Occupation Profile for Internists

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Diagnose and provide non-surgical treatment of diseases and injuries of internal organ systems. Provide care mainly for adults who have a wide range of problems associated with the internal organs.

Signficant Points

  • Many physicians and surgeons work long, irregular hours; more than one-third of full-time physicians worked 60 hours or more a week in 2006.
  • Acceptance to medical school is highly competitive.
  • Formal education and training requirements are among the most demanding of any occupation, but earnings are among the highest.
  • Job opportunities should be very good, particularly in rural and low-income areas.
 

Earnings

Earnings of physicians and surgeons are among the highest of any occupation. The Medical Group Management Association’s Physician Compensation and Production Survey, reports that median total compensation for physicians in 2005 varied by specialty, as shown in table 2. Total compensation for physicians reflects the amount reported as direct compensation for tax purposes, plus all voluntary salary reductions. Salary, bonus and incentive payments, research stipends, honoraria, and distribution of profits were included in total compensation.

Table 2. Median compensation for physicians, 2005.
Specialty Less than two years in specialty Over one year in specialty

Anesthesiology

 $259,948 $321,686

Surgery: General

 228,839 282,504

Obstetrics/gynecology: General

 203,270 247,348

Psychiatry: General

 173,922 180,000

Internal medicine: General

 141,912 166,420

Pediatrics: General

 132,953 161,331

Family practice (without obstetrics)

 137,119 156,010

Footnotes:
 (NOTE) Source: Medical Group Management Association, Physician Compensation and Production Report, 2005.

Self-employed physicians—those who own or are part owners of their medical practice—generally have higher median incomes than salaried physicians. Earnings vary according to number of years in practice, geographic region, hours worked, skill, personality, and professional reputation. Self-employed physicians and surgeons must provide for their own health insurance and retirement.

Job Outlook

Employment of physicians and surgeons is expected to grow faster than the average for all occupations. Job opportunities should be very good, especially for physicians and surgeons willing to practice in specialties—including family practice, internal medicine, and OB/GYN—or in rural and low-income areas where there is a perceived shortage of medical practitioners.

Employment change. Employment of physicians and surgeons is projected to grow 14 percent from 2006 to 2016, faster than the average for all occupations. Job growth will occur because of continued expansion of health care related industries. The growing and aging population will drive overall growth in the demand for physician services, as consumers continue to demand high levels of care using the latest technologies, diagnostic tests, and therapies.

Demand for physicians’ services is highly sensitive to changes in consumer preferences, health care reimbursement policies, and legislation. For example, if changes to health coverage result in consumers facing higher out-of-pocket costs, they may demand fewer physician services. Patients relying more on other health care providers—such as physician assistants, nurse practitioners, optometrists, and nurse anesthetists—also may temper demand for physician services. In addition, new technologies will increase physician productivity. These technologies include electronic medical records, test and prescription orders, billing, and scheduling.

Job prospects. Opportunities for individuals interested in becoming physicians and surgeons are expected to be very good. In addition to job openings from employment growth, numerous openings will result from the need to replace physicians and surgeons who retire over the 2006-16 decade.

Unlike their predecessors, newly trained physicians face radically different choices of where and how to practice. New physicians are much less likely to enter solo practice and more likely to take salaried jobs in group medical practices, clinics, and health networks.

Reports of shortages in some specialties, such as general or family practice, internal medicine, and OB/GYN, or in rural or low-income areas should attract new entrants, encouraging schools to expand programs and hospitals to increase available residency slots. However, because physician training is so lengthy, employment change happens gradually. In the short term, to meet increased demand, experienced physicians may work longer hours, delay retirement, or take measures to increase productivity, such as using more support staff to provide services. Opportunities should be particularly good in rural and low-income areas, as some physicians find these areas unattractive because of less control over work hours, isolation from medical colleagues, or other reasons.

Employment

Physicians and surgeons held about 633,000 jobs in 2006; approximately 15 percent were self-employed. About half of wageand-salary physicians and surgeons worked in offices of physicians, and 18 percent were employed by hospitals. Others practiced in Federal, State, and local governments, including colleges, universities, and professional schools; private colleges, universities, and professional schools; and outpatient care centers.

According to 2005 data from the American Medical Association (AMA), about one half of physicians in patient care were in primary care, but not in a subspecialty of primary care. (See table 1.)

Table 1. Percent distribution of active physicians in patient care by specialty, 2005
Percent

Total

 100.0

Primary care

 40.4

Family medicine and general practice

 12.3

Internal medicine

 15.0

Obstetrics & gynecology

 5.5

Pediatrics

 7.5

Specialties

 59.6

Anesthesiology

 5.2

Psychiatry

 5.1

Surgical specialties, selected

 10.8

All other specialties

 38.5

Footnotes:
 (NOTE) Source: American Medical Association, Physician Characteristics and Distribution in the US, 2007.

A growing number of physicians are partners or wage-and-salary employees of group practices. Organized as clinics or as associations of physicians, medical groups can more easily afford expensive medical equipment, can share support staff, and benefit from other business advantages.

According to the AMA, the New England and Middle Atlantic States have the highest ratio of physicians to population; the South Central and Mountain States have the lowest. D.O.s are more likely than M.D.s to practice in small cities and towns and in rural areas. M.D.s tend to locate in urban areas, close to hospitals and education centers.