I’m a family doctor and I didn’t become one for the money. I went into medicine because I thought it would be challenging and I knew I’d always have an opportunity to make an impact on something important to us all—human suffering. And I think that is true for a lot of doctors.

But that doesn’t change the fact that doctors in the US are paid a lot of money—too much, in my opinion. A recent study in the Journal of the American Medical Association sheds new light on the issue. In the study, researchers compared the US health care system to 10 other developed countries across a myriad of topics. One of those was workforce renumeration. And the results are striking.

The US (in yellow below) ranks #1 in almost every category when compared to other countries—and it isn’t even close. The salary discrepancies are not only limited to specialists, but apply to primary care docs too. (Note: I do believe the salary discrepancy between primary care docs and specialists should be narrower, as it is in most other countries in the list above, but that is a separate issue.)

Let’s look at some numbers. First, it is easy to see that the US physician renumeration is far above the mean, which is found in the right-most column. For generalist physicians it is $218,173 in the US compared to the mean of $133,723, which comes out to 1.63 times more. For specialists it is even worse. Specialists in the US make on average $316,000 compared to a mean of $182,657, which comes out to 1.73 times more.

There is no other country that even comes close. The #2 countries in these categories are 1.15 times the mean in the case of German generalist physician salaries and 1.11 times the mean in the case of Australian specialist physician salaries.

So why is this the case? There are probably many reasons, but none of them justify these high salaries. They only try to explain them. We don’t have better outcomes, nor lower medical error rates. And while our education is far more expensive, the best way to address that problem is not to pay doctors exorbitantly, but rather to address the root problems of cost in our higher education system.

Another response is to claim there is no “too much” when it comes to physician salaries. Physicians are doing good work, and anyway salaries are determined by what the market will bear. Which is true, but also precisely the problem.

The US invests far too much of our economy in healthcare (18%), to the detriment of other sectors, such as education. In contrast to the above chart, a similar chart looking at teacher salaries doesn’t paint the US in such a flattering light (click here to scroll through the full list of countries).

This list of 13 countries does not include all of the 11 developed countries that were compared in the JAMA article, but it includes many of them. And while it isn’t true (as Obama claimed in 2011) that other countries with high test scores pay teachers on par with physicians, relatively speaking they invest more in teachers than the US does.

Regardless how one might personally choose to invest in healthcare relative to education in an ideal society, it is hard to defend our inverted investments, as compared to other developed countries. Additionally, given how much we spend on healthcare in our country, it is hard to defend the inequitable outcomes in our healthcare system, which are also highlighted in the JAMA study. And finally, there is no getting around the high physician salaries in the US, which are so far outside the norm.

I am suggesting that things be different.

As a physician, and someone who stands to lose out in such an imagined world, I believe it is time to have an honest conversation about the medical-industrial complex and how it enables bloated physician salaries at the expense of other important investments, such as education and other social programs. We must honestly acknowledge the appetite for profit that our hospitals have and doctors develop throughout their careers. And we must right-size the ratio of salary to benefit that physicians currently enjoy in our society.