requested specialties between April 1, 2012, and March 31, 2013. The salaries do not include signing bonuses, performance bonuses, or benefits.

According to the report, on average:

  • Orthopedic surgeons made $464,500;
  • Invasive cardiologists made $461,364;
  • Non-invasive cardiologists made $447,143;
  • Gastroenterologists made $441,421;
  • Urologists made $424,091;
  • Hematologists and oncologists made $396,000;
  • Dermatologists made $370,952;
  • Radiologists made $368,250;
  • Pulmonologists made $351,125; and
  • General surgeons made $336,375.

Starting primary care physicians (PCPs), internists, and pediatricians earned significantly less than their specialist peers, with average starting salaries of less than $210,000.

According to Merritt Senior Vice President Travis Singleton, specialists are offered higher salaries simply because they bring in more revenue, but "the curve is bending" because of reimbursement cuts and "emerging delivery models that promote preventive care, efficiency, and quality based outcomes."

He added, "We are counting on primary care doctors to drive these emerging systems which promote value over volume," because PCPs will "have greater influence over what happens to the patient: the specialists they see, the tests and procedures they receive, and the hospital to which they may be admitted."

The lagging salaries for PCPs have contributed to the growing shortage of PCPs as medical residents seek out careers to help them pay off student debt more quickly, according to Singleton. "[T]he truth is that medical students have long been deterred from going into primary care not only because of economic concerns, but also for reasons connected to professional prestige," he says.

As the compensation trend reverses, more medical students are choosing to enter primary care; the "stigma attached to primary care in medical education is coming off, though this is a cultural change that will take time," Singleton says (Smith, Forbes, 7/18).

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