Physicians in the United States

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

Physicians in the United States are doctors that practice medicine for the human body. They are an important part of health care in the United States. The vast majority of physicians in the US have a Doctorate of Medicine (MD) degree, though some have a DO or MBBS.

The American College of Physicians, uses the term physician to describe specialists in internal medicine, while the American Medical Association uses the term physician to describe members of all specialties.

Working conditions[edit]

Doctors may work independently, as part of a larger group practice, or for a hospital or healthcare organization. Independent practices are defined as one in which the physician owns a majority of his or her practice and has decision making rights. In 2000, 57% of doctors were independent, but this decreased to 33% by 2016. Between 2012 and 2015, there was a 50% increase in the number of physicians employed by hospitals.[1] 26 percent have opted out of seeing patients with Medicaid and 15 percent have opted out of seeing patients with health insurance exchange plans.[2]

On average, physicians in the US work 55 hours each week and earn a salary of $270,000, although work hours and compensation vary by specialty.[3] 25% of physicians work more than 60 hours per week.[4]

Demographics[edit]

While an impending "doctor shortage" has been reported, from 2010 to 2016, the actively licensed U.S. physician-to-population ratio increased from 277 to 295 physicians per 100,000 people. Additionally, the number of female physicians, and osteopathic and Caribbean graduates have increased at a greater percentage.[5] The percentage of females skews younger. In 2016, 34% of female physicians were under 40 years old, compared with 19% of male physicians.[5]

As of 2016, there were over 950,000 practicing physicians in the United States. 93% have an MD degree, and 76% were educated in the United States. 65% were male. 79% were licensed in a medical specialty. 22% held active licenses in two or more states.[5] The District of Columbia has, by far, the largest number of physicians as a percentage of the population, with 1,838 per 100,000 people.[5]

Specialists[edit]

The term, hospitalist, was introduced in 1996,[6] 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.[7]

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.[citation needed]

Salaries[edit]

Compared to foreign countries[edit]

The United States has the highest paid general practitioners in the world.[8] The US has the second-highest paid specialists in the world behind the Netherlands.[8] 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.[9] 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.[9] Higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, mainly drive higher US spending.[9]

Variations within the US[edit]

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.[10][10] Also, female physicians are more likely to report working fewer hours than their male counterparts.[10]

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 $225,000 per year, as per 2010. The next highest earning physicians were those in the South Central region, comprising Texas, Oklahoma, and Arkansas, at $216,000. Those physicians reporting the lowest compensation levels were located in the Northeast and Southwest, earning an across-specialty median annual income of $190,000.[10]

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).[10]

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.[10]

In contrast, the Bureau of Labor Statistics reports median annual income for physicians at $166,400.[11]

Medical education[edit]

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[12] or a Doctor of Osteopathic Medicine (D.O.) degree.[13] During the process of medical school, physicians who wish to practice in the U.S. must take standardized exams, such as the USMLE steps 1, 2 and 3.

In addition, the completion of a residency is required to practice independently. Physicians must have a medical license to practice in any state.

See also[edit]

References[edit]

  1. ^ "Number of Hospital-Employed Physicians Up 50% Since 2012 - staffing, human resources, physician, health system, cost - HealthLeaders Media". www.healthleadersmedia.com. 
  2. ^ https://www.accenture.com/t20150608T044420__w__/us-en/_acnmedia/Accenture/Conversion-Assets/DotCom/Documents/Global/PDF/Dualpub_15/Accenture-The-Doctor-Will-Not-See-You.pdf
  3. ^ "$1 million mistake: Becoming a doctor". 
  4. ^ "How many hours are in the average physician workweek?". 6 January 2015. 
  5. ^ a b c d https://www.fsmb.org/Media/Default/PDF/Census/2016census.pdf
  6. ^ Wachter R, Goldman L (1996). "The emerging role of "hospitalists" in the American health care system". N Engl J Med. 335 (7): 514–7. doi:10.1056/NEJM199608153350713. PMID 8672160. 
  7. ^ Kuo, YF; Sharma, G; Freeman, JL; Goodwin, JS (2009). "Growth in the care of older patients by hospitalists in the United States". N Engl J Med. 360 (11): 1102–1112. doi:10.1056/NEJMsa0802381. PMC 2977939Freely accessible. PMID 19279342. 
  8. ^ a b Rie Fujisawa; Gaetan Lafortune (2008). "OECD health working papers #41: The renumeration of general practitioners an specialists in 14 OECD countries: What are the factors influencing variations across countries?" (PDF). Directorate for Employment, Labour, and Social Affairs. OECD. p. 63. Retrieved 17 March 2013. 
  9. ^ a b c Laugesen, M. J.; Glied, S. A. (2011). "Higher Fees Paid to US Physicians Drive Higher Spending for Physician Services Compared to Other Countries". Health Affairs. 30 (9): 1647–1656. doi:10.1377/hlthaff.2010.0204. PMID 21900654. 
  10. ^ a b c d e f "Medscape Log In". www.medscape.com. 
  11. ^ Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, Physicians and Surgeons, on the Internet at http://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm (visited November 01, 2013).
  12. ^ Medline Plus (2012). "Doctor of medicine profession (MD)". U.S. National Library of Medicine of National Institutes of Health. Retrieved 20 December 2012. 
  13. ^ Medline Plus (2012). "Doctor of Osteopathic Medicine". U.S. National Library of Medicine of National Institutes of Health. Retrieved 20 December 2012.