Lifetime earnings for physicians across specialties.
Lifetime earnings for physicians across specialties.
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跨专业医生的终生收入。
DOI：
10.1097/mlr.0b013e318268ac0c
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发表时间：
2012
期刊：
影响因子：
3
通讯作者：
Kravitz,RichardL
中科院分区：
文献类型：
--
作者：
Leigh,JPaul;Tancredi,Daniel;Jerant,Anthony;Romano,PatrickS;Kravitz,RichardL
背景：早期的研究估计跨专业的年收入差异，但终身收入可能是更相关的医生的长期commitments to specialties.Methods：年收入和工作时间的数据收集了6381名医生在全国代表性的2004-2005年社区跟踪研究。关于居住年限的数据来自AMA FREIDA。现值模型乃假设3%贴现率而构建。根据人口统计学和市场协变量调整估计值。敏感度分析包括4个替代模型，涉及工作时间，退休，外生变量和1%的贴现率。估计产生了4大专业类别（初级保健，外科，内科和儿科专科，和其他），并为41个具体specialties.Results：终身收入的外科，内科和儿科专科，和其他专业的广泛类别的估计分别为1,587,722美元，1,099,655美元，761,402美元以上的初级保健。在41个特定专科中，排名前3位（以家庭医学为参考）的是神经外科（2，880，601美元）、内科肿瘤学（2，772，665美元）和放射肿瘤学（2，659，657美元）。不同退休率和只包括外生变量的模型的估计数与首选模型的估计数相似。1%的折扣模型产生的估计是大约150%大于3% model.Conclusions：有相当大的变化，在医生专业的终身收入。在考虑到不同的住院年限和未来收入的折扣后，初级保健专业的收入比其他专业少了大约100万到300万美元。不同专业的收入差异可能会破坏卫生改革控制成本和确保足够数量的初级保健医生的努力。
Background:Earlier studies estimated annual income differences across specialties, but lifetime income may be more relevant given physicians’ long-term commitments to specialties.Methods:Annual income and work hours data were collected from 6381 physicians in the nationally representative 2004–2005 Community Tracking Study. Data regarding years of residency were collected from AMA FREIDA. Present value models were constructed assuming 3% discount rates. Estimates were adjusted for demographic and market covariates. Sensitivity analyses included 4 alternative models involving work hours, retirement, exogenous variables, and 1% discount rate. Estimates were generated for 4 broad specialty categories (Primary Care, Surgery, Internal Medicine and Pediatric Subspecialties, and Other), and for 41 specific specialties.Results:The estimates of lifetime earnings for the broad categories of Surgery, Internal Medicine and Pediatric Subspecialties, and Other specialties were $1,587,722, $1,099,655, and $761,402 more than for Primary Care. For the 41 specific specialties, the top 3 (with family medicine as reference) were neurological surgery ($2,880,601), medical oncology ($2,772,665), and radiation oncology ($2,659,657). The estimates from models with varying rates of retirement and including only exogenous variables were similar to those in the preferred model. The 1% discount model generated estimates that were roughly 150% larger than the 3% model.Conclusions:There was considerable variation in the lifetime earnings across physician specialties. After accounting for varying residency years and discounting future earnings, primary care specialties earned roughly $1–3 million less than other specialties. Earnings’ differences across specialties may undermine health reform efforts to control costs and ensure adequate numbers of primary care physicians.