E D I T O R I A L

Physician hourly wages by specialty: how do

orthopaedists stack up?
David E. Ruckle, BS and Elizabeth Yeo, BS

Loma Linda University School of Medicine, Loma Linda University Health, Loma Linda, California

INTRODUCTION DISCUSSION

T
here is an ongoing discussion about reimbursement of We found that procedure-based specialties are paid at a
physicians, differences in hours worked by specialty, higher hourly wage than their cognitive-based counterparts.
and income differences by specialty.1,2 Prior studies These results are in line with prior studies on annual wage by
have evaluated hours worked by specialty and annual salaries specialty.1,2 The lowest hourly wage was still eleven times
made by physicians; however, none have attempted to that of federal minimum wage; however, to put this number
estimate the hourly wage of physicians by specialty. into perspective, a previous thought experiment came to the
conclusion that after adjusting for training, the average
internist makes only $4 more per hour than high-school
MATERIALS AND METHODS teachers and almost $30 less per hour than general dentists
Data on hours worked were drawn from an article by Leigh et al.,1 over the course of a career.5 If this is assumed true then the
and data on annual physician wages were drawn from the annual lowest hourly earning physicians (geriatric physicians) make
Medical Group Management Association Physician Compensa- less per hour than high-school teachers over the course of
tion and Production Survey and the Physician Placement Starting their careers.
Salary Survey.3,4 Hours per year were calculated by adding or Neurosurgery was a big leap ahead of the next highest
subtracting yearly hours above mean to annual mean hours hourly earning specialty. Considering the near decade spent
worked for each specialty. Hourly wage was calculated by taking in residency and fellowship training brings up the interesting
annual salary and dividing it by annual hours worked. topic of opportunity cost that accompanies different resi-
Annual work hours were reported on 38 different specialties, dency and fellowship combinations. Another explanation for
and annual median salaries were reported on 53 different this could be that because the annual hours survey did not
specialties. The MGMA report was used for physician salaries. account for hours worked while on call, the hourly wages
Pediatric varieties of cardiology, intensive care, endocrinology, were possibly inflated by not accounting for a larger than
gastroenterology, hematology/oncology, infectious disease, average call burden.
nephrology, pulmonology, and rheumatology fell under the An additional interesting point was that specialties on the
“other pediatrics” designation. Colorectal and pediatric surgeries much talked about, but never documented “ROAD to happiness”
fell under the “other surgical specialty” designation. Cardiology, (radiation oncology, ophthalmology, anesthesiology, and derma-
interventional cardiology, and electrophysiology fell under the tology) were all in the top third for highest hourly earnings and
“cardiology” designation. yet worked below average hours. Despite not being part of the
comical acronym, it was also notable that plastic surgery was the
only other specialty that fulfilled the above criteria.
RESULTS Orthopaedics as a specialty was well compensated for
The mean hourly wage across 38 specialties was $145.52 per hourly work performed. At $216 per hour, the average
hour, and the median was $130.68 per hour. Figure 1 presents orthopaedist makes the highest hourly wage aside from a
the individual specialty data in graphical form with orthopaedics neurosurgeon. Even starting orthopaedists make more per
highlighted at the different junctures of career (starting, assistant hour than 71% of their colleagues in other specialties. Even
professor, associate professor, and overall). The three highest though academic medicine has traditionally paid less than
hourly earners were radiation oncologists, orthopaedic surgeons, private practice, the hourly wage for associate professors is
and neurosurgeons; and the three lowest hourly earners were only $2 per hour less than the average orthopaedist.
family medicine, “other pediatrics,” and geriatric medicine. Part of the reason for neurosurgeons placing at the top of the
hourly wage list could be due to the close relationship that
neurosurgeons have with industry. Neurosurgeons utilize a
Financial Disclosure: The authors report no conflicts of wide variety of specialized tools that put them in direct contact
interest.
with the medical industry. This is in line with the fact that
Correspondence to David E. Ruckle, BS, Loma Linda University School of
Medicine, 11175 Campus Street, CP-A1108, Loma Linda, California, 92350 neurosurgeons have the second highest payments per physi-
Tel: +909-558-4271; fax: +909-558-4146; cian according to the Open Payments Database.6
e-mail: [email protected]. In line with conventional wisdom, orthopaedics would be
1941-7551 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. thought to have profuse industry ties due to the specialty’s

284 Current Orthopaedic Practice Volume 30  Number 3  May/June 2019

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Current Orthopaedic Practice www.c-orthopaedicpractice.com | 285

FIGURE 1. Hourly wage by specialty with orthopaedists highlighted.

high utilization of implants. However, that does not prove REFERENCES

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Copyright r 2019 Wolters Kluwer Health, Inc. All rights reserved.