Nasseh K, Vujucic M. JAMA Network Open. 2018;doi:10.1001/jamanetworkopen.2018.0431.
Number of self-employed health care professionals drops 10% since 2001
The percentage of health care professionals who were self-employed declined and the gap in earnings between employed and self-employed health care professionals reversed or narrowed since 2001, according to findings recently published in JAMA Network Open.
“Over the last 15 years, the health care practitioner landscape has changed significantly. There has been a shift away from self-employment, Kamyar Nasseh, PhD, and Marko Vujicic, PhD, both of the Health Policy Institute, American Dental Association, wrote. “Little is known about the gap in earnings between self-employed health care professionals and those employed by for-profit or nonprofit organizations.”
The researchers looked at American Community Survey data from 175,714 self-identified physicians (n = 99,077), pharmacists (n = 26,143), optometrists (n = 4,238), podiatrists (n =1,164), chiropractors (n = 6,076), physical therapists (n = 19,008) and dentists (n = 20,008) aged older than 30 years, who worked at least 20 hours per week and at least 40 weeks per year from 2001 to 2015.
Nasseh and Vujicic found that after controlling for age, race, residence, sex, and year, and after comparing the years 2001 to 2005, to 2011 to 2015, the weighted percentage of self-employed physicians dropped from 35.2% (95% CI, 34.4-36.1) to 24.7% (95% CI, 24.2-25.2). Also among physicians and when comparing those who were self-employed to those employed by for-profit or nonprofit organizations, the regression-adjusted earnings gap reversed from $19,679 (95% CI, 14,431-24,927) during 2001 through 2005 to –$10,623 (95% CI, –14,547 to –6,699) during 2011 through 2015.
Researchers also found from 2001 to 2015 the earnings gap also reversed among optometrists, podiatrists and pharmacists when comparing the self-employed vs. those employed by the organizations and that the regression-adjusted earnings gap narrowed among physical therapists and chiropractors when comparing the self-employed vs. those employed by the organizations.
“Information on physician specialty is not included in the [American Community Survey]. There may be wide variability among specialties in physician income. If changes over time in employment modality vary by specialty, comparisons could be biased. Because the [American Community Survey] top-codes income, trends in earnings among high earners could be masked,” Nasseh and Vujicic wrote.
“Future research is warranted to determine the driving forces behind the shift away from self-employment and the shrinking earnings gap between employed and self-employed health care professionals,” the pair concluded. – by Janel Miller
Disclosures: Neither Nasseh nor Vujicic report any relevant financial disclosures.