Another view is that the US free market more or less accurately determines how much money it takes to attract and keep talented people in medicine. In a country where the top 1% have an average pretax income of $380,000, not counting capital gains,[1] while the median household income is about $50,000, these observers say that it takes the promise of high and secure earnings to convince the brightest young people to choose a career in medicine rather than the potentially more lucrative fields of finance, management, law, and lobbying.
....
Uwe Reinhardt, PhD, a Princeton University economics professor, has suggested that doctors should earn enough after expenses to place them at or above the 95th percentile of US income -- $200,000 in 2011, according to the Tax Policy Center's breakdown of U.S. income distribution. Indeed, the median primary care physician compensation of $212,840 last year met that standard, while the median specialist physician compensation level of $384,467 placed specialists above the 98th percentile, according to the latest Medical Group Management Association (MGMA) physician compensation survey.
...
It's no secret that different types of US physicians make hugely different amounts of money. According to the latest MGMA physician compensation survey, in 2011, geneticists earned median pay of $142,234, geriatricians $195,000, general pediatricians $203,948, family physicians doing obstetrical work $204,411, general internists $215,689, invasive cardiologists $472,446, invasive radiologists $486,764, and general orthopedic surgeons $520,119. Certain subspecialists earned substantially more, with neurologic surgeons earning $704,170 and cardiovascular-pediatric surgeons making $725,704.
Physicians owning ancillary facilities such as diagnostic imaging may actually earn more than the MGMA figures because what they reported may not have included ancillary revenues, according to the MGMA.
Looking at those numbers, "it's hard for any [US] doctor to complain about income," says Glen Stream, MD, president of the American Academy of Family Physicians. "But our grave concern is the disparity between primary care and subspecialty income. That's a huge driver in medical students choosing specialties other than primary care. Attracting more people to primary care would make our healthcare system higher-functioning and more cost-effective."
Still, even US primary care physicians generally receive higher fees and higher incomes than their counterparts in other advanced countries, while US orthopedic surgeons and other specialists earn far more than their international colleagues, according to the aforementioned Health Affairs article.[2] Adjusted for purchasing-power parity, US primary care physicians in 2008 earned an average of $186,582 before taxes and after expenses, compared with $159,532 in the United Kingdom, $131,809 in Germany, and $95,585 in France. US orthopedic surgeons earned $442,450, compared with $324,138 in the United Kingdom, $202,771 in Germany, and $154,380 in France.
. I wonder what would happen if he ended up having to do his residency in Detroit.
