Specialist earnings – who are the winners & losers?


Incomes of rheumatologists and dermatologists have surged in recent years while endocrinologists and cardiologists have seen a decline in earnings, a new report shows.

After adjusting for inflation, the majority of specialties experienced a real increase in hourly earnings between 2013 and 2017, with the largest increases for rheumatology, followed by infectious diseases, ophthalmology, and dermatology, according to the “Future Of The Medical Workforce Report”.

Rheumatologists saw an increase of more than 10% in median hourly earnings between 2013 and 2017 with dermatologists seeing a hike of close to 6% during the same period.

Gastroenterology, respiratory, neurology and radiation oncology also showed increases in earnings.

But earnings for endocrinologists dropped 3% and cardiologists dropped 2% during the same period as did those for general and orthopaedic surgery, and intensive Care, the ANZ Bank sponsored report said.

Credit; The Melbourne Institute, University of Melbourne

The report’s author, Professor Anthony Scott of the Melbourne Institute told the limbic there had been no analysis of the specific variations in earnings, but he speculated these could reflect changing supply and demand across the different specialities.

The report showed an overall increase in the medical workforce numbers of 5.7%. But even though this meant more competition, particularly for junior doctors,  specialists’ earnings had generally continued to outstrip inflation, he noted.

“Demand is coming from chronic disease but it’s a bit conflicting because rheumatology is seeing increased demand,” said Professor Scott.

“But the fact that endocrinology is falling is an issue because of the rising demand and prevalence of diabetes as well.”

He speculated that increased participation by GPs in some practices and procedures could be having an effect on specialist earnings. If more people were being managed in primary care there would be no need for them to be referred.

Earnings may also reflect decreasing specialist use of ‘low clinical value’ procedures such as arthroscopy, as encouraged by Choosing Wisely and the RACP, he postulated.

The report also showed the gender pay gap in the specialties was beginning to narrow, albeit because female specialists appeared to be putting in more hours.

“Data on earnings growth by age show the highest growth was for females aged between 45 and 54 years, followed by females aged between 55 and 64 years,” the report stated.

“This could reflect increased demand for experienced female doctors as male… specialists reduce their working hours, while the working hours of females are unchanged or increasing in some age groups.”

Figures in the report were taken from the Medicine in Australia Balancing Employment and Life (MABEL) longitudinal study,  showing earnings before tax but after practice expenses, and included revenue from patients and Medicare for doctors in private practice, and salaries and other payments for doctors in public hospitals.

The report was the third in the health sector-specific series researched and written by the University of Melbourne.

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