Economic boom of '90s left many physicians behind












While other skilled professionals enjoyed sharp increases in wages and salaries between 1995 and 1999, the average physician's net income from the practice of medicine dropped 5 percent, according to a survey released by the Center for Studying Health System Change. Primary care physicians' income fell 6.4 percent in constant dollars, notably further than the 4 percent drop reported for specialists.

Still, medicine remains one of the highest paid professions in America. More than half of all physicians earned in excess of $150,000 in 1999, and the mean was about $187,000, the study found: $219,000 for specialists in 1999, compared with $138,000 for primary care physicians.

Managed care's growth from 1995 to 1999 probably played a role in the physician income decline by holding down spending on physician services through discounted fees and restrictions on the use of care. However, the decline in physician income slowed between 1997 and 1999 as managed care restrictions eased and both the volume and price of physician services increased.

"The real-dollar decline in physician income may help explain why physicians have objected so strongly to Medicare payment reductions and why a smaller proportion of physicians is providing charity care," says Paul Ginsburg, PhD, coauthor of the study and the Center's director.

These findings are detailed in "Behind the Times: Physician Income, 1995-99," which is available online at <http://www.hschange.org>. The study is based on results from HSC's Community Tracking Study Physician Survey, a nationally representative survey involving about 12,000 practicing physicians.

1995–1999: Not very good years

Note: Physician income data are based on reported net income from the practice of medicine (after expenses and before taxes). The federal Bureau of Labor Statistics (BLS) Employment Cost Index of wages and salaries for private "professional, technical, and specialty" workers was used to calculate estimates for these workers. Data were adjusted for inflation using the BLS online inflation calculator at <http://146.142.4.24/cgi-bin/cpicalc.pl>.

SOURCE: HSC COMMUNITY TRACKING STUDY PHYSICIAN SURVEY

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