Study: Inflation-adjusted compensation has declined for orthopedic surgeons
Key takeaways:
- Orthopedic surgeons had the largest decrease in inflation-adjusted compensation among many skilled professions from 2000 to 2020.
- Compensation for orthopedic surgeons decreased 38% after adjusting for inflation.
According to results published in the Journal of Arthroplasty, compensation for orthopedic surgeons has declined 38% from 2000 to 2020 after adjusting for inflation.
Results showed orthopedic surgeons had the greatest inflation-adjusted declines in compensation compared with other health care professionals and high-skilled professionals, such as economists, lawyers and engineers.
“This trend carries major implications for the future of the field, potentially affecting recruitment, satisfaction, burnout and patient access to care,” Daniel E. Pereira, MD, and colleagues wrote in the study. “It underscores the need for a reevaluation of compensation models in orthopedic surgery to ensure sustainability.”
Pereira and colleagues used income data from the United States Bureau of Labor Statistics to study compensation trends for various skilled professions from 2000 to 2020.
According to the study, Pereira and colleagues analyzed income data for orthopedic surgeons, general surgeons, internal medicine physicians, podiatrists, dentists, nurses, hospital or health care managers, secondary school teachers, attorneys, accountants, engineers, economists, social workers, actuaries and police officers.
Overall, orthopedic surgeons had a compensation rate increase of 15% from 2000 to 2020 – the lowest rate increase among all professions included in the study. Internal medicine physicians had the second lowest compensation rate increase of 53% from 2000 to 2020.
After adjusting for a concurrent increase in inflation of 53% from 2000 to 2020, orthopedic surgeons had an absolute difference of –38% in inflation-adjusted compensation. Pereira and colleagues noted this decrease in inflation-adjusted compensation was the largest among all professions included in the study.
Economists, lawyers and engineers had the largest increases in inflation-adjusted compensation outside of the health care profession at 31%, 26% and 24%, respectively.
Pereira and colleagues noted inflation, rising interest rates, staff shortages, policy changes, decreases in per-case reimbursement, financial burdens of Medicare and Medicaid patients, as well as increasing year-over-year expenses, may play a role in compensation decreases for orthopedic surgeons.
Perspective
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Orthopedic surgery has become one of the more competitive and popular surgical subspecialties over the last 3 decades, driven in part by rapidly evolving technology, life-changing patient impact, increased demand due to expectations of remaining active as the population lives longer and high compensation relative to other medical specialties.
Higher compensation is likely a reflection that orthopedics is a demanding field with a high rate of surgeon burnout, suicidality and dissatisfaction in recent years.
Pereira and colleagues performed a comparative analysis over 20 years and found that orthopedic surgeon salary rates adjusted for inflation declined the most of all professions analyzed (–38%), including all health care workers, while economists, lawyers and engineers saw some of the highest increases (31%, 26% and 24%, respectively).
During the same time period, some orthopedic surgeons have developed sources of ancillary income including physical therapy, durable medical equipment, imaging and ASCs. It is likely that this ancillary income was not accounted for by the data source used in the study.
Nevertheless, orthopedics remains an incredibly impactful and rewarding field, but continuation of a disproportionate inflation-adjusted compensation decline could impact the supply of orthopedic surgeons as demand increases in the coming decades.
Perspective
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I love what I do, AND I want to be compensated fairly. However, this study by Pereira and colleagues suggests this may not be the case.
Over the past 2 decades, orthopedic surgeon compensation has remained almost stagnant, with inflation-adjusted income declining significantly compared with other professions. Despite the high level of skill and training required, orthopedic surgeons have experienced the steepest decline in compensation among health care professionals. This trend raises critical concerns about the sustainability of the profession, including physician burnout, recruitment challenges and potential impacts on patient access to care. Given the established link between compensation, job satisfaction and burnout, ongoing financial pressures may deter future medical students from entering the field.
To preserve the quality and availability of orthopedic care, policymakers and health care institutions must reassess compensation models and ensure the long-term viability of the profession.
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