Specialists’ Incomes on the Rise as Patients’ Medical Costs Grow
Medical specialists can earn on average two to four times as much as primary care physicians, which in turn is having a direct effect on patients' medical bills and the overall cost of health care in the U.S., the New York Times reports.
According to the Times, many specialists -- particularly those who deal with issues related to cancer, the digestive system or skin care -- have been able to boost their incomes by:
- Becoming more entrepreneurial;
- Lobbying to protect their fields from government-sponsored cuts and legislation; and
- Offering new procedures or performing more services that are particularly lucrative.
For example, some specialists can perform a dozen smaller procedures in the same time that it takes a cardiac surgeon to perform a few bypass operations, allowing those specialists to bring in more revenue. As a result, the incomes of specialists in dermatology, gastroenterology and oncology, for example, increased by at least 50% between 1995 and 2012. By comparison, PCPs' incomes increased by an average of only 10% during that same time period, the Times reports.
Meanwhile, specialists' reported salaries often understate their total incomes because they do not include revenue from business activities, according to the Times. Such activities include:
- Fees for certain lab tests performed at facilities in which they have a financial stake; and
- Charges at ambulatory surgery centers in which physicians have made investments.
In addition, when Medicare payments are reduced for one procedure, specialists might attempt to increase the amount of more lucrative procedures they perform.
Critics note that these practices often lead to increases in patients' medical bills, particularly because they can be tied to overuse. Further, specialists might insist on certain medical procedures that might not be necessary because of their higher revenues (Rosenthal, New York Times, 1/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.