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     As a practicing specialty physician I could make more money in other countries such as Canada or Australia.  While true in the not so distant past American physicians were paid more than their counterparts in other first world countries this is no longer the case primiarily secondary to flat physician salaries for the last ten to fifteen years combined with rising living costs and in particular much higher liability insurance costs.  Primary care physicians are under paid in this country compared to other nations particularly when factoring in length of training, medical school costs with high debt levels, and liability insurance costs.

     Many studies show physican salaries account for no more than 10% of the cost of American medicine.  No question there should be more parity in physician salaries across specialities but if Americans want the best and brightest to be their medical doctors a good salary should be provided given the length and cost of medical training combined with the extreme liability issues. 

     Secondary care providers play an important role but many such as PAs, Nurse Practioners, etc ultimately work under the supervision of a physican who is responsible from a medical-legal standpoint.  No question there should be more emphasis in preventive and primary care in this country but keep in mind many medical students do not do primary care residencies because of the relative modest salaries when compared to medical student debt than can easily exceed 300K.  No other first world country requires medical students to go into such debt.  Are there some outlier physicians who are overpaid?  Of course.  But I would argue the vast majority of physicians are not overpaid.  In debating the hight cost of American medicine compared to other countries look at the one major difference.  A multi-payor, private, for profit insurance industry compared to most other countries single payor, not for profit insurance model.

Jonathan Helwig, MD

Portland, OR

posted 3 years, 1 month ago
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