Weeks William B, Wallace Amy E
Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire, USA.
Acad Med. 2002 Apr;77(4):312-9. doi: 10.1097/00001888-200204000-00010.
The authors previously compared the 1990 educational costs and incomes of physicians and other professional groups. Since then, there have been dramatic changes in the market for the groups examined. This article reports their update of the previous analysis, using 1997 data. For this update, the authors applied standard financial techniques to expected incomes and educational costs to determine the return on educational investment over the working lifetime for five professional groups: primary care physicians, procedure-based physicians, dentists, attorneys, and graduates of the top 20 business schools. The hours-adjusted net present values of the educational investments for attorneys ($10.73) and procedure-based physicians ($10.40) are considerably higher than those for dentists ($8.90) and businessmen ($8.27); the return for primary care physicians ($5.97) remains much lower than all others. Primary care physicians have an hours-adjusted internal rate of return on their educational investment equal to 16%, compared with 18% for procedure-based medicine, 22% for dentistry, 23% for law, and 26% for business. Although it remains the lowest of all professional groups examined, primary care medicine has made the largest percentage gain in net present value of all groups. Although anticipated changes in physician incomes have occurred, the standing of physicians relative to other professional groups has not changed. Students can still anticipate relatively poorer returns on their educational investment when they choose a career in primary care medicine as compared with careers in procedure-based medicine or surgical specialties, business, law, or dentistry.
作者们此前比较了1990年医生及其他专业群体的教育成本和收入。自那时起，所研究群体的市场情况发生了巨大变化。本文报告了他们使用1997年数据对先前分析的更新情况。对于此次更新，作者们将标准财务技术应用于预期收入和教育成本，以确定五个专业群体在整个工作生涯中的教育投资回报率：初级保健医生、从事手术类的医生、牙医、律师以及排名前20的商学院毕业生。律师（10.73美元）和从事手术类的医生（10.40美元）教育投资的经工时调整后的净现值显著高于牙医（8.90美元）和商人（8.27美元）；初级保健医生的回报率（5.97美元）仍远低于其他所有群体。初级保健医生教育投资的经工时调整后的内部收益率为16%，相比之下，从事手术类医疗的为18%，牙科为22%，法律为23%，商业为26%。尽管初级保健医学仍是所有研究的专业群体中回报率最低的，但在所有群体中，其净现值的增长百分比却是最大的。尽管医生收入出现了预期中的变化，但医生相对于其他专业群体的地位并未改变。与从事手术类医疗或外科专科、商业、法律或牙科职业相比，学生若选择从事初级保健医学职业，仍可预期其教育投资回报相对较低。
