Intended for healthcare professionals


US doctors' incomes fell in 1999

BMJ 2000; 321 doi: (Published 25 November 2000) Cite this as: BMJ 2000;321:1309
  1. Fred Charatan
  1. Florida

    A survey conducted by Medical Economics, a medical business journal, showed a decline in gross and net annual income of many American doctors in 1999.

    Compared with 1998, the median gross revenue for internists fell by 6.4% to $202560 (£144700) and for family practitioners fell by 3.2% to $211820. Net income fell even more—by 10.5% for internists and by 7% for family practitioners.

    All surgical specialists' gross income fell by less than half a per cent, while their net earnings rose by 2.6% On the other hand, the gross income of all non-surgeons fell by 5.4% with a net income drop of 2.6% The top earners (gross income) in 1999 were plastic surgeons—each of whom earned nearly half a million dollars—followed closely by neurosurgeons.

    In non-surgical specialties, non-invasive cardiologists topped the table with a net income of $208000, with paediatricians in second place ($134000) and family practitioners next ($128000). The lowest earners were GPs ($107000), followed by psychiatrists ($126000) and internists ($127000).

    In 1999 women earned 77% less than men. Female surgeons earned 80% of their male counterparts' income. As might be expected, an increased caseload boosted earnings; for all fields, for example, less than 50 consultations a week brought in a net income of $142730 a year, and 100-124 consultations a week brought in $169660.

    Two hundred or more consultations a week in all settings—for exampleoffice, hospital house calls—brought in $223500 net income. Longer hours (including all professional activities—patient care hospital rounds meetings, medical reading, and office business tasks)—had an even bigger impact. For all fields, less than 30 hours worked each week brought in a net income of $94410 annually. Doubling the hours worked to 50-59 hours a week brought in $160030.

    Doctors working in managed care plans (health maintenance organisations) did not do so well. In 1999, for the second consecutive year, the net income of doctors who participated in such organisations dropped, while that of doctors who did not work in managed care continued to rise.

    The Medical Economics survey, conducted by Sandy Johnson, manager of field services, was based on mailings in March to 64135 doctors and doctors of osteopathy in private practice nationwide from the American Medical Association master list; 10299 responses resulted in a final working sample of 7492 doctors (12% of the first mailing).

    The full report can be accessed at

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