One of the main considerations in physician pay under CMS’ relative value system is the training required to complete a task. This is generally thought to be well understood but is, in fact. a quagmire of controversy.
Take for example the specialty of family medicine compared with dermatology, anesthesiology, or ophthalmology. Family physicians make between 1/2 and 1/3 of what these other specialties make, so one would think that there is a huge training difference. The truth is that each of the four require 16 years before medical school, 4 years of medical school, and 3 years of residency. The 3 highly paid fields require 1 additional year in a transitional internship. So the family physician education represents 23/24 or 96% of the length of education required for the others. Since when is a 4% investment worth a 200% to 300% return?