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Specialists Make Twice as Much as Primary Care Doctors, Study Finds

The amount of money medical specialists accumulate over their careers is twice as high as that of primary care physicians, according to a new Duke University study published in the journal Health Affairs, the Wall Street Journal reports.

Many observers consider the higher income for specialists a significant reason for the shortage of primary care physicians in the U.S., according to the Journal (Wang, Wall Street Journal, 5/4).

Duke researchers examined income and interest minus living expenses -- what they called career wealth accumulation -- for cardiologists, PCPs, college graduates with Master's in business administration, college graduates who became physician assistants and people with bachelor's degrees (Rovner, "Shots," NPR, 5/4).

The model incorporated estimates for the doctors' medical school debt and the age at which physicians began earning an income. According to their calculations, cardiologists accumulate more than $5 million on average, compared with $2.5 million for PCPs (Wall Street Journal, 5/4). Cardiologists are the 14th highest-paid specialists, according to NPR's "Shots" ("Shots," NPR, 5/4). People with MBAs accumulated $1.7 million, while physician assistants accumulated $846,735 and people with bachelor's degrees accumulated $340,629 on average.

The researchers also estimated how much additional compensation would be necessary to make choosing primary care more financially desirable for physicians (Wall Street Journal, 5/4). They estimated that increasing pay for PCPs by 50% would reduce the gap between cardiologists' income and PCP's income from about $2.7 million to $1 million. In order to completely eliminate the gap, PCPs would have to receive an average annual income increase of $122,000, researchers found (Gallagher, Triangle Business Journal, 5/4).

Kevin Schulman, study author and professor of medicine and business administration at Duke, said, "Small incentives are not going to be enough to shift the market in a dynamic way," adding, "The magnitude of the differential on the income side is greater than anything we've been talking about on the policy level."

According to the Journal, potential changes for leveling physician pay could include cutting reimbursement to specialists or raising PCPs' income to a certain percentage of what is earned by specialists.

However, according to Schulman, there are drawbacks to both approaches. Another possible solution to the PCP shortage is to increase the efficiency of primary care by hiring more nurse practitioners or physician assistants (Wall Street Journal, 5/4).

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