Tamir says the government also has placed a salary cap on National Institutes of Health grant research funds. "There are fewer applications being funded, and the physician salaries are being reduced," he says.
While the government may represent a steady erosion of income, physicians face more salary variables from other, "imponderable" sources, such as geography, Tamir says.
In the East, urologists reported $368,401 in median compensation, compared with $300,000 in the Midwest, $336,000 in the South and $445,247 in the West, the MGMA report shows. Tamir says he's unsure why there are such marked differences in urologist pay scales.
Dermatologists in academic settings reported median compensation of $277,765 in the Midwest, and $236,939 in the West. General pediatricians in the East reported $157,289 in median compensation and compared to $139,410 in the South.
When it comes to dermatology, Tamir thinks he has identified factors that explain the salary differences. "Dermatology is clear," he says. "The specialty has a large number of aesthetic procedures that are not covered by insurance and must be paid for in cash," he adds. "Not having to wait for payment and not needing staff to do paperwork is the ideal reimbursement situation."