The Remuneration of General Practitioners and Specialists in 14 OECD Countries: What are the Factors Influencing Variations acro

When comparing the remuneration of general practitioners (GPs) and specialists in each country, this study finds that in nearly all countries, the remuneration of specialists is higher than that of GPs and has tended to increase more rapidly than that of GPs over the past decade (apart from the United Kingdom). In the Netherlands and Luxembourg, the remuneration of self-employed specialists is more than two-times greater than for self-employed GPs. The study finds that there are large variations across countries in the remuneration levels of GPs, and even greater variations for specialists. The remuneration of GPs and specialists converted in USD PPPs (purchasing power parity) is relatively low in Eastern European countries such as the Czech Republic and Hungary, at less than half of the remuneration levels in most other countries. Measured as a ratio to the average wage in each country, the remuneration of GPs varies from being two times greater in Finland and the Czech Republic, to three-and-a-half times greater in the United States and Iceland. The remuneration of specialists varies even more, ranging from one-and-a-half times to two times higher than the average wage of all workers for salaried specialists in Hungary and the Czech Republic, to five to seven times higher for self-employed specialists in the Netherlands, the United States and Austria. Some of the variations in remuneration levels across countries may be explained by the use of different remuneration methods (e.g., salaries or fee-for-services for self-employed doctors), by the role of GPs as gatekeepers, by differences in workload (as measured by working time) and by the number of doctors per capita. In general, the remuneration of doctors (mostly specialists) tends to be higher in those countries where they are self-employed and paid by fee-for-services, compared with those countries where they are paid by salaries.

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