Physicians in the United States

U.S. physicians per 10,000 people, 1850-2009

Physicians in the United States include both ones trained by medical education in the United States (which produce MDs and DOs) and ones that are international medical graduates (MBBS and MDs) who have progressed through the necessary steps to acquire a medical license to practice in a state. They are an important part of health care in the United States.

The American College of Physicians, uses the term physician to describe specialists in internal medicine. The American Medical Association as well as the American Osteopathic Association both currently use the term physician to describe members.

Medical education

The US medical education for physicians includes participation in a US medical school that eventually grants a US form of Doctor of Medicine (M.D.) degree^[1] or a Doctor of Osteopathic Medicine (D.O.) degree.^[2] After graduating from a first-professional school, physicians who wish to practice in the U.S. usually take standardized exams, such as the USMLE and/or the COMLEX-USA.

In addition, the completion of a residency is required to practice independently.

Specialists

Currently, a specialist physician may be described in the United States as an internist. Another term, hospitalist, was introduced in 1996,^[3] to describe US specialists in internal medicine who work largely or exclusively in hospitals. Such 'hospitalists' now make up about 19% of all US general internists.^[4]

There are three agencies or organizations in the United States which collectively oversee physician board certification of M.D. and D.O. physicians in the United States in the 26 approved medical specialties recognized in the country. These organizations are the American Board of Medical Specialties (ABMS) and the American Medical Association; the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) and the American Osteopathic Association; the American Board of Physician Specialties (ABPS) and the American Association of Physician Specialists. Each of these agencies and their associated national medical organization functions as its various specialty academies, colleges, and societies.

All boards of certification now require that medical practitioners demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years.

Salaries

Compared to foreign countries

America has the highest paid general practitioners in the world.^[5] America has the second-highest paid specialists in the world behind the Netherlands.^[5] Public and private payers pay higher fees to US primary care physicians for office visits (overall 27 percent more for public and 70 percent more for private) than in Australia, Canada, France, Germany and the United Kingdom.^[6] US primary care physicians also earn more (overall earning $186,000 yearly) than the foreign counterparts, with even higher numbers for physician compensation for medical specialists.^[6] Higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, mainly drive higher US spending.^[6]

Variations within the US

A survey of 15,000 physicians practicing in the United States reported that, across all specialties, male physicians earn approximately 41% more than female physicians.^[7] An attributable variable is that female physicians tend to a higher degree to choose medical specialties of relatively lower compensation, such as obstetrics.^[7] Also, female physicians are more likely to report working fewer hours than their male counterparts.^[7]

The same survey reported that, the highest-earning physicians were located in North Central region, comprising Kansas, Nebraska, North and South Dakota, Iowa, and Missouri, with a median salary of $900,000 per year, as per 2010. The next highest earning physicians were those in the South Central region, comprising Texas, Oklahoma, and Arkansas, at $555,000. Those physicians reporting the lowest compensation levels were located in the Northeast and Southwest, earning an across-specialty median annual income of $190,000.^[7]

The survey concluded that physicians in small cities (50,000–100,000) earned slightly more than those living in community types of other sizes, ranging from metropolitan to rural, but the differences were only marginal (a few percent more or less).^[7]

Other results from the survey were that those running a solo practice earned marginally less than private practice employees, who, in turn, earned marginally less than hospital employees.^[7]

In contrast, the Bureau of Labor Statistics reports median annual income for physicians at $166,400.^[8]

References