A survey indicates that at least half of the physicians in the United States don’t feel they are paid enough. Before you break out the violin: Some experts say they might have good reason to complain.

Would you be happy if you made $200,000 a year?

Apparently, about half of the doctors in the United States who make that kind of money feel they aren’t being paid enough. And some medical experts say there are some legitimate reasons for their dissatisfaction.

Doctors say they deserve high compensation because they have at least five years of post-college training, they often leave medical school with hundreds of thousands of dollars of debt, and they provide a vital service to the community.

“It’s important to understand the investment physicians make to get into their field,” said Maureen Jamieson, a senior search consultant with Cejka Search, a medical staffing firm.

“If you don’t feel valued,” said Dr. Robert Wergin, a Nebraska doctor who is president of the American Academy of Family Physicians, “then no matter what you’re paid, it seems unfair.”

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The Physician Compensation Report was conducted earlier this year and it was posted on the Medscape website.

In all, 19,500 physicians from 25 specialties responded.

The unscientific survey indicated that primary care doctors earn $195,000 on average a year while specialists get $284,000.

The highest earners were orthopedists at $421,000 a year, followed by cardiologists at $376,000 and gastroenterologists at $370,000.

The top salaries were found in North Dakota and Alaska, both with annual average incomes of $330,000. The lowest were in the District of Columbia ($186,000) and Rhode Island ($217,000).

Of the doctors who responded, more than 60 percent said they were employed by an institution of some sort while about a third said they were in private practice.

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Medical experts said they felt the Medscape survey was probably an accurate portrayal of doctors’ feelings across the country.

They added that there seem to be a number of reasons for their discontentment.

One is the number of years physicians spend in college, medical school, and then in training. Many doctors don’t get their first jobs until they are 30. By that time, other college graduates have been earning salaries for eight years or so.

Most medical graduates also step into the workforce with $200,000 to $300,000 in educational debt.

“Their compensation reflects their time and commitment to their field,” said Jamieson.

Wergin pointed to his son, who is just getting his first job in the medical field at the age of 30. His debt tops $200,000.

“It’s a lot of sacrifice and a lot of hours,” Wergin said.

Another reason is the service doctors provide to society.

“They’re dealing with people’s health and people’s lives,” said Wergin. “Especially in small towns, not many people can take their place.”

That’s especially true of specialists, who reflected higher dissatisfaction in the survey.

People should probably want their physicians to be paid a lot, Jamieson said.

“How comfortable would we be with a doctor who is making 15 dollars an hour?” she said.

Changes in the medical field may be fueling some of the discontent, too. Specialists who used to work on their own and garner 100 percent of their fees may now work for a medical group or hospital and only get a portion of that.

Many doctors are also being asked to perform more administrative tasks and perhaps see more patients.

“Like a lot of people, they are being asked to do more with less,” said Jamieson.

Both Wergin and Jamieson said compensation might start to climb in the near future. One reason is the emerging emphasis on quality care over quantity of care.

Jamieson said some medical institutions are starting to add bonuses and other enhancements for doctors who do good work.

Just over half of the primary care physicians and exactly half of the specialists who answered the survey said they weren’t compensated fairly.

Pediatricians earn less on average than any other type of physician, at $189,000 a year. Family doctors, endocrinologists, and internists earned just a little more.

Since last year’s survey, infectious disease physicians got a 22 percent pay hike, and pulmonologists’ pay rose by 15 percent.

Only rheumatologists and urologists saw their salaries go down, with 4-percent and 2-percent dips, respectively.

Of all specialists, dermatologists were happiest. Sixty-one percent of them said they were compensated fairly. Next up were doctors in emergency medicine and pathologists, where 60 percent said they were satisfied with their rate of pay.

The least satisfied were ophthalmologists. Only 4 in 10 said they were happy with their salaries. They were followed by immunologists and general surgeons, at 41 percent.

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