1. In a study that modeled lifetime earning potentials, adult physicians averaged 25% higher earning potential than their pediatric counterparts.
2. In both adult and pediatric medicine, inpatient medicine specialties with higher volume of procedures were associated with higher lifetime earning potentials.
Evidence Rating Level: 2 (Good)
Study Rundown: It is well-known that pediatric physicians receive lower compensation than adult physicians. This study modelled lifetime earning potential using the net present value (NPV) technique to better characterize these discrepancies. Researchers found that lifetime NPV for pediatric physicians was lower in every subspecialty as well as in general practice when compared to adult physicians. Both pediatric and adult subspecialties with a high volume of procedures and an inpatient-focus were the highest-earning. The cause of this gap in lifetime earning potential is likely multifactorial, and may be a result of a generally lower volume of procedures performed in pediatric populations. In addition, a high proportion of the pediatric population is insured by government insurance programs that tend to provide lower payments than Medicare. Because prior research has shown that increased reimbursement is associated with improved access to care, decreasing the gap between pediatric and adult physicians by improving pediatrician compensation has the potential to improve health care for children, especially those of lower socio-economic status and with complex medical issues. This study is limited by the many assumptions necessary to perform this kind of modeling, as well as its focus only on physicians who practice academic medicine.
Click to read the study in PEDIATRICS
Relevant Reading: Differences in Lifetime Earning Potential for Pediatric Subspecialists
In-Depth [cross-sectional study]: This study used national physician survey compensation data from 9915 pediatric physicians and 28,622 adult physicians to model lifetime earning potential in academic practice. The Net Present Value (NPV) technique was used to adjust for the fact that present income is more valuable than future income given the opportunity for investment. When compared, the average adult physician had a lifetime NPV 25% higher than pediatric physicians in the same specialty. The highest discrepancy was found between adult and pediatric gastroenterology ($2.2 million) and the smallest gap was in allergy-immunology ($220,000). 4 pediatric subspecialties had lifetime NPVs above the median ($4.8 million): cardiology, critical care, gastroenterology, and emergency medicine. Even when researchers adjusted for the longer duration of pediatric training, there was no substantial decrease in the disparity between adult and pediatric earnings.
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