Stortz Sharon K, Foglia Lisa M, Thagard Andrew S, Staat Barton, Lutgendorf Monica A
Obstetrics and Gynecology, U.S. Naval Hospital (USNH) Okinawa, Okinawa, USA.
Obstetrics and Gynecology, Maternal Fetal Medicine, Womack Army Medical Center, Fort Bragg, USA.
Cureus. 2021 Jan 27;13(1):e12931. doi: 10.7759/cureus.12931.
Introduction Resident physicians have a professional degree but are compensated less than other recently graduated professionals such as lawyers or nurse practitioners. The U.S. Military Healthcare System differs from the civilian setting in that physicians' salaries are based primarily on military rank. We compared military and civilian physician salaries across various specialties to determine if the increased military pay during residency compensates for military attending physicians' lower income as compared to their civilian counterparts. Methods This cross-sectional study compares military and civilian pay for resident and attending physicians in the fields of Obstetrics & Gynecology (OB/GYN), Family Medicine, and General Surgery. Military pay was obtained from 2018 Defense Finance and Accounting Service (DFAS) data. Civilian salaries were obtained from the Medscape 2018 Residents Salary & Debt Report, Medical Group Management Association (MGMA) 2018 Provider Compensation Report, and 2017-2018 Association of American Medical Colleges (AAMC) Faculty Salary Report. Results Military resident physicians earned 53% more than civilian residents while military attending physicians earned 32%-58% less (after taxes) than their civilian counterparts, varying by specialty. Military attending physicians' negative pay differential occurred in both academic and non-academic practice environments through MGMA data. Discussion The positive pay differential in military residency does not compensate for the negative pay differential of military attending physicians face as compared to their civilian counterparts. This negative pay differential persisted when comparing post-tax pay. Some military service benefits, such as decreased educational debt, are challenging to quantify and vary considerably between individuals. As the military seeks to reshape its healthcare force, military and civilian compensation differences should be considered.
引言 住院医师拥有专业学位，但薪酬却低于律师或执业护士等其他近期毕业的专业人士。美国军事医疗系统与民用医疗系统不同，医生的薪水主要基于军阶。我们比较了不同专业的军队和民用医生的薪水，以确定住院医师培训期间军队增加的薪酬是否能弥补军队主治医生相对于民用同行较低的收入。方法 这项横断面研究比较了妇产科（OB/GYN）、家庭医学和普通外科领域住院医师和主治医生的军队和民用薪酬。军队薪酬来自2018年国防财务与会计服务局（DFAS）的数据。民用薪水来自Medscape 2018年住院医师薪水与债务报告、医疗集团管理协会（MGMA）2018年医疗服务提供者薪酬报告以及2017 - 2018年美国医学院协会（AAMC）教员薪水报告。结果 军队住院医师的收入比民用住院医师高53%，而军队主治医生的收入（税后）比民用同行低32% - 58%，因专业而异。通过MGMA数据可知，军队主治医生的负薪酬差异在学术和非学术实践环境中均存在。讨论 军队住院医师培训期间的正薪酬差异并不能弥补军队主治医生相对于民用同行所面临的负薪酬差异。在比较税后薪酬时，这种负薪酬差异依然存在。一些军队服务福利，如教育债务的减少，难以量化，且个体之间差异很大。随着军队寻求重塑其医疗力量，应考虑军队和民用薪酬的差异。
