The $2.8 million primary care pay gap

October 5, 2012

J. Paul Leigh at the University of California in Davis has taken one of the most in depth - and most recent - looks at what doctors earn. He finds that over a lifetime, a primary care doctor can expect to make $1.5 million less than a medical school classmate who goes into specialty care - and $2.8 million less than a doctor in the best-paid specialty, neurological surgery.

Here's the full chart of how the earnings of various doctors stack up:

This aligns with previous research that has also shown a big pay gap between primary care doctors and specialists. (There is some variation, though, which may be a product of certain studies not accounting for variables like gender and payment during residency, which tends to be lower).

One big question this study raises is: How much does the pay gap matter to medical students? Research from the Graham Center found, perhaps surprisingly, that it might not factor in as much as we thought: Having higher student debt actually correlates with a higher likelihood of pursuing a primary care career. Debt-free doctors, the thinking goes, are more likely to come from a higher income background - and expect a higher salary. Those who accumulate debt to pursue a medical degree may have lower expectations - or put less emphasis on - their ultimate earnings.

More recent research on medical student decision-making suggests even more nuance to how doctors select their ultimate career path. Yeshiva University's Martha Grayson recently looked at students who entered medical school intending to pursue a career in primary care - and how much debt they accrued. Her research, published in the journal Medical Education, did find a relationship between debt and career choice: Students with more debt were more likely to shift their career path away from primary care.

"Compared with their peers who sustained PC [primary care] career goals, those who switched career goals anticipated more debt and attached greater value to income," Grayson concludes. "Moreover, the decision to switch was associated with a marked increase in income expectations of an average of US$75,153." 

Her research suggests - much as would be expected - that money does indeed matter in career decision making. 

Show Comments

Get Wonkbook in your inbox

Sign up for our morning economic policy primer.

Most Read Business
Next Story
Brad Plumer · October 5, 2012