United States physicians make far more on average than their counterparts in 10 other countries, according to Medscape's survey of physicians in North America, South America, and Europe.
Whereas US doctors averaged $352,000 per year in salary, the country closest in pay was Canada ($273,000). The lowest-paying country was Mexico, at $19,000. In Germany, which has the highest pay among the European countries in the survey, doctors make $160,000 on average.
Medscape surveyed full-time, practicing physicians in 11 countries not only about their pay and net worth, but also about how they feel about their pay and their jobs. All currencies were converted to US dollars for comparison.
Why the Large Gaps?
The report lists several reasons for the differences in pay. In the US and Canada, for instance, pay for highly skilled, highly educated workers is high. Those two countries also have fewer physicians per capita than do other developed countries, and labor shortages tend to drive up compensation, the authors note.
Additionally, physicians in the US and Canada typically complete 4 years of undergraduate study and 4 years of medical school before residency. In parts of Europe, however, some study medicine in 5-6 years of undergraduate courses.
The pay structure and healthcare markets also diverge widely between countries. This divergence was reflected in the 2022 physician strikes and protests over low pay and lack of staff in France, Germany, Spain, Portugal, and Greece. In contrast, physician strikes in the US are rare.
Also, governments in several countries, including the United Kingdom, France, Italy, and Spain, employ physicians, who provide many services at no charge under a national health plan.
Like those European countries, Brazil and Argentina have universal public healthcare, but South America invests less in hospitals and other medical centers than does Europe, and "that translates into fewer opportunities to become a higher-paid specialist," the authors write.
In Germany, healthcare delivery combines a public system for employed citizens with qualifying income levels and a private system for others.
Unhappiness With Pay
Satisfaction with pay was low in all 11 countries surveyed. The country with the highest percentage of respondents who said they were fairly compensated was the US (52%), followed by Canada (43%). Physicians in those countries had the highest pay and more flexibility or involvement by the private sector in setting the pay.
The lowest satisfaction was in Argentina, where 5% of physicians felt fairly compensated. Physicians there make an average of $21,000, according to the report. In Italy and Portugal, only 11% were satisfied. In Italy, physicians make an average $64,000; in Portugal, physicians make $44,000.
"The fact that 'yes' responses are at or below 20% in half our list points to a possibly serious problem with how physicians view their financial futures," wrote the report author about the low satisfaction levels.
Net worth includes not only pay but also investments and savings rates. In that category, comparisons among the countries were even more stark. The US physicians had by far the highest net worth, at nearly $2 million. At the other end of the spectrum is Argentina, where physicians estimate their net worth at $3000.
"Thanks largely to hyperinflation and major volatility in the country's markets, an average Argentinian physician has a net worth of less than 1% of that of their American counterpart," the authors explain.
They also note that it's important to consider that physicians in several of the European and South American countries surveyed will collect a government pension.
Pay for male doctors was significantly higher than for their female counterparts across the board, but the size of the advantage varied greatly. Portugal had the widest gap, with men making 56% more. Male doctors in neighboring Spain had the smallest pay advantage, at 15%.
Do It Again?
Factors beyond pay, of course, contribute to satisfaction. Physicians were asked how many patients they saw, on average, each week. Those in Germany saw the most (113 per week), and physicians in Mexico saw the fewest (53 per week).
An average US doctor saw 72 patients per week, which was 36% fewer than his or her counterparts in Germany, 29% fewer than in Spain, and 17% fewer than in France.
The survey asked, "If you had it to do all over again, would you choose medicine as a career?" The proportion of affirmative answers ranged from only 53% in Portugal to 73% in the US. That affirmation doesn't always correlate with level of pay.
"Interestingly," the author writes, "Mexico trailed behind all other countries in average physician compensation, but its doctors were about as willing (at 72%) as those in the US to say they'd pick medicine again."
Conversely, the UK was in the top half of the countries for average physician pay but near the bottom for the percentage of physicians who said they'd chosen the right career.
Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News, and Nurse.com, and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St.Cloud (Minnesota) Times. Follow her on Twitter at @MLfrellick
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