Studies on the disparities in remuneration between primary care and other physician specialties are many, but a new study boils the differences down to the wages-per-hour level. The Center for Healthcare Policy and Research at the University of California–Davis compared wages across broad and narrow categories of physician specialists from data collected in the 2004–2005 Community Tracking Study, the latest data available.

Overall, clinicians earned an average annual income of $187,857 and worked an average of 53.1 hours per week. Neurologic surgeons and radiation oncologists received the highest wages, $132/hour and $126/hour, respectively.

“I see a problem with a heavy reliance on specialists, especially in this country,” says J. Paul Leigh, PhD, a professor at the center and lead author of the study. He says physicians in general are very smart and he doesn’t think that there is “a big difference in intellectual ability between a student who decides to go into primary care and one who becomes a neurologic surgeon. So why is one group paid double or triple the other group? That doesn’t make a lot of economic sense.” And yet, that’s the current pay scale in this country. He takes an aggressive approach: “Freeze the pay on specialists. Don’t give them any more raises, and allow the pay for primary care physicians to increase.”

On a promising note, Leigh says there were no wage disparities between physicians who are white, Hispanic, or black. But women were paid on average $9/hour less than their male counterparts.

Ranking specialty pay

Among 41 specific specialties, the top 2 ranking specialties were neurologic surgery and medical oncology. General practice and internal medicine and pediatrics were the lowest paid specialists. In terms of general broad category rankings (from highest to lowest) researchers found physicians who performed surgery at the high end, followed by other medical, and internal medicine and pediatrics subspecialties. At the low end were physicians who provided primary care.

Ranking specialty pay

Source: Leigh JP, Tancredi D, Jerant A, Kravitz RL. Physician wages across specialties: Informing the physician reimbursement debate. Arch Intern Med. 2010;170(19):1728–1734

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

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The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

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Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.