Physicians

The physician is a person of recognized experience, with educational and legal qualifications, who diagnoses, prescribes medicines for, and otherwise treats diseases and disorders of the human body. A physician may also perform surgery and often specializes in one aspect of medical care and treatment. Physicians hold either a doctor of medicine or osteopathy degree

The greatest number of physicians are in private practice. They see patients by appointment in their offices and examining rooms, and visit patients who are confined to the hospital. Some physicians also make calls on patients at home if the patient is not able to get to the physicians office or if the illness is an emergency

Approximately 15 percent of physicians in private practice are general practitioners or family practitioners. They see patients of all ages and both sexes and will diagnose and treat those ailments that are not severe enough or unusual enough to require the services of a specialist. When special problems arise, however, the general practitioner will refer the patient to a specialist.

Employment

Physicians (M.D.'s and D.O.'s) held about 580,000 jobs in 1990. About 2 out of 3 were office based practice, including clinics and HMO; about one fifth were employed in hospitals; and most others practiced in the Federal Government.

While physicians have traditionally been solo practitioners, a growing number are partners, or salaried employees of group practices. Organized as clinics, HMO's, or as groups of physicians, medical groups can afford expensive medical equipment and realize other business advantages.

The Northeast has the highest ratio of physicians to population; the South, the lowest. D.O.'s tend to practice in small cities and towns and in rural areas. M.D.'s, on the other hand tend to locate in urban areas, close to hospital and educational centers. Some rural areas remained undeserved, although the situation is changing somewhat. Currently, more medical students are being exposed to practice in rural communities with direct support of educational centers and hospitals in more populous areas.

Osteopathic physicians are located chiefly in states that have osteopathic schools. In 1991, 4 out of 5 D.O.'s were practicing in 16 states. Michigan had the most D.O.'s followed by Pennsylvania, Ohio, Florida, Texas, and New Jersey.

Occupational Outlook Handbook, p. 145.

Occupational Outlook Handbook, , p. 145.

Job Outlook

Employment of physicians is expected to grow faster than average for all occupations through the year 2005 due to the continued expansion of the health industry. The population is growing and aging, and health care needs increase sharply with age. In addition, new technologies permit physicians to do more test, perform more procedures, and treat conditions previously regarded as untreatable. Despite efforts to control cost, the payment of most services through private insurance, Medicare, and Medicaid will continue to encourage growth. The need to replace physicians is lower than most occupations because almost all physicians remain in the profession until they retire.

Job prospects are better for primary care physicians such as family practitioners and internist, than for those in some non primary care specialty such as surgery and radiology. However, changes in Federal Medicare and Medicaid reimbursement, which are designed to encourage, more physicians to provide primary care services, may equalize prospects.

There are shortages of physicians in some rural and low income areas. This is because physicians find these areas unattractive due to low earning potentials, isolation from medical colleagues, or other reasons, not because of any overall shortage.

Some health care analysts believe that there is, or there will soon be a general oversupply of physicians; others disagree. In analyzing job prospects, it should be kept in mind that an oversupply may not necessarily limit the ability of physicians to find employment or to set up and maintain a practice. It could result in physicians performing more procedures than otherwise so as to keep up their incomes, or it could result in their providing more time to each patient, giving more attention to preventive care, and providing more services in rural and poor areas.
Unlike their predecessors, newly trained physicians face radically different choices of where and how to practice. Many new physicians are likely to avoid solo practice and take salaried jobs in group medical practices, clinics, and HMO's, in order to have regular work hours and the opportunity for peer consultation. Others will take salaried positions simply because they cannot afford the high cost of establishing a private practice while paying off student loans.

Earnings

Usually physicians do not begin to earn a good living until their middle 30s. Because they have undergone eight or more years of education after high school, they may be twenty-six years or older before starting postgraduate training. The average resident received a salary of about $20,000 to $24,000 a year in the early 1990s, depending on the type of residency, the size of the hospital, and the geographic area.

Physicians who have completed their residencies but had no other experience began work at the Department of veterans Affairs at salaries of about $44,000. In addition those working full-time could receive other cash benefits up to $13,000.

If the physician enters private practice, earnings during the first year may be impressive. As the patients increase in number, earnings will also increase. The median income, after expenses, for general and family practitioners in early 1990s was estimated to be about $81,200 per year.

Physicians have among the highest average earnings of any occupational group. The level of income for any physician depends on a number of factors, such as region of the country, economic status of the patients, and the physicians skill, experience, professional reputation, and personality. self-employed physicians generally earn more than those on salary.

Physicians salaries during the past year has increased modestly or seen no significant change in the various regions (see list of regions). Regionally, it appeared that increase occurred in the western and southwestern states. Salaries in other parts of the country remained unchanged or decreased from the previous year. (See Table 1.0)

The Encyclopedia of Careers and Vocational Library , p. 500.

The Encyclopedia of Careers and Vocational Library , p. 500.

Breakdown of Regions Surveyed

· Western Region:
Alaska, California, Hawaii, Nevada, Oregon, and Washington

· Southwest Region:
Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, and Texas

· Midwest Region:
Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Missouri, Ohio, West Virginia, and Wisconsin

· Northeast Region:
Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and Virginia

· Southeast Region:
Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee.

Bibliography

1. Cochran, Burt M.D. Student Health Center. San Luis Obispo, California: Cal Poly State Univ., November 18, 1994.

2. "Physicians," The Encyclopedia of Careers and Vocational Library Vol 2. Chicago, Illinois: J.G. Ferguson Publishing Company, 1990, pp. 494-500.

3. Statistical Reference Index 1993 Annual. Bethseda, Maryland: Congressman Informational Service, Incorporated, 1994, pp. 5, 12.

4. U.S. Department of Labor. Occupational Outlook Handbook 1992-1993 Ed. Bureau of labor Statistics. May 1990. Bulletin 2400, pp. 145-147.