Study: Rural doctors earn more

Dr. Porcia Love laughs when asked if she stays busy at Montgomery Dermatology.

"I have a lot of patients, which is a great thing," Love said.

She spoke while working on her day off so she could squeeze in a few more people, but the Montgomery native always expected to be this busy. It's one of the reasons she decided to practice here.

"My husband and I were looking at Atlanta and Montgomery," she said. "The fact is, Montgomery had a shortage of dermatologists, whereas a lot of the metropolitan areas are saturated."

That situation has contributed to a somewhat surprising trend: rural physicians tend to make more money on average than those in major cities, according to a congressional report from the Medicare Payment Advisory Commission. A separate, annual study of doctor salaries by WebMD subsidiary Medscape shows that the Southeast, specifically, has one of the highest average doctor salaries in the nation.

A 2003 act increased Medicare rates for rural physicians, and rural hospitals often have to pay more to bring in those same doctors.

But that may not tell the whole story.

Baptist Health Vice President Julia Henig, who helps recruit physicians to Montgomery, pointed to the crowded schedules and long hours faced by some of the central Alabama's most in-demand specialists.

"Our physicians work harder," Henig said. "If you were to look at a per-patient basis, the compensation is actually not as high."

While crowded practices may add up to more money than in major cities, Henig doesn't rely on that as a recruitment tool. Instead, she focuses on cost of living and quality of life, factors that aren't considered in the salary numbers.

"When you drive physicians around the community and show them nice neighborhoods, they're shocked by the (low) price of homes," she said. "We have a lot of amenities."

Doctors often are concerned about how much time they'll have to enjoy that home. The Medscape study found that physician satisfaction wasn't as closely connected to salary as lifestyle.

For instance, most anesthesiologists said they wouldn't choose that specialty if they could do it over again, despite making one of the top annual salaries of any physician. More of them worked over 40 hours per week than any other group.

Dermatologists don't make quite as much on average, but they have one of the lightest workloads of any specialty in the study and don't often deal with emergencies. They also have the highest career satisfaction rate by a wide margin.

Love said she rarely gets called to the hospital, but her satisfaction comes more from the hands-on, visual nature of her job and the often instant diagnosis process.

She said it was easy to sell her on practicing in her hometown, especially when Montgomery was in need of more specialists in her field. She started last August, and the community has quickly embraced her.

"It's been wonderful to come back home and see patients that baby-sat me and taught me," Love said. "The dermatologists in the community have been very supportive, as well as the referring doctors, so have the family medicine internists, gynecologists and pediatricians. Everyone's been wonderful."