title: Lifetime earnings for physicians across specialties.
abstract: 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.
authors.affiliation: Center for Healthcare Policy and Research, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA 95616-8638, USA. pleigh@ucdavis.edu
authors.forename: J Paul
authors.initials: JP
authors.lastname: Leigh
authors.forename: Daniel
authors.initials: D
authors.lastname: Tancredi
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Romano
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data*; D018803:Models, Economic; D010820:Physicians / Q000706:statistics & numerical data*; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data*; D014481:United States