Specialties work equally hard, study supports equitable pay

Aptly timed, as physician groups implore the Centers for Medicare & Medicaid Services (CMS) to make changes to its proposed 2012 fee schedule and others fight for primary care to be more highly valued, a new study sheds light on how hard doctors across specialties actually work.

Contrary to the popular perceptions that surgeons' work is more difficult, physicians across specialties experience similar levels of mental effort and stress, according to research from the University of Cincinnati.

The study, published in the Sept. 3 issue of Medical Care, used work intensity measurement tools to compare a sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons across five states.

Although researchers determined that, at the end of the day, most doctors put in a similar total effort, their findings revealed the following variances in what aspects of the job are most demanding across specialties:

  • A great deal of surgeons' work effort comes from mental concentration on the task at hand, as well as the physical demands of performing surgery
  • Family physicians reported the highest demands on their time compared to other specialties, while surgeons reported the lowest intensity for time demand
  • General internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists

"Although preliminary, the findings suggest that these instruments can be used to further investigate clinical work intensity and that currently accepted assumptions of extremely differing work intensity among medical specialists may be flawed," said Ronnie Horner, chair of the UC College of Medicine's public health sciences department and lead investigator on the study, in a UC Health News article.

To learn more:
- read the article from UC Health News
- see the study abstract from Medical Care
- check out this article from Cardiovascular Business
- see this post from the Wall Street Journal
see MGMA's comments on the fee schedule
- read the AAFP's letter to CMS about its proposal (.pdf)

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