Tuesday, November 10, 2009

How Much Money Do French Doctors Make?

This wouldn’t seem to be such an important question but for the fact that it comes up quite often when people compare the US and the French health care delivery systems. When someone argues that the French system achieves good outcomes for much less the response is often that French physician make so much less money. The oft cited figure for their annual salary is about $50,000 or “one-fourth” what American doctors make. But is that true?

I rummaged through a series of reports on French physician salaries and I found that it’s not so easy to assign an “average” income for physicians but there are some indications that they make a good deal more than the $52,000 annually that Dr. Bonnaud said he made in an interview with T.R. Reid. In January, 2009 the French Inspector General for Social Affairs issued a report on a study of “Remuneration of Hospital Based Physicians and Surgeons.” It was leaked into the press before final publication because the salaries were so high.: “The report lifts the veil on the remuneration of doctors” said toutemasante.com. That’s because it showed hospital based radiotherapists pulling in 686,913 euros in 2007. Surgeons were comparatively less paid but getting 198,766 euros (that’s $299,000 at today’s exchange rate) with internists getting, on average 111,705 euros.

Those numbers are for hospital based physicians and, as is the case in the United States, office based practitioners may make less. The French IG report did compare office based incomes for an earlier year listing the average income for general practitioners in 2005 at 69,521 euros ($104,281). That’s a bit more than the $50,000 that is often cited.

The organization that represents most of the general practitioners in France reported that their “real” average income in 2007 was just over 70,000 euros; this was their “take home” from a total income of 132,949 euros. These are based on their retirement accounts that the physicians hold; their retirement incomes are based on their “taxable” or reported income. That 70,000 euros is worth $105,000 today.; again, a lot more than the numbers we read in the blogs.

The Medical Group Management Association (MGMA) produces a very useful annual survey of physician “compensation” in the United States. For 2006, they report that family physicians in the US made, on average, $171,519; general surgeons $306,115; and diagnostic radiologists $446,517. Clearly, on average, US physicians make more than their French counterparts, but not always more and not 400% of their American counterparts, maybe 1.5 times would be good benchmark for comparison.

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