Doctors in America make more money than those in other countries, which raises the questions about whether it is driving up healthcare costs.

Doctors in the United States charge sometimes twice as much for procedures than their counterparts overseas, according to a study by scientists at the Mailman School of Public Health at Columbia.

The pay gap is biggest for speciality procedures, such as hip replacements.


The study compared the cost of care in the United States to that in Australia, Canada, France, Germany and the United Kingdom. The findings were published in the September issue of Health Affairs.

The higher fees in turn lead to higher incomes for US doctors and are the main driver of higher overall spending in the United States on physicians' services, the researchers found.

The largest difference in fees paid to doctors was for hip replacements. U.S. physicians were paid 70 percent more for these procedures by public insurance such as Medicaid, and 120 percent more by private insurers, than the average fees paid to physicians in the other countries.

"For decades, policy makers and medical leaders in this country have debated financial incentives to spur more doctors to become primary care physicians," said lead author Miriam Laugesen. "Our work shows that continuing attention needs to be paid to the difference in payments across specialties, and how we can get better value for those expenditures."

The study also further proved that the biggest disparities in U.S. pay to physicians are on the private side. Fees paid by large private national insurers in six markets in the United States were on average about one-third higher than Medicare rates for primary care and 50 percent higher than Medicare for hip replacements. Private insurers have been less successful in negotiating fees with orthopedic surgeons than with generalist physicians, the authors said.

Physicians in the United States also reported higher salaries in comparison to the other countries, despite the fact that there was little difference in the amount of services performed. The authors suggest that the differences may reflect the fact that US physicians are being paid more for their skill and time than are physicians in other countries.

The study did not look into whether the higher salaries were warranted.

US primary care physicians earned the highest average annual incomes at $186,582, while the French at $95,585 and Australian at $92,844 earned the lowest. US orthopedic surgeons earned the highest average annual incomes at $442,450, followed by $324,138 for orthopedic surgeons in the United Kingdom.

The finding that US health care fees and spending are higher than in other countries is nothing new. However, the study finds that the higher fees paid to physicians—rather than factors such as higher practice costs, volume of services, or medical school tuition expenses—are the main drivers of higher US spending on physicians, particularly in orthopedics.

The authors of the study said that as policy makers look for ways to restrain health care spending, findings from the new study could provide a reason to look at physician fees for savings.

So what do readers out there think. Are doctors paid too much in the United States?

Doctors, are you being paid your worth?

Chime in and let us know.