Do physicians fare better under socialism?

May 16, 2005

An article in the Britain section of the May 14 Economist (Practice makes perfect) got me thinking: Do physicians do better in the single payer, socialistic National Health Service than in the free-wheeling US market?

Here’s some food for thought:

  • The average family practitioner salary in the UK is $170,000 (90,000 GBP) compared to $144,000 for a generalist in the US (US national average from Monster.com)
  • The typical UK physician receives 90% of his or her compensation from the NHS. In the US physicians complain about all the administrative hassles and expense of chasing payments from a multitude of payers
  • Almost all UK physicians have electronic medical records; the hardware and software is often owned by the NHS. In the US EMR adoption is about 15%, and physicians have to pay for the infrastructure and tools themselves
  • Pay for performance programs have taken off in the UK. Physicians are leveraging electronic medical records and decision support tools to achieve higher scores than expected. It means more income for the physicians and better care for patients. In the US, pay-for-performance programs are really just getting off the ground, hobbled by the fragmentation of the payer market and lack of electronic point-of-care tools

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May 25 update –My comment on the comments

A number of readers have pointed out that the cost of living is higher in the UK than the US. That’s true, and it means that the standard of living is lower at the same salary level.

In general, US wages are higher than UK wages. But, for primary care physicians the reverse is true. Not only are UK physician salaries higher than for their US counterparts in absolute terms, but UK physicians also do better financially relative to other professions than do US physicians.

Somehow the socialist health care system in the UK has given primary care physicians a higher financial standing in society than the “free market” US system.

8 thoughts on “Do physicians fare better under socialism?”

  1. Children’s Hospital in Boston is booking new-patient Neurology consults in October (that’s 5 months from now). So much for reduced waiting lists.

    Socialized medicine presents problems that are not shared by our semi-socialized system. Waiting times, however, are not unique to these countries.

  2. A doctor earning £90,000 is really earning much less than a doctor earning $144,000.

    Using the exchange rate in this context is misleading. The actual purchasing power of the pound is about equal to the actual purchasing power of the dollar: a book that costs $12.99 here costs £12.99 there; a dress that costs $75 here costs £75 there; and so on. The exchange rate is not so much a functon of purchasing power as it is of international macroeconomic events such as the balance of trade.

  3. Its all very well to say that all physicians in the UK have EMR. The question is, do they have EMR that they are happy with, that helps them do their jobs, that does all the things EMR is supposed to do?

    I am peripherally involved in EMR implementation here in the states, and I can tell you that EMR isn’t some magic wand. Most docs who have it bitch about it endlessly.

    I shudder to imagine what kind of monstrosity we would have if the federal government were in charging of speccing and buying EMR for our practices.

  4. The ionteresting qusetion I have is this:
    Would a move towards socialized medicine mean better LIVINGSTANDARDS for phsycians.. Will we work less per year? More vacations? better benefits?
    I suppose if everyone is covered under this insurance than that would also illiminate buisnesses having to pay for theirs, would that translate into higher salaries?

    hmmmm…

    I would suck for most patients though. That’s pretty clear!

  5. Second what anonymous said. As a temporary expat who moved from London to New York, I can testify that for most things (though not health care!) you should expect to pay in pounds what you pay in dollars. Thus, when I calculated what I would need to replicate my (exceedingly modest) lifestyle in New York, it came out that I would need to make almost the same amount in pounds that I had in dollars. You can replicate that result yourself, by going to any of the expat calculators and plugging in your own income. Your calculations are the result of a high exchange rate, which only helps British doctors when they vacation in America.

    Of course, there are areas of the country where the cost of living is lower . . . but that’s really only real estate. A McDonalds dollar menu is a £ menu here, and things that are a similar price everywhere, like books and Starbucks coffees and so forth, show the same tendency to match American prices in pounds. My colleagues who travel do their shopping for clothes, electronics and so forth elsewhere.

  6. Pingback: WorldHealthCareBlog.org » “It’s the Prices, Stupid!” Take 2: a hosted discussion on innovation in health care
  7. Basically am from INDIA, i thought physicians earn more money compare to IT professionals.
    This is very less income compare to indian physicians, where as here physicians will earn more money by just visiting other hospitals.

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