ObGyn compensation: Strides in the gender wage gap indicate closure possible
While male physicians’ earnings remained stagnant, female physicians’ earnings increased 2%. And if you think the largest cities pay the best, read on.
According to the latest Medscape report, 50% of responding physicians employ nurse practitioners (NPs) and 36% employ physician assistants (PAs); 38% employ neither. Almost half (47%) of respondents report increased profitability as a result of employing NPs/PAs.1
NPs and PAs may be increasingly important in rural America, suggests Skinner and colleagues in an article in New England Journal of Medicine.2,3 They report that the total number of rural physicians grew only 3% between 2000 and 2017 (from 61,000 to 62,700) and that the number of physicians under 50 years of age living in rural areas decreased by 25% during the same time period (from 39,200 to 29,600). As a result, the rural physician workforce is aging. In 2017, only about 25% of rural physicians were under the age of 50 years. Without a sizeable influx of younger physicians, the size of the rural physician workforce will decrease by 23% by 2030, as all of the current rural physicians retire.
To help offset the difference, the authors suggest that the rapidly growing NP workforce is poised to help. NPs provide cost-effective, high-quality care, and many more go into primary care in rural areas than do physicians. The authors suggest that sites training primary care clinicians, particularly those in or near rural areas, should work with programs educating NPs to develop ways to make it conducive for rural NPs to consult with physicians and other rural health specialists, and, in this way, help to stave off the coming dearth of physicians in rural America.
In addition to utilizing an NP workforce, Skinner and colleagues suggest that further strategies will be needed to address the rural physician shortfall and greater patient workload. Although certain actions instituted in the past have been helpful, including physician loan repayment, expansion of the national health service corps, medical school grants, and funding of rural teaching clinics, they have not done enough to address the growing needs of rural patient populations. The authors additionally suggest2:
- expansion of graduate medical education programs in rural hospitals
- higher payments for physicians in rural areas
- expanding use of mobile health vans equipped with diagnostic and treatment technology
- overcoming barriers that have slowed adoption of telehealth services.
References
- Kane L. Medscape physician compensation report 2019. Color/Word_R0_G0_B255https://www.medscape.com/slideshow/2019-compensation-overview-6011286#30. Accessed August 19, 2019.
- Skinner L, Staiger DO, Auerbach DI, Buerhaus PI. Implications of an aging rural physician workforce. N Engl J Med. 2019;381(4):299-300. https://www.nejm.org/doi/pdf/10.1056/NEJMp1900808?articleTools=true. Accessed August 19, 2019.
- Morr M. Nurse practitioners may alleviate dwindling physician workforce in rural populations. Clinical Advisor.
