Last week’s Health Wonk Review included an excellent article by Brad Flansbaum at The Hospitalist Leader. Brad’s article discussed the details of physician pay and the wide disparity in income between specialists and primary care doctors. The charts Brad included gave an interesting picture of how physician pay in the US compares with other countries. They indicate that our primary care docs are earning just a little more (compared with the average wage earner in each country) than their counterparts in other countries. But our specialists are earning quite a bit more than those in other countries (except in the Netherlands, where they apparently really appreciate their specialists!)
Medical school in the US isn’t subsidized for the most part, and most of our new doctors are saddled with significant medical school loans. Thus it makes sense that our doctors earn a bit more than they would in other countries. But there is definitely too much of a gap between what a cardiologist earns and what a primary care doctor earns.
If we expect to get a handle on the shortage of primary care docs, we have to find a way to narrow that gap. The PCP shortage is likely to become even more of a problem once the health care reform provisions kick in and millions of currently uninsured Americans become insured and presumably start to seek out more health care. Unless we can make primary care more attractive to people in medical school, all of those newly insured people are going to end up seeing expensive specialists instead of PCPs, and the burden of paying for health care will only become harder to bear.