Abstract
BackgroundSalary is perceived as a key factor affecting job satisfaction, employment, and the retention or migration of physicians within and across countries. This study aimed to describe physicians’ salary and workload and to examine the factors determining the salary of physicians in China.MethodsWe conducted a self-administered, smartphone-based national survey in 136 tertiary hospitals across 31 provinces. A total of 17,615 physicians self-reported their salaries after tax and their characteristics, practice settings, and work efforts in 2015. Then, 2498 of the physicians were followed up for the second-round survey in 2016. Univariate analysis and general estimate equations were applied to evaluate the factors associated with salary.ResultIn 2015, the average annual salary of the physicians was US$13,764. Physicians in eastern China earned more than those in central (p < 0.001) and western China (p = 0.002) after adjustment for locality expenditure per capita. The salary for men in 2015 was US$14,832, which was more than that for women (US$12,912; p < 0.001). Of the respondents, 76.3% worked more than 40 h per week. The physicians dealt with 40 patients per day on average. Consequently, 67.2% physicians spent no more than 10 min with each outpatient. After adjustments for age and management position, salary was associated with years in practice, education background, and specialty, but not with weekly work hours and gender.ConclusionsThe physicians’ salaries were relatively low, and the majority of the respondents worked more than 40 h per week. Years in practice, education background, specialty, and region were associated with salary, while weekly work hours and gender were not. To better remunerate Chinese physicians, more resources are demanded, and a workload-based salary scheme should be adopted.
Highlights
Salary is perceived as a key factor affecting job satisfaction, employment, and the retention or migration of physicians within and across countries
The physicians’ salaries were relatively low, and the majority of the respondents worked more than 40 h per week
Education background, specialty, and region were associated with salary, while weekly work hours and gender were not
Summary
Salary is perceived as a key factor affecting job satisfaction, employment, and the retention or migration of physicians within and across countries. This study aimed to describe physicians’ salary and workload and to examine the factors determining the salary of physicians in China. In China, hospitals consist of 3 types: general hospitals, traditional Chinese medicine (TCM) hospitals, and specialty hospitals, and approximately 10% of hospitals are TCM hospitals. The majority of hospitals are public and run by the government. The routine subsidy from the government is mainly used to pay health care workers’ basic salaries in public. The salaries of physicians in Chinese public hospitals consist of 3 parts: basic salary, benefits, and bonuses [2]. The basic salary subsidized by the government follows a unified standard and is determined by the physician’s educational background, technical title, and years of practice. Supplemental welfare usually consists of transportation subsidies, management allowance, and malpractice insurance, among other items.
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