Physician Salaries Vary Widely Among Academics

Go West, academic urologist. You may earn more than $455,000 annually there, compared to $300,000 in the Midwest.

(If you are an academic dermatologist, the Midwest is the place to be, not the West, if you want optimum income.)

Whatever you do in academic circles, if you seek a very nice, comfortable salary, be a department chair and a specialist. Then again, if you are engaged in academia, it isn't all about the money is it? There's more money in private practice, of course, but we'll get to that later.

There's a wide variation in physician-related academic salaries, often dependent on geography and rank within academic settings, says the Academic Practice Compensation and Production Survey for Faculty and Management of 2012. The Medical Group Management Association report, based on 2011 data, contains information on more than 20,000 faculty physicians and non-physician providers categorized by specialty, and more than 2,000 managers.

The salaries also depend upon academic settings, clinical productivity and research support, according to Jonathan Tamir, vice chairman of finance and administration at the Yale University School of Medicine's Department of Internal Medicine.

Department rank, of course, also influences compensation.

While primary care associate professors reported median income of $198,000, primary care department chairs reported a median compensation of $282,296. Specialty care associate professors earned $260,075 and full professors earned $280,000. Specialty care department chairs reported median compensation of $506,200.

Don't expect those income levels to grow much, at least in the near future, Tamir tells HealthLeaders Media. With economic conditions and federal reimbursement changes, "there's a lot of downward pressure on salaries, compensation, and support in general."

"Healthcare is a weird system where you have the usual supply and demand factors at work in some places, but not at work in others," Tamir says. "If you look at medical insurers, they will pay the same amount for services regardless of the tenure and experience of the person doing it. I see salaries increasing marginally. You want to make sure your faculty are not de-motivated by their salaries not keeping up with inflation."

For academic researchers, there have been "negative developments recently," particularly from the government, he says. He referred to reduced support for research, as well as salary reductions. "We're actually seeing mid-term reductions of funding, where someone may be going along and believe they would be funded at a certain amount for five years and then, the government is saying, ‘guess what, we're reducing it,'" Tamir says. "After year three of a grant, the government may say, ‘We're cutting you 10 or 20%.'

"Then, as a researcher, you have to scramble, maybe cut supplies or support staff to produce the results despite the cuts," Tamir says.

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."

The MGMA report shows that physician compensation in academic settings is behind that of doctors in private practice, as "is customary," Tamir says. Family practitioners in academic settings reported median compensation of $173,801, compared with $189,402 in private practice.

Specialists in academic settings also were behind physician earnings in private practice, according to the report. Anesthesiologists earned $326,000 in median compensation in academic settings, compared to $407,292 in private practice. General surgeons in academic settings earned $297,260 in median compensation, compared to $343,958 in private practice.

"Salaries in academic practices will always be lower than that of salaries in private practices," Tamir said in a statement. "Physicians in private practices concentrate their effort on providing clinical care to patients, while physicians in academic practices split their efforts between clinical care and research activities. These research activities are never as well compensated as clinical care." 

Despite what many people may think, generally "physicians are not going into (the profession) for the money," Tamir says. "If you want to go into big finance, you go to Wall Street and law school, where there's more immediate bang for your buck," he says. "Physicians don't start earning money, for the most part, until they are in their 30s, and they have loans to pay off." There are many years where doctors have to "catch up," he says.

If the downward pressure on physician salaries continues, catching up is bound to take even longer.