We recently posted about the increasing despair felt by academic physicians.
Those of us in who are in the primary care or generalist fields, e.g., general internal medicine, general pediatrics, and family medicine, seem to be particularly despairing. We feel ever-increasing economic pressure, and see our students endure more pressure when they go into practice. Yearly efforts to freeze or cut physicians' reimbursement fall especially hard on physicians whose reimbursement is already relatively low, and whose costs uncontrollably increase.
But this economic pressure occurs in a health care system whose overall spending continues to increase rapidly. This year, according to the New York Times, health care spending grew at the "moderate" yearly rate of 7.9%, while total health care costs in the US approached $2 trillion.
Why do we feel so economically threatened while more and more money flows into the rest of the health care system? I wonder whether at the root of this contrast is the persistent meme of greedy, over-paid doctors who are responsible for ever-rising health care costs. We don't feel like we are greedy, or over-paid, but yet are held responsible for controlling costs.
Are we greedy and over-paid? To get some idea, I compared the yearly and hourly pay of academic generalists to some other types of educators, using the data about physicians' work hours found in the recent survey in Academic Medicine.
My first assumption was that academics make no more than physicians in practice. Thus data from the most recent 2004 MGMA survey (see link here) should apply to them. It showed that family practitioners' median compensation was $156,011, pediatricians, $161,188, and internists (which includes sub-specialists), $168,551. The survey in Academic Medicine reported that academic physicians worked an average of 61.1 hours a week. Assuming (conservatively) that physicians work an average of 46 weeks a year, I computed average yearly pay and hourly pay were: Family Physicians- $156,011, $55.51; Internists- 168,551; 59.97; Pediatricians- 161,188; 57.35.
My first tried to compare these figures with those pertaining to college professsors. The American Association of University Professors (AAUP) survey showed that faculty at institutions that granted doctoral degrees had average salaries from $60,567 for an assistant professor to $104,411 for a full professor. However, at well known top-tier institutions, salaries were considerably higher. For example, average professor's salaries were $127,135 at Georgetown, $136,326 at Northwestern, $145,550 at Yale, and $163,162 at Harvard. However, I have not been able to find reliable data on university faculty work hours. But in any event, yearly salaries for primary care faculty are not tremendously higher than those for other university faculty, and it is possible that the medical faculty work longer hours.
My second comparison group was public school teachers, chosen because their hours are well-defined by contracts. I was able to use salary figures from the budget for the town in which I live, Barrington, RI. Salaries for teachers range from $45,000 to $77,999. The median is between $65,000 and $69,000. The school year is 180 days, and the defined work day is less than seven hours.
So to compare yearly and hourly pay received by academic generalists and public school teachers: Family Physicians- average yearly pay $156,011, average hourly pay $55.51; Internists - 168,551, 59.97; Pediatricians- 161,188, 57.35; Public School Teacher (Low)- 45,000, 35.71; Public School Teacher (Median) - 66,500, 52.78; Public School Teacher (High)- 77,999, 61.90.
Thus, although public school teachers make considerably less than academic generalist physicians (and practicing generalist physicians) per year, their hourly pay is comparable, and in some cases, higher. No wonder we don't feel overpaid and greedy. It is time to vanquish the meme that overpaid, greedy physicians are mainly responsible for the high cost of health care.
But that meme has served as a fine way to distract the public from the mismanagement and corruption by the leaders of health care organizations that we have documented on Health Care Renewal.
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