Expansion of managed care, intensified price competition,
and the introduction
of the Medicare Fee Schedule have all affected physician
compensation during
the past decade. We examine trends in the salaries of medical
school faculty,
particularly MD clinical faculty, based on a more extensive
salary database
than has been used previously. Data collected through the
Association of American
Medical Colleges' Faculty Salary Survey for the academic years
1988-1989,
1993-1994, and 1998-1999 were analyzed, and inflation-adjusted
salary growth
rates for clinical and basic science faculty during two 5-year
periods, 1988-1993
and 1993-1998, compared across faculty ranks, departments, and
various school
characteristics.
The comparison showed that, between 1988 and 1998, the
actual median
clinical faculty salary increased from $101,000 to $150,000, and
the actual
median basic science faculty salary increased from $52,000 to
$78,000. Bivariate
and multivariate analyses showed that the proportionate change
in real mean
salary (base year, 1988) in each 5-year period was related to
department and
faculty rank for clinical faculty (P<.001) and
faculty rank for basic science faculty (P<.001).
The inflation-adjusted annualized compound growth rate of
clinical faculty
salaries declined from 1.9% per year (1988-1993) to 0.2% per
year (1993-1998),
while the growth rate of basic science faculty salaries
increased from 0.3%
per year (1988-1993) to 1.3% per year (1993-1998). From 1993 to
1998, inflation-adjusted
annualized salary growth rates in several clinical departments
were negative
(anesthesiology, –1.1%; obstetrics and gynecology,
–0.5%; radiology,
–0.4%; and neurology, –0.1%) but were positive for
family practice
(+2.7%). Significant differences in salary growth related to
school characteristics
(eg, geographic region, public vs private, community based vs
non–community
based, and research intensity) were specific to particular study
periods.
Overall, while actual average medical school faculty salaries
are increasing,
the real growth rate of average clinical faculty salaries is
declining and
that of basic science faculty increasing.