What determines earnings of self-employed physicians in Austria? Evidence from quantile regressions using linked tax records

BACKGROUND: Shortage of healthcare workers is a growing challenge and financial remuneration may influence recruitment efforts. In Austria, self-employed physicians can either work as contracted or non-contracted physicians. While non-contracted practices are expanding, sickness funds face increasing difficulties in recruiting contracted physicians. OBJECTIVE: To analyze physician income, its key determinants and whether financial incentives could help SHI funds address recruitment challenges. METHODS: We used data from the Federal Ministry of Finance and the Federation of Social Security Institutions to derive descriptive statistics for self-employed physicians. In-depth data on contracted physicians enabled us to explore determinants of their income using quantile regressions. RESULTS: In 2022, contracted GPs had median annual earnings of EUR 191,649 before taxes, while contracted specialists earned EUR 210,988. Among GPs, an additional consultation was associated with an increase in earnings of EUR 11.70. Being a male GP corresponded with higher earnings of EUR 6763 compared to female GPs. For specialists, each additional consultation increased earnings by EUR 27.94, and being female was associated with decreased earnings of EUR 13,413. Due to missing data on key variables, regression analysis was not possible for non-contracted physicians, but their median income was EUR 100,849. CONCLUSION: Given higher earnings of contracted physicians compared to their non-contracted peers, it seems unlikely that increased financial incentives would help SHI funds in recruiting contracted physicians.