The remuneration level and structure for the different categories of doctors affects the (relative) financial attractiveness of these specialities. In many countries, governments can determine or influence the level and structure of physician remuneration by regulating their fees or by setting salaries when doctors are employed in the public sector. As for any other category of workers, differences in remuneration levels of doctors across countries can be a push or pull factor when it comes to physician migration (OECD, 2019[1]).
Across OECD countries, the remuneration of doctors (both general practitioners and specialists) is substantially higher than the average wages (Figure 8.8). In most countries, general practitioners earn two to four times more than the average wage in each country, while specialists earn two to six times more.
In most countries, specialists earned more than general practitioners (Figure 8.8). In Australia, Belgium, and Luxembourg self-employed specialists earned at least twice as much as self-employed general practitioners. In Germany the difference between specialists and general practitioners is much smaller, at only 20%. Among salaried physicians, specialists in Israel and the United Kingdom earned twice as much as general practitioners in 2017. In Poland, however, salaried specialists earned 40% less than salaried general practitioners.
The remuneration of physicians has generally increased since 2010, but at different rates across countries and between general practitioners and specialists (Figure 8.9). Both generalists and specialists in Hungary and Estonia have obtained substantial pay raises in recent years. To reduce shortages and emigration of doctors, the Hungarian government has substantially increased their remuneration since 2010, with the income of general practitioners increasing by about 80% between 2010 and 2017 and that of specialists nearly doubling. These pay raises have started to have a measurable impact on the intention of Hungarian doctors to leave the country: between 2017 and 2018, the number of doctors asking for foreign work certificates decreased by over 10%.
In several countries, the remuneration of specialists has risen faster than those of generalists since 2010, thereby increasing the remuneration gap. However, in Austria and Belgium, the gap has narrowed slightly, as the income of general practitioners grew a little more than that of specialists (Figure 8.9).
