Friday, May 25, 2012

U.S. Physician Compensation Among Lowest

The United States may have a reputation for having one of the most expensive health care systems in the world, but it apparently is not because of physician payments.

According to a study released in May by Jackson Healthcare, physician compensation in the United States is among the lowest of the major western nations.

Payments to physicians accounted for 8.6 percent of total health care costs in the United States in 2011. That was about $216 billion of the $2.5 trillion spent on health care. Only Sweden spent less on overall health care costs dedicated to physician compensation with 8.5 percent allotted to the costs of paying doctors.

Germany topped the list for physician compensation, with 15 percent of its health care costs going to pay physicians. Australia was next at 11.6 percent, France at 11 percent, and the United Kingdom at 9.7 percent.

"As we continue to debate how to reform health care, many often blame physicians' salaries for driving up the cost of health care," said Richard L. Jackson, chair and chief executive officer of Jackson Healthcare. "What this illustrates is that the compensation for American doctors is not what is driving up health care costs in our country."

The data was provided by Overseas Employment Development Board and a 2011 Physician Compensation Survey by Jackson Healthcare, a health care staffing and technology company.

1 comment :

Vince Fonseca, MD, MPH, FACPM said...

This report is hitting the medical news services today and it seems a little misleading because it describes proportions rather than dollars.

The smallest proportion (8.6%) of overall healthcare expenditures ("pie size") does not necessarily mean that compensation to physicians is the lowest, because our "pie" is so much bigger per capita (over twice the size) to begin with.

A smaller slice of a bigger pie can mean more pie, as it does in this case. So, Germany with a proportion of 15% going to physicians equates to $561 per capita and the US' 8.6% equates to $692 per capita. Similarly with the other countries: Australia ($364), France ($385), and UK ($287).

So we spend the most, not the least, per capita on physicians than the other major Western nations and spend even more capita on other healthcare expenditures. Therefore, we need to slow the growth in spending more in non-physician expenditures (~91% of US expenditures) than physician expenditures. We need to more effectively use our expenditures related to health.

Cost-effective policy and environmental change interventions are one way to do this. Increasing evidence-based public health and prevention services prevents and supports families maintain and improve their health...providing greater value for health-related expenditures.

Targeting lower value physician services is another way to do this. The recent Choosing Wisely initiative with 9 specialty groups each identifying 5 lower value activities that represent overuse problems is a great start. Now we need to support system changes to decrease these activities.

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