Journal of General Internal Medicine

, Volume 34, Issue 11, pp 2649–2651 | Cite as

Physician Payment Disparities and Access to Services—a Look Across Specialties

  • John D. GoodsonEmail author
  • Sara Shahbazi
  • Zirui Song
Much has been written about the shortage of primary care physicians. 1 However, the supply and distribution of a whole range of specialties needed to care for an aging population raise similar concerns. Declining interest among trainees for certain specialties render potential disparities in access as an underappreciated issue in US health policy. Consider the following simple observation. Figure 1 shows the percent of counties in the USA that lack a single physician serving Medicare across a number of specialties, as well as the population in those counties. Relative to highly paid specialties, lower paid specialties are more likely to be absent in a county. While an outlier, the young but critically important specialty of addiction medicine, given the opioid epidemic, is currently absent in the vast majority of counties.


Funding Information

This study is financially supported by a grant from the Office of the Director, National Institutes of Health (NIH Director’s Early Independence Award, 1DP5OD024564, to Dr. Song).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


  1. 1.
    Kane L. Medscape Physician Compensation Report 2018. ( Accessed 2019 Apr 4.
  2. 2.
    Leigh JP, Tancredi D, Jerant A, Romano PS, Kravitz RL. Lifetime Earnings for Physicians across Specialties. Med Care. 2012;50(12):1093–101.CrossRefGoogle Scholar
  3. 3.
    Centers for Medicare and Medicaid Services. Medicare program; revisions to payment policies under the Physician Fee Schedule and other revisions to Part B for CY 2019; Medicare Shared Savings Program requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program. 2018. Accessed 2019 Apr 4.
  4. 4.
    Schmitt S, MacIntyre AT, Bleasdale SC, et al. Early Infectious Diseases Specialty Intervention Is Associated With Shorter Hospital Stays and Lower Readmission Rates: A Retrospective Cohort Study. Clin Infect Dis. 2019;68:239–46.CrossRefGoogle Scholar
  5. 5.
    Kranz AM, Mulcahy A, Ruder T, Lovejoy S, Mehrotra A. Patterns of Postoperative Visits Among Medicare Fee-for-Service Beneficiaries. Ann Surg. 2018.Google Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Division of General Internal Medicine, Department of Medicine Massachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA

Personalised recommendations