How much do consultants earn?
Neurosurgeons rank top on the consultant income scale. ATO data shows the breakdown of average salaries for other specialties showing surgeons and proceduralists often out earn their internal medicine colleagues.
It's usually assumed that neurosurgeons rank top on the consultant income scale. However, data on how other specialties compare in terms of salary is hard to find. Conveniently, the ATO published income data in 2021 showing average incomes by their specialisation.
From neurosurgery to thoracic medicine, these specialties earn the most and can be categorised as surgeons and proceduralists. In contrast, the remaining specialties, with the exception of pediatric surgery, are primarily specialist physicians or generalists focused on clinical medicine. But the breakdown of public verse private practice and how it influences consultants earnings is not clear.
The study 'Preferences of physicians for public and private sector work' concluded that physicians prefer the public sector despite reduced benefits for additional work. This means that additional work in the public sector is not always commensurate with the effort required compared to private practice. Their findings did not indicate a bias towards more risk-averse individuals in the public sector, but they did confirm that public hospital consultants tend to earn less than their private practice colleagues.
However, another study in 2013, An empirical analysis of public and private medical practice in Australia, found mixed practice earned the most, averaging $362,220, while only public work earned the least, at $227,130.
In mixed practice, consultants derived the majority of their income from Medicare (47%) and hospital work (39%), with the remainder coming from other sources. However, those in mixed practice worked the most hours, while those in private practice worked the least.
Additionally, the data cannot account for non-monetary benefits that consultants working in public hospitals may receive, such as professional development allowances and other leave entitlements, that their private practice counterparts would need to pay for out of pocket. Public consultants also have lower expenses, such as insurance and business operating costs, which those in private practice may have to cover themselves.
Not all specialties are paid equally, and the private/public dichotomy of the Australian healthcare system creates opportunities for consultants working in mixed practice to out-earn their colleagues who work exclusively in either the public or private sectors. Although the ATO data from 2021 provides a league table of consultants' salaries, it does not indicate the type or mix of practice that influences the range of possible earnings.