For the first time in the 14 years that the American Medical Association (AMA) has been keeping track, doctors' incomes are falling as managed care organizations tighten their grip on the nation's health care system.The median earnings of all physicians, from front-line general practitioners to highly-paid specialists like brain surgeons, dropped 3.8% last year to $150,000, from $156,000 in 1993, according to preliminary results from the AMA's latest annual survey.The pressure on pay comes mostly from outside the profession: employers are demanding lower insurance premiums, and insurers are leaning on health care providers to cut costs.But another factor is at work from within: an explosion in America's doctor population over the last 30 years. The number of physicians has soared to 660,582 today, or 252 for each 100,000 Americans—not counting federal government doctors—compared with 266,045, or 139 for each 100,000 in 1965.
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