Medscape last week released its International Physician Compensation Report 2019, which found that physician pay in the United States is far higher than in other countries investigated—with U.S. physicians earning nearly twice as much as German physicians, who were the second-highest-paid.

Report: How to engage physicians in conversations about pay

Report details

For the report, Medscape invited full-time practicing physicians from Brazil, France, Germany, Mexico, the United Kingdom, and the United States to participate in an online survey to compare their training, medical education costs, compensation—which included their bonus, salaries, profit sharing—and more. In total, Medscape received responses from:

• 19,328 U.S. physicians between Oct. 18, 2018 and Feb. 14, 2019;
• 1,599 Brazilian physicians between Feb. 28, 2019 and April 10, 2019;
• 1,390 Mexican physicians between Feb. 21, 2019 and April 19, 2019;
• 1,022 U.K. physicians between Jan. 8, 2019 and Feb. 13, 2019;
• 963 Spanish physicians between Feb. 21, 2019 and April 8, 2019
• 863 French physicians between Jan. 28, 2019 and April 10, 2019; and
• 534 German physicians between Feb. 13, 2019 and April 10, 2019.

The researchers converted international currencies to U.S. dollars for the report. 

Findings

Medscape found U.S. physicians have the highest annual salaries, at $313,000, and German physicians have the second-highest annual salaries, at $163,000:

Medscape noted that a number of factors could affect physician salaries. For example, the cost of living varies significantly among the countries studied, with the average cost of rent in Mexico being about 75% lower than in the United States.

Another factor affecting physician salaries could be the cost of a medical education, according to Medscape. Medscape found the average annual cost of a private medical school education in the United States is $50,000, compared to up to $17,000 in Spain:

In the United States, the cost of public medical school—meaning in-state tuition for in-state students—averages $35,000 annually. In Brazil and Mexico, there is no cost for public school. However, doctors in Mexico who go to public medical school must work at a government service hospital or medical center for a certain amount of time. Private medical schools in Mexico costs $37,000 to $56,000 annually. In Germany, medical school at public universities close to free, with students paying about $600 in administrative fees annually. In France, both private and public medical schools costs about $800 annually.

According to Medscape, U.S. physicians were most likely to say they were fairly compensated—though many still feel unfairly compensated. In the United States, 53% of primary care physicians and 56% of specialists said they were fairly compensated. Physicians in Spain were least likely to say they were fairly compensated. In Spain, 16% of primary care physicians and 13% of specialists said they were fairly compensated.

Across all the countries, Medscape found women had lower salaries than men—particularly among specialists. In Germany, where the specialist gender gap was greatest, male specialists are paid about 47% more than female specialists.

In terms of hours spent with patients, Medscape found primary care physicians in France spent on average the most hours with patients, at 45 hours per week for male physicians and 43 hours per week for female physicians. U.S. physicians spent the second-highest number of hours with patients on average, at 40 hours per week for a male physician and 36 hours per week for a female physician:

(Frellick, Medscape, 9/18; Kane et al., Medscape, 9/16).