10 Reasons Why Some Doctors Earn More (Even in the Same Specialty)

Leigh Page


August 12, 2019

However, many employed doctors who bring definite value to their organization aren't rewarded with more pay, says urologist Andrew J. Portis, MD, founder of the Kidney Stone Institute at HealthEast Care System in St Paul, Minnesota.

"I'm bringing in patients who wouldn't be here otherwise," Portis says. "I enlarge the pie for everybody."

But he doesn't get extra payment for the work, he says. This does not bother him, because he gets to do what he likes. "I enjoy my work," he says.

In terms of nonfinancial boosts, Portis says he may get better access to operating rooms and funding for new projects. "I'm supported, instead of having to fight for things," he says.

2. You Have Taken a Job in Administration

Administrative jobs have become more lucrative for physicians, and now, when they go into the C-suite, they make more money than they did in practice.

The wage gap at hospitals between management and physicians has grown in the past decade, according to a 2018 study. On average, orthopedic surgeons now earn one fifth and pediatricians one twelfth of what hospital CEOs earn.[5]

Much of the income for administrators comes in the form of bonuses. At Bronx-Lebanon Hospital in New York in 2012, for example, the chief of obstetrics and gynecology was paid a salary of $283,427 and a bonus of $999,500, whereas the chairman of emergency medicine got a salary of $520,795 in salary plus an $800,000 bonus, according to tax filings reported by the New York Post.[6]

In Minneapolis, however, doctors still don't see a pay boost until they reach the very highest administrative positions, according to Joel Greenwald, MD, a wealth management advisor for doctors.

When doctors enter administration, "the organization may agree to keep them whole, so that they will never earn less than their clinical income, but they will not earn more," he says.

Portis is still mostly involved in clinical work. His contract stipulates that 20% of his time is spent on administrative duties at the Kidney Stone Institute, and his continuing clinical duties require him to work a total of 60 hours a week.

3. You Have Taken on More Patients

Simply treating more patients remains the primary factor in higher income for most physicians.

In a study of family physicians, the number of patients seen was the primary factor in income differences. The mean number of patients per week seen by high earners was 122, whereas low earners saw 84.[7]

Seeing a lot of patients, however, does not necessarily mean working longer hours, says Dike Drummond, MD, who coaches physicians on attaining professional satisfaction. Some doctors simply have a faster pace, he says.

Doctors who work at a slower rate will still need to put in long hours—60-80 hours a week—to see more patients, but they won't necessarily be burned out, says Drummond, who is an expert on physician burnout. "Doctors who love their work can work their butts off without getting burned out," he says.

Portis says that this is true for him. "I am comfortable working harder and being more productive because I love what I do," he says.


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