In the past eight years, doctors have seen a 7 percent average drop in net income. The opposite has been true in other professions which have seen a 7 percent increase in salaries in the same time frame, according to a recent study by the Center for Studying Health System Change, a nonpartisan policy research organization.
"The downward trend in real incomes since the mid-1990s likely is an important driver of growing physician unwillingness to provide such pro bono work as charity care and serving on hospital committees," said Paul B. Ginsburg, PhD, coauthor of the study and president of HSC.
Some physicians have seen an even worse drop, such as primary-care physicians with a 10.2 percent decline in income between 1995 and 2003; second worst were surgeons who saw a decline of 8.2 percent. However, medical specialists' real income essentially remained unchanged, according to the study.
"Flat or declining fees from both public and private payers appear to be a major factor underlying declining real incomes for physicians," said Ha T. Tu, MPA, HSC Researcher, and a study coauthor.
Now, everything is relative. Overall, being a doctor means you can expect to be one of the most well-paid professionals in the United States. In 2003 nearly 50 percent of all patient care physicians earned over $170,000, and physician average net income was about $203,000, the study found.
Also, surgeons remain the highest earning of all physicians, with average incomes of $272,000 in 2003—29 percent higher than medical specialists and 86 percent higher than primary-care physicians.
The decline in salaries has created some shifts in the areas that potential doctors choose to go in to. Physicians are trending away from primary care into certain medical specialties that offer higher compensation and have kept better pace with inflation. The composition of the physician population changed between 1995 and 2003, with the proportion of medical specialists steadily increasing from 32 percent to 38 percent, while the proportion of primary-care physicians and surgical specialists each declined by about 3 percentage points, the study found.
"In choosing which area of medicine to specialize in, many physicians today already show preferences for medical specialties that offer more control over work hours," Ginsburg said. "Reinforced by diverging income trends between these specialties and primary care, the result is likely to be an imbalance in the physician workforce and perhaps a coming shortage of primary-care physicians and other specialties that provide primarily cognitive services."